Legislature(1995 - 1996)

02/14/1995 03:06 PM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
          HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                          
                       STANDING COMMITTEE                                      
                       February 14, 1995                                       
                           3:06 p.m.                                           
                                                                               
 MEMBERS PRESENT                                                               
                                                                               
 Representative Cynthia Toohey, Co-Chair                                       
 Representative Con Bunde, Co-Chair                                            
 Representative Al Vezey                                                       
 Representative Norman Rokeberg                                                
 Representative Caren Robinson                                                 
 Representative Tom Brice                                                      
                                                                               
 MEMBERS ABSENT                                                                
                                                                               
 Representative Gary Davis                                                     
                                                                               
 COMMITTEE CALENDAR                                                            
                                                                               
 * HB 28:"An Act relating to the possession of weapons within the             
 grounds of or on the parking lot of preschools,                               
 elementary, junior high, and secondary schools or while                       
 participating in a school-sponsored event; requiring the                      
 expulsion or suspension of students possessing deadly                         
 weapons on school grounds; and relating to school lockers                     
 and other containers provided in a public or private                          
 school by the school or the school district."                                 
                                                                               
   SCHEDULED BUT NOT HEARD                                                     
                                                                               
 CONFIRMATION HEARINGS:                                                        
                                                                               
 Karen Perdue, Department of Health and Social Services                        
                                                                               
 Brian Carter, William McCain, Mary Lou Madden and Christine Niemi             
 for the Professional Teaching Practices Commission.                           
                                                                               
 * HJR 18: "Relating to medical savings account legislation."                  
                                                                               
   PASSED OUT OF COMMITTEE                                                     
                                                                               
 WITNESS REGISTER                                                              
                                                                               
 KAREN PERDUE, Commissioner Designee                                           
 Department of Health and Social Services                                      
 350 Main Street, Room 229                                                     
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-3030                                                    
                                                                               
 CHRISTINE NIEMI, Administrator                                                
 Teacher Education and Certification                                           
 Alaska Department of Education                                                
 801 W. 10th Street, Suite 200                                                 
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-2857                                                    
                                                                               
 BRIAN L. CARTER, Interim Principal/Teacher                                    
 Salcha Elementary School                                                      
 613 Pleasure Drive                                                            
 North Pole, AK  99705                                                         
 Telephone:  (907) 488-6684                                                    
 Interviewed via teleconference from Salcha.                                   
                                                                               
 WILLIAM A. McCAIN, Teacher                                                    
 Chugiak Elementary School                                                     
 P.O. Box 873042                                                               
 Wasilla, AK  99687                                                            
 Telephone:  (907) 376-0653                                                    
 Interviewed via teleconference from Chugiak.                                  
                                                                               
 MARY LOU MADDEN, Provost/Vice President                                       
 Sheldon Jackson College                                                       
 801 Lincoln Street                                                            
 Sitka, AK  99835                                                              
 Telephone:  (907) 747-5215                                                    
 Interviewed via teleconference from Sitka.                                    
                                                                               
 ROD MOURANT, Administrative Assistant                                         
 Representative Pete Kott's Office                                             
 Room 432, State Capitol                                                       
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-3777                                                    
 POSITION STATEMENT:  Provided sponsor statement for HJR 18.                   
                                                                               
 PREVIOUS ACTION                                                               
                                                                               
 BILL:  HB 28                                                                
 SHORT TITLE: POSSESSION OF GUNS ON SCHOOL PROPERTY                            
 BILL VERSION:                                                                 
 SPONSOR(S): REPRESENTATIVE(S)                                                 
 BUNDE,Rokeberg,Green,Toohey,Kott,Elton                                        
                                                                               
 JRN-DATE     JRN-PG                  ACTION                                   
 01/06/95        28    (H)   PREFILE RELEASED                                  
 01/16/95        28    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 01/16/95        28    (H)   HES, JUD, FIN                                     
 01/18/95        75    (H)   COSPONSOR(S): GREEN                               
 01/20/95       104    (H)   COSPONSOR(S): TOOHEY                              
 01/27/95       161    (H)   COSPONSOR(S): KOTT, ELTON                         
 02/14/95              (H)   HES AT 03:00 PM CAPITOL 106                       
                                                                               
 BILL:  HJR 18                                                               
 SHORT TITLE: SUPPORT MEDICAL SAVINGS ACCT LEGISLATION                         
 BILL VERSION:                                                                 
 SPONSOR(S): REPRESENTATIVE(S) KOTT                                            
                                                                               
