Legislature(1993 - 1994)
03/08/1993 03:00 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
March 8, 1993
3:00 p.m.
MEMBERS PRESENT
Rep. Cynthia Toohey, Co-Chair
Rep. Con Bunde, Co-Chair
Rep. Gary Davis, Vice Chair
Rep. Al Vezey
Rep. Pete Kott
Rep. Harley Olberg
Rep. Bettye Davis
Rep. Irene Nicholia
Rep. Tom Brice
MEMBERS ABSENT
None
OTHER LEGISLATORS PRESENT
Rep. Jerry Mackie
COMMITTEE CALENDAR
*HCR 7: Relating to Alcohol-Related Birth Defects
Awareness Week.
PASSED WITH INDIVIDUAL RECOMMENDATIONS
*HB 3: "An Act relating to public home care providers;
and providing for an effective date."
PASSED WITH INDIVIDUAL RECOMMENDATIONS
*HB 4: "An Act adding as an aggravating factor at
sentencing that a victim was elderly or disabled;
and relating to failure to report harm or assaults
of the elderly or disabled."
PASSED WITH INDIVIDUAL RECOMMENDATIONS
(* First public hearing.)
WITNESS REGISTER
REP. IRENE NICHOLIA
Alaska State Legislature
State Courthouse, Room 606
Phone: (907) 465-4527
Juneau, Alaska 9801-1182
Position Statement: Prime Sponsor of HCR 7
ERMALEE HICKEL, First Lady
716 Calhoun St.
Juneau, Alaska 99801
Phone: (907) 465-3500
Position Statement: Testified in favor of HCR 7
SUZANNE PERRY
Regional Program Coordinator
Division of Alcoholism and Drug Abuse
Department of Health and Social Services
P.O. Box 110607
Juneau, Alaska 99811-0607
Phone: (907) 225-2071
Position Statement: Presented slide show on FAS/FAE
REP. JERRY MACKIE
Alaska State Legislature
State Courthouse, Room 602
Juneau, Alaska 99801
Phone: (907) 465-4925
Position Statement: Sponsor of HB 3 and HB 4
ELMER LINDSTROM
Special Assistant to the Commissioner
Department of Health and Social Services
P.O. Box 110601
Juneau, Alaska 99811-0601
Phone: (907) 465-3030
PREVIOUS ACTION
BILL: HCR 7
SHORT TITLE: ALCOHOL-RELATED BIRTH DEFECTS AWARENESS
BILL VERSION:
SPONSOR(S): REPRESENTATIVE(S) NICHOLIA,Brice,Nordlund,
Finkelstein,Parnell,James,Navarre,Menard,Ulmer,Brown,
B.Davis,Sitton; SENATOR(S)Lincoln,Jacko
TITLE: Relating to Alcohol-Related Birth Defects Awareness
Week.
JRN-DATE JRN-PG ACTION
02/19/93 389 (H) READ THE FIRST TIME/REFERRAL(S)
02/19/93 390 (H) HEALTH, EDUCATION & SOCIAL
SERVICES
02/22/93 421 (H) COSPONSOR(S): B.DAVIS, SITTON
03/04/93 (H) HES AT 03:00 PM CAPITOL 106
03/08/93 (H) HES AT 03:00 PM CAPITOL 106
BILL: HB 3
SHORT TITLE: REGULATION OF HOME CARE PROVIDERS
BILL VERSION:
SPONSOR(S): REPRESENTATIVE(S) MACKIE,Ulmer
TITLE: "An Act relating to public home care providers; and
providing for an effective date."