 JRN-DATE     JRN-PG                  ACTION                                   
 01/20/95       100    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 01/20/95       100    (H)   HEALTH, EDUCATION & SOCIAL SERVICES               
 02/14/95              (H)   HES AT 03:00 PM CAPITOL 106                       
                                                                               
 ACTION NARRATIVE                                                              
                                                                               
 TAPE 95-7, SIDE A                                                             
 Number 000                                                                    
                                                                               
 CO-CHAIR CON BUNDE called the meeting to order at 3:06 p.m.                   
 Members present at the call to order were Representatives Bunde,              
 Toohey, Vezey and Robinson.  Co-Chair Bunde announced that a quorum           
 was present and read the calendar.                                            
 HHES - 02/14/95                                                               
 HB 28 - POSSESSION OF GUNS ON SCHOOL PROPERTY                               
                                                                               
 CO-CHAIR BUNDE stated that HB 28 would be held until February 21,             
 1995.                                                                         
 HHES - 02/14/95                                                               
 CONFIRMATION HEARING - COMMISSIONER DESIGNEE KAREN PERDUE                   
                                                                               
 Number 067                                                                    
                                                                               
 KAREN PERDUE, Commissioner Designee for the Department of Health              
 and Social Services (DHSS), offered to answer any questions the               
 HESS Committee members may have about her background.  She said she           
 was originally from Fairbanks and announced that the dean of                  
 students from her high school, and other members of her community,            
 were present.  Both Ms. Perdue and her husband have family members            
 in the Fairbanks area.                                                        
                                                                               
 Number 160                                                                    
                                                                               
 MS. PERDUE said that she previously worked for the United States              
 Congress under Senator Ted Stevens and learned how the governmental           
 process works.  She feels this was valuable experience, considering           
 the federal changes which are pending in the area of Health and               
 Social Services.  Ms. Perdue also worked in the Alaska state                  
 government working for former Lt. Governor Terry Miller.  She                 
 learned a lot about public service from that job.                             
                                                                               
 Number 192                                                                    
                                                                               
 MS. PERDUE stated that she has served under three governors in                
 program management and administration.  A number of years ago she             
 left Juneau for Fairbanks and has been working as a consultant to             
 human services agencies.  She has learned a lot about human service           
 delivery and making services more efficient.  She comes back to               
 Juneau with enthusiasm for new approaches.                                    
                                                                               
 Number 240                                                                    
                                                                               
 CO-CHAIR BUNDE said that one of the issues that comes repeatedly              
 before the legislature is that of welfare reform.  He asked Ms.               
 Perdue if she had any ideas to share about that topic and how to              
 make the system more efficient.                                               
                                                                               
 MS. PERDUE said she thought the state was about to get a major                
 opportunity to fundamentally redesign the welfare system.  She                
 feels that Congress is about to give Alaska the opportunity to try            
 some new ideas.  Most people who are on welfare and those who                 
 administer the program are ready for changes that encourage work              
 while a person is on welfare, and encourage people to get off                 
 welfare as quickly as possible.  Welfare should be used basically             
 only as a safety net.                                                         
                                                                               
 Number 295                                                                    
                                                                               
 MS. PERDUE continued that the aforementioned changes are of primary           
 concern when looking at redesigning a short-term welfare reform               
 package and a long-term package.  One of the major things that has            
 happened to the state's Aid to Families with Dependent Children               
 (AFDC) Program in the last several years is that in 1988 two-parent           
 families were added to the AFDC rules.  That was a federal                    
 congressional mandate to Alaska.  Alaska, at that time, was one of            
 the few states that did not cover two-parent families.  The                   
 reasoning behind this mandate was that welfare was breaking up                
 families, therefore, two-parent families should be added.                     
                                                                               
 MS. PERDUE said that currently, the majority of the case load                 
 increase is due to two-parent families.  In the two-parent family,            
 there is usually at least one person who is able-bodied.  So Ms.              
 Perdue feels that at least one of those parents should be working             
 or in training, and taking advantage of state and federal                     
 government support to go out and improve themselves.  Ms. Perdue              
 thinks that will be a key feature in any reforms that the DHSS                
 looks at.  They want 100 percent participation from two-parent                
 families in some sort of training program.                                    
                                                                               
 Number 373                                                                    
                                                                               
 MS. PERDUE announced that currently DHSS is trying to collect                 
 short-term strategies for lowering the number of people on a case             
 load, making sure that no one who is on a case load is cheating the           
 system in any way, making sure that absent parents are paying child           
 support so the state is not paying in their absence, and still                
 trying to move ahead with some reform while not wasting resources             
 so that programs will not have to be redone if the Congress passes            
 fundamental welfare reforms in November.                                      
                                                                               
 Number 240                                                                    
                                                                               
 CO-CHAIR BUNDE asked Ms. Perdue to speculate on the possibility of            
 Congress passing the block grant idea and giving Alaska a large               
 amount of money.  He asked if she had ideas about restructuring               
 Alaska's welfare program, specifically in the area of "Two years              
 then out" (a two-year welfare assistance limit), and also in those            
 areas in Alaska where welfare is a lifestyle.  He asked if a block            
 grant would involve a rate reduction considering Alaska's rate is             
 higher than anywhere else in the United States.                               
                                                                               
 MS. PERDUE answered that Congress is looking into putting AFDC food           
 stamps and the Women, Infants and Children (WIC) program in a block           
 grant.  Currently, there is a bill before the Federal Congressional           
 House, the Clay Shaw bill, that caps the contribution for five                
 years.  That puts a lot of pressure on the states because the money           
 is not an entitlement anymore.  That is a fundamental shift in the            
 way Alaska has been doing business in the past.  That is currently            
 the most active proposal, and the Alaska DHSS is analyzing what               
 that proposal would mean in terms of Alaska's current program.  Ms.           
 Perdue said that one can only guess, if the AFDC federal funding              
 grows three to six percent every year, that would mean less money             
 to go around.                                                                 
                                                                               
 MS. PERDUE said that in terms of the contribution limits, the                 
 Republicans have now revised their entitlement to five years with             
 some credits for working, and then there is an absolute cutoff.               
 There are other proposals that create a bank of a two-year time               
 limit, and a person may buy back time if he or she goes to work.              
                                                                               
 MS. PERDUE commended the number of creative ideas which have been             
 proposed.  However, the time limit concept is one which both                  
 Democratic and Republican governors have accepted at this point.              
 Ms. Perdue felt that the time limit concept was going to be                   
 enacted.                                                                      
                                                                               
 Number 546                                                                    
                                                                               
 CO-CHAIR BUNDE hoped that Ms. Perdue would address the problem of             
 rural Alaska.  Some feel that in rural Alaska there cannot be a               
 time limit.  Others say perhaps time limits should exist                      
 everywhere.                                                                   
                                                                               
 Number 564                                                                    
                                                                               
 CO-CHAIR BUNDE announced that Representative Brice and                        
 Representative Rokeberg joined the meeting at 3:08 p.m.                       
                                                                               
 REPRESENTATIVE TOM BRICE inquired that considering Alaska has one             
 of the lowest rates of welfare fraud in the nation, what does Ms.             
 Perdue see Alaska doing in the future to decrease that number of              
 welfare fraud cases even further.                                             
                                                                               
 Number 593                                                                    
                                                                               
 MS. PERDUE replied that one of the biggest areas of welfare fraud             
 is food stamps, because they are essentially cash and can be                  
 traded.  Her understanding is that there is an active food stamp              
 trade in Anchorage.  One of the ways states are dealing with this             
 fraud is by providing people with a "swipe card," which transfers             
 benefits electronically.  Alaska is actively exploring that option            
 and is very interested in working with grocers in Fairbanks and               
 Anchorage.  The technology has seemed out of reach because Alaska             
 has a comparatively small number of grocery stores.  However,                 
 governors in the western states have put together an alliance with            
 Wyoming, Idaho and other states which Alaska is looking to join and           
 buy some off-the-shelf technology.                                            
                                                                               
 REPRESENTATIVE BRICE said the very essence of welfare reform lies             
 within child support - making those who have helped create the                
 problem pay for the problem.  He encouraged Ms. Perdue to look at             
 a large number of state departments that provide not only benefits            
 for poor people and children, but also make sure that those who               
 abandon their children start paying more.                                     
                                                                               
 REPRESENTATIVE BRICE concluded by saying that currently most of the           
 discussion at the federal congressional level is that the creation            
 of children is only the woman's responsibility, and this is not               
 true.                                                                         
                                                                               