JRN-DATE JRN-PG ACTION
01/04/93 25 (H) PREFILE RELEASED
01/11/93 25 (H) READ THE FIRST TIME/REFERRAL(S)
01/11/93 25 (H) HES, JUDICIARY, FINANCE
03/04/93 (H) HES AT 03:00 PM CAPITOL 106
03/08/93 (H) HES AT 03:00 PM CAPITOL 106
BILL: HB 4
SHORT TITLE: PROTECT ELDERLY AND DISABLED ADULTS
BILL VERSION:
SPONSOR(S): REPRESENTATIVE(S) MACKIE
TITLE: "An Act adding as an aggravating factor at sentencing
that a victim was elderly or disabled; and relating to
failure to report harm or assaults of the elderly or
disabled."
JRN-DATE JRN-PG ACTION
01/04/93 25 (H) PREFILE RELEASED
01/11/93 25 (H) READ THE FIRST TIME/REFERRAL(S)
01/11/93 25 (H) HES, JUDICIARY, FINANCE
03/04/93 (H) HES AT 03:00 PM CAPITOL 106
03/08/93 (H) HES AT 03:00 PM CAPITOL 106
ACTION NARRATIVE
TAPE 93-30, SIDE A
Number 000
CHAIR TOOHEY called the meeting to order at 3:07 p.m., noted
members present, and announced the calendar.
HCR 7 - ALCOHOL-RELATED BIRTH DEFECTS AWARENESS
Number 030
REP. IRENE NICHOLIA testified as PRIME SPONSOR of the
resolution. She read a sponsor statement, which is on file
in the committee room. In summary, she said HCR 7 was an
attempt to inform the public about the problem of babies
born with Fetal Alcohol Syndrome (FAS) or Fetal Alcohol
Effect (FAE), and the rates in which Alaska leads the
nation. Such defects cost society as a whole in health care
expenses. The individuals involved are hurt because their
development is retarded. She said the problem is
preventable. Information is the first step toward
prevention, and resolutions such as hers are a first step
toward greater public information.
Number 071
ERMALEE HICKEL, ALASKA'S FIRST LADY, testified in Juneau in
support of HCR 7. She said alcohol-related birth defects,
which are preventable, are a leading cause of birth defects
and developmental disabilities; cost the state in health
care costs; are not limited to any one social group; and
represent a growing problem in the state. She said men
share the responsibility for helping pregnant women avoid
alcohol. She cited the success of the Dena A Coy program, a
Southcentral Foundation group home in Anchorage where
expectant mothers with alcohol problems can live alcohol
free in an effort to avoid alcohol-related birth defects.
She presented the governor's proclamation declaring May 9
through 15, 1993, as Alcohol-Related Birth Defects Awareness
Week. She encouraged passage of HCR 7 as part of a
statewide education program.
Number 175
REP. BUNDE thanked Mrs. Hickel, and expressed special
concern over FAS/FAE in light of the state's high teen
pregnancy rate. He asked whether women in the Dena A Coy
program have drinking problems, and whether they can enter
the program as soon as they discover they are pregnant.
MRS. HICKEL answered yes, given space restrictions.
Number 214
REP. VEZEY moved passage of HCR 7 with individual
recommendations.
REP. G. DAVIS said he appreciated Rep. Nicholia's
sponsorship and Mrs. Hickel's support. He asked whether the
resolution should not include notice that FAS/FAE was a
preventable birth defect.
Number 234
REP. BRICE pointed out that the fourth "whereas" clause in
the resolution did address that point.
Number 246
CHAIR TOOHEY invited public testimony.
SUZANNE PERRY, REGIONAL PROGRAM COORDINATOR FOR THE DIVISION
OF ALCOHOLISM AND DRUG ABUSE IN THE DEPARTMENT OF HEALTH AND
SOCIAL SERVICES, presented a slide show on FAS/FAE,
outlining the symptoms of FAS/FAE and showing the physical
characteristics and stunted development of children born
with alcohol-related birth defects in Alaska.
Number 400
CHAIR TOOHEY asked whether a female child born with FAS will
later pass along the syndrome's physical deformities to her
children.
MS. PERRY answered no. She added that the best way to
prevent FAS/FAE is for women to abstain from any alcohol
during pregnancy.