 Number 753                                                                    
                                                                               
 CO-CHAIR CYNTHIA TOOHEY is pleased to see Ms. Perdue appointed for            
 the position.  She is confident with Ms. Perdue's knowledge of the            
 system and feels she will do a very good job.  Co-Chair Toohey                
 hopes Ms. Perdue is strong enough for the upcoming challenges.                
 There are some major budget cuts coming for Health and Social                 
 Services as well as many other departments.  The cuts are not going           
 to be pretty and it will break everyone's heart but they must be              
 done.                                                                         
                                                                               
 CO-CHAIR TOOHEY discussed an article from the Washington Post.                
 There is a county in New York that spends 62 cents from every                 
 dollar they collect on MedicAid.  Co-Chair Toohey said that this is           
 not a projected figure for ten years in the future, this is what              
 this county is paying currently.  She warned that this type of                
 spending will be seen in Alaska if some major changes are not made.           
                                                                               
 Number 807                                                                    
                                                                               
 MS. PERDUE felt the article to which Co-Chair Toohey referred was             
 excellent because it showed how difficult decisions were for the              
 government.                                                                   
                                                                               
 CO-CHAIR TOOHEY said that the Alaska government will soon be making           
 those decisions.  Some were made last year and everybody blamed               
 everybody--legislators did not make popular decisions.                        
                                                                               
 CO-CHAIR TOOHEY continued that the issue of unwed teenage pregnancy           
 must be addressed, and she did not know how it would be dealt with.           
 Co-Chair Toohey would like to see funding for unwed teenage mothers           
 stopped.  They should be encouraged to go back home to their                  
 families.  Co-Chair Toohey hoped that with the help of Ms. Perdue             
 and her staff, this problem will be stopped.                                  
                                                                               
 Number 850                                                                    
                                                                               
 REPRESENTATIVE NORMAN ROKEBERG said that Representative Brice made            
 a very good point when he said that the level of welfare fraud in             
 Alaska is the lowest in the nation.  However, Representative                  
 Rokeberg felt that represented the amount of reported fraud.  He              
 asked Ms. Perdue if she could comment on the fact whether the                 
 actual incidence of fraud is substantially greater than is                    
 reported, and what was being done within the DHSS.                            
                                                                               
 MS. PERDUE answered that initially, the fraud must be reported so             
 DHSS can investigate it.  Some of Ms. Perdue's relatives in                   
 Interior Alaska have reported suspected welfare fraud.  There are             
 DHSS people who do home visits, investigate and follow up on                  
 suspected fraud even in rural areas.  It could be the DHSS is                 
 understaffed in this area, but maybe the DHSS needs to be more                
 visible when they investigate fraud and more encouraging of public            
 reports.  It is essential that the public feel their money is being           
 well-spent.                                                                   
                                                                               
 Number 930                                                                    
                                                                               
 REPRESENTATIVE ROKEBERG understood that a film had been produced to           
 help fraud investigation within the last few years.  He heard this            
 from DHSS fraud investigators who also told Representative Rokeberg           
 that the incidence of fraud was much higher than what was being               
 reported.                                                                     
                                                                               
 Number 956                                                                    
                                                                               
 CO-CHAIR BUNDE encouraged the publicizing of fraud investigations.            
 No matter what the regulations are, and no matter how diligent the            
 DHSS investigators are, there will always be people clever enough             
 to figure out how to fraud the system.  Publicizing investigations            
 and prosecutions would discourage the least ambitious.                        
                                                                               
 MS. PERDUE said that is called the "Sentinel Effect," and she feels           
 that effect does have an impact.  Such publicity should be done for           
 MedicAid fraud and for public assistance fraud.  It is important to           
 publicize not only the $50 to $100 frauds, but also the bigger                
 frauds.  There are also cases of public assistance providers who              
 fraud the system and those cases should also be publicized.                   
                                                                               
 CO-CHAIR BUNDE agreed with Ms. Perdue.                                        
                                                                               
 Number 1053                                                                   
                                                                               
 CO-CHAIR BUNDE mentioned concerns that he shares with Co-Chair                
 Toohey, such as STDs, fetal alcohol syndrome and teenage pregnancy.           
 He encouraged Ms. Perdue to work on those problems.  Co-Chair Bunde           
 continued that some state departments and the legislature tend to             
 diverge.  The legislature has ideas, but somewhere along the line             
 the policy changes don't reflect the legislative goals.  Such a               
 divergence would be unfortunate in this case, however Co-Chair                
 Bunde does not anticipate these problems.  He desires a working               
 partnership between the HESS Committee members, Ms. Perdue and the            
 DHSS.                                                                         
                                                                               