Number 419
CHAIR TOOHEY noted that a drug counselor had told her that
about 68 percent of children born in either Bethel or
Barrow, she did not remember which, were born with FAS or
FAE.
MS. PERRY agreed that the problem is an epidemic.
Number 424
REP. BUNDE asked whether infants can get FAS through the
alcohol that might be present in mother's milk.
MS. PERRY answered no, but a child's development may be
impaired by ingesting alcohol while young.
REP. BUNDE referred to a case in which an ultimately
unsuccessful attempt was made to convict a Bethel woman with
child abuse for drinking alcohol while nursing and passing
along alcohol to her child while nursing.
Number 437
CHAIR TOOHEY asked for any objections to passing HCR 7 from
the committee. Hearing none, he declared HCR 7 passed with
individual recommendations. She then brought HB 3 to the
table.
HB 3 - REGULATION OF HOME CARE PROVIDERS
Number 445
REP. JERRY MACKIE testified as PRIME SPONSOR of HB 3. He
noted that similar bills passed through the Senate in 1992,
but died in the session's final days. He read a sponsor
statement, which is on file in the committee room. In
summary, the statement said that HB 3 would protect elderly
people by restricting public home care providers (HCPs) from
assuming sole power of attorney for their clients, and by
requiring background checks on home care providers paid
under certain state programs. He referred to a case in
which a health care provider took control of a client's
finances through a power of attorney and spent $500,000 of
the client's money. He said he was not attacking the HCPs,
but was trying to afford their clients' protection. He
noted that 30 percent of state required background checks
reveal criminal histories.
Number 496
REP. BUNDE asked whether a criminal record automatically
barred a person from working as an HCP.
REP. MACKIE stated that this might be a question that would
be addressed in regulations under the bill, not by the
statutory language. He said the bill proposed in the
previous legislative session required background checks to
be completed within 10 days of hiring and upon request, and
that certain actions had to take place within five days of
receipt of such reports. He said such provisions were in
effect in HB 3.
Number 522
REP. BUNDE asked again whether a criminal record
automatically barred a person from working as an HCP.
REP. MACKIE said it would depend on individual
circumstances, and the issue would be addressed in
regulations.
Number 522
REP. VEZEY observed that HB 3 would do little to deter a
determined fraud.
REP. MACKIE said all legislation can do is provide penalties
for crimes, but cannot order 100 percent compliance with
law. He said the bill is a substantial improvement over
current law. He stated that courts, which usually give
powers of attorney, would have to determine an acceptable
second person, most likely not a partner of the HCP, but a
relative of the elderly person.
REP. VEZEY asked the need for two powers of attorney if an
elderly person had a relative to whom such power could be
given.
Number 546
REP. MACKIE said that would be a decision of the court. The
bill would prevent the HCP from being sole power of
attorney, he said.
REP. VEZEY asked whether HB 3 deprived elderly people of the
right to bestow power of attorney of their own, and if it
was directing the court to appoint people who would have
power of attorney.
Number 552
CHAIR TOOHEY said lonely old people frequently become
dependent on HCPs as surrogate families. She related a case
in which one client granted power of attorney to the HCP,
who then proceeded to wipe out the client's money. Chair
Toohey said under the bill, the courts could bar an HCP from
assuming the sole power of attorney for a client.
REP. VEZEY asked what was to bar an elderly person from
signing over a second power of attorney to the HCP's partner
in crime.
CHAIR TOOHEY answered that nothing prevented that.
REP. VEZEY said the bill therefore provided no protection.
CHAIR TOOHEY said she disagreed.
Number 565
REP. BUNDE said that, in his experience working with
nonprofits, he had learned that it was best to share
responsibility for financial expenditures between two people
as a way to reduce the possibility of theft.
Number 572
REP. VEZEY said HB 3 provided very little protection against
a determined fraud.
REP. MACKIE asked for suggestions on how to address that
concern.
REP. VEZEY said he had none.
REP. MACKIE pointed out the limits of law to deter
determined criminals.
Number 580
REP. VEZEY suggested amending HB 3 to bar HCPs from holding
power of attorney for their clients.
REP. MACKIE said that in some cases it may be beneficial to
grant an HCP the authority to act on a client's behalf, with
oversight from a relative of the client's.
REP. VEZEY stated it was not necessary to have power of
attorney in such cases.
Number 590
REP. MACKIE said it was beneficial not to give power of
attorney to just one person. He referred to a situation in
which an HCP in Haines had sole power of attorney and abused
that power. He said some elderly people are being robbed of
benefits through physical intimidation, with no legal
protection.
CHAIR TOOHEY said nurse practitioners are state licensed and
may lose their licenses for unethical actions, while most
HCPs do not have licenses. She expressed support for HB 3
as a bill that would address the needs she has seen as a
nurse.
Number 604
REP. G. DAVIS asked Rep. Mackie whether the section of the
bill identified as Section 13.26.358 resulted from changes
to the bill in the 1992 legislative session.
TAPE 93-30, SIDE B
Number 000
REP. MACKIE said the bill was modified through much work by
the committees and had been thoroughly considered.
Number 015
REP. BUNDE cautioned against barring an HCP from being
granted power of attorney for a client. He said the bill
might reduce the temptation to commit fraud on elderly
people.
REP. MACKIE said it might be necessary to consider whether
elderly people who had become state wards or subject to
governance by an estate might not need to have a second
power of attorney appointed for them in addition to the
state or estate.
Number 066
REP. BRICE noted that HB 3 dealt with publicly funded HCPs
who were not necessarily invited into the client's home.
REP. MACKIE said section 2 of his bill bars the state from
paying for an HCP without subjecting that person to a
background check within 10 days of hire.
Number 100
CHAIR TOOHEY asked if Rep. Mackie was referring to Medicaid
funding for HCPs.
REP. MACKIE answered that he meant any public funds, not
just funds through the Medicaid program.
Number 106
REP. VEZEY said he had not interpreted HCPs as indicating
solely a public employees.
REP. MACKIE said the bill referred to HCPs paid with state
funds. He said the bill did not bar an elderly person from
hiring and giving power of attorney to any private
individual. He stated it was aimed at taking steps to
prevent the state from paying for HCPs that might try to
take advantage of their clients by obtaining powers of
attorney.
Number 123
CHAIR TOOHEY said that caring for elderly people with home
care providers was an alternative to institutionalizing the
elderly.
REP. BUNDE asked what might happen if the state funded an
HCP for a person with no living relatives, and therefore no
one to whom a second power of attorney could be granted.
Number 140
REP. MACKIE said it would be in the elderly person's best
interest to have another person other than the state, such
as a minister or public official, with power to sign off on
actions concerning that elderly person.
Number 143
REP. VEZEY said he believed that courts require bonds of
those to whom they grant powers of attorney, usually members
of the bar association.
REP. BUNDE noted that such people get paid for that service.
REP. VEZEY said they get paid fees from the elderly person's
benefits.
REP. MACKIE said it only related to HCPs.
REP. VEZEY said a court would never grant power of attorney
to a non-bonded person, to ensure accountability.
Number 156
REP. MACKIE said he wanted to make sure the courts did not
appoint just an HCP as a person with power of attorney and
not a second person.
REP. VEZEY said requiring bonds of HCPs would alleviate the
problem.
Number 164
CHAIR TOOHEY noted that HCP jobs pay only about $8 per hour,
and few, if any, are bonded.
REP. BUNDE said the second person would probably be an
attorney. He asked whether the attorney would be paid from
the elderly person's estate.
Number 180
REP. MACKIE said that question dealt with a different area
of state statutes than that addressed by HB 3. He repeated
that the bill just dealt with what HCPs could and could not
do; an HCP cannot have sole power of attorney for a client.