 Number 1118                                                                   
                                                                               
 CO-CHAIR TOOHEY asked Ms. Perdue about the future of permanency               
 planning for foster children.                                                 
                                                                               
 MS. PERDUE answered that she is not well informed on that topic,              
 however, she will study that area.                                            
                                                                               
 Number 1142                                                                   
                                                                               
 REPRESENTATIVE CAREN ROBINSON said that last week the HESS                    
 Committee passed HB 92, which extended the termination date of the            
 Citizen's Review Panel for Permanency Planning.  She said that due            
 to some unfortunate circumstances the Panel was not implemented the           
 first year it was supposed to be.  Now the program is under funded.           
 Representative Robinson hopes that Ms. Perdue will work with the              
 Commissioner of the Department of Administration to encourage the             
 implementation of the program.                                                
                                                                               
 REPRESENTATIVE ROBINSON said that currently, the focus for Health             
 and Social Service departments across the nation is on welfare                
 reform.  She asked Ms. Perdue about other priorities during her               
 tenure as commissioner.                                                       
                                                                               
 Number 1186                                                                   
                                                                               
 MS. PERDUE answered that she has spoken with the HESS Committee               
 about prevention and the need to change the collective attitude               
 toward issues.  Ms. Perdue strongly feels that most children in               
 Alaska are healthy and that most parents are doing good jobs.  In             
 addition, the schools are doing well.  But the tendency is to focus           
 on the 10 percent of the children who are driving 90 percent of the           
 costs.  That attitude needs to be changed in the DHSS so the                  
 department has the ability to cope with the problem better.  The              
 department needs the courage to focus on prevention.                          
                                                                               
 MS. PERDUE said that, using alcohol as an example, the answer to              
 alcohol problems is not to do more treatment of the expensive cases           
 at the community level to influence people's choices about their              
 own lifestyles.  Instead, the state must start with young children,           
 and start with communities where people see pregnant women                    
 drinking.  Ms. Perdue reminded HESS Committee members about the               
 "Celebration of Life Project" in which women in a community                   
 surround a pregnant women who are in a situation where drinking is            
 prevalent.  Such programs do not cost a lot of money.  These                  
 programs cost significantly less than the amount it will cost to              
 take care of the baby if it is born with fetal alcohol effects or             
 Fetal Alcohol Syndrome.  However, few proactive programs like this            
 are being used.                                                               
                                                                               
 MS. PERDUE said that the state talks about tough funding choices,             
 but there might also be tough policy choices.  This may be                    
 particularly true in relation to alcohol.  Alcohol is driving most            
 of the department's health costs.                                             
                                                                               
 CO-CHAIR TOOHEY strongly agreed with Ms. Perdue that early                    
 education is where funding should go.                                         
                                                                               
 Number 1275                                                                   
                                                                               
 CO-CHAIR BUNDE added his support to Ms. Perdue and expressed                  
 concern that the current system rewards the wrong people.  The                
 people who are the problem receive all the state's attention and              
 resources.  But the people who are in same circumstances and make             
 something of their life, in spite of perhaps humble beginnings or             
 challenges, receive little or no reward.  He offered his assistance           
 to Ms. Perdue in rectifying that situation.                                   
                                                                               
 CO-CHAIR BUNDE continued that in Anchorage, there are about 50                
 people with alcohol problems who take up 80 to 90 percent of the              
 community service patrol.  Co-Chair Bunde asked if the state was              
 doing a little more than simply delaying their death from                     
 alcoholism.  He said it was a tough question as to whether or not             
 their behavior is being changed.  He said that such a question                
 should be looked at by Ms. Perdue and the legislature.                        
                                                                               
 Number 1336                                                                   
                                                                               
 REPRESENTATIVE BRICE noticed that throughout the current session,             
 there has been a lot of attention paid to prevention, children and            
 public health issues.  He wanted to remind HESS Committee members             
 and audience members that those who have severe developmental or              
 mental health disabilities must also be looked out for.  He                   
 encouraged Ms. Perdue to continue the move toward appropriate                 
 community based services.  He wanted that issue to remain a strong            
 focus of the DHSS.                                                            
                                                                               
 CO-CHAIR BUNDE said there is a reasonable possibility