He said it might cause problems if the client had no
relatives, but he said that the abuses of powers of attorney
by HCPs far outweighed any inconvenience the court may have
in dealing with such possibilities.
REP. BUNDE said he was trying to visualize some of the
demands that might come up.
Number 198
REP. BRICE moved passage of HB 3 with individual
recommendations.
CHAIR TOOHEY, hearing no objections, declared HB 3 passed
with individual recommendations. She then brought HB 4 to
the table.
(Rep. Kott arrived at 4:08 p.m.)
HB 4 - PROTECT ELDERLY AND DISABLED ADULTS
Number 202
REP. JERRY MACKIE testified as PRIME SPONSOR of HB 4. He
read a sponsor statement, which is on file in the committee
room. In summation, he said the bill is a companion bill to
HB 3. It would place in state law deterrents to attacks on
elderly and disabled adults. It would establish as an
aggravating factor in sentencing the fact that such attacks
were made on those who more easily victimized by crime and
who were less able to defend themselves. He said the
state's senior citizen population is growing, with about 200
reported cases of elderly abuse made each year in the state.
He noted that 28 other states have similar laws.
Number 236
REP. MACKIE said that the House Judiciary Committee did a
lot of work on a similar bill in 1992, creating the
aggravating factor rather than establishing a new crime. He
also noted the penalties for failing to report abuse, which
were included in the bill.
(Rep. Olberg departed at 4:07 p.m.)
REP. BUNDE asked who was the intended target of the bill's
provisions for penalties for those who failed to report
abuse.
Number 272
REP. MACKIE said the bill could apply to anyone who failed
to report such abuse, including a doctor, social worker,
friend or neighbor. He said his intention was to provide a
deterrent for failure to report known abuse to the
authorities.
REP. BUNDE noted the significant fiscal note from the
Division of Occupational Licensing and the Department of
Corrections, and invited the sponsor's comment.
REP. MACKIE said the Department of Corrections' fiscal note
showed no additional expenditure in FY94, and a $48,800
fiscal note for FY95. He said the possibility of putting
more people in jail leads to the anticipation of increased
incarceration costs.
Number 301
REP. BUNDE said it appeared that the Department of
Corrections anticipated charging more people under the bill
than he did. He asked why the fiscal note from Occupational
Licensing assumed the need for a new investigator.
REP. MACKIE said it would be up to the Department of
Commerce to answer the question. He said he did not see why
the bill would require an additional investigator.
Number 324
REP. BUNDE questioned the need for an additional
investigator to deal with professionals who failed to report
elderly abuse.
REP. MACKIE said he had experienced problems with fiscal
notes in the past as well.
Number 330
REP. G. DAVIS said it appeared to him that the fiscal note
referred to HB 3 and the need to investigate abuse by
licensed home care providers.
Number 337
CHAIR TOOHEY agreed, but said she had a problem with the
fiscal note as well. She asked what would happen to money
in the Department of Commerce fiscal note if it was not
spent it for the purpose indicated.
REP. MACKIE said the fiscal note was an estimate of the cost
to fulfill the directives of the bill, not an appropriation.
Number 355
ELMER LINDSTROM, SPECIAL ASSISTANT TO THE COMMISSIONER
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, said that one of
the last actions at the end of the 1993 legislative session,
as at the end of previous sessions, would likely be that the
Finance Committee would tally all the fiscal impacts for
FY94 for all bills likely to pass at the end of that
session. Each of the amounts listed in each fiscal note
would likely then be incorporated into the appropriations
bill, he said. In subsequent years, those amounts would
likely be included in each department's appropriations, and
it would be difficult to differentiate as to what bills each
appropriation was funding.
REP. G. DAVIS moved passage of HB 4 with individual
recommendations.
CHAIR TOOHEY, hearing no objections, declared HB 4 passed
with individual recommendations. There being no further
business before the committee, she ADJOURNED the meeting at
4:16 p.m.
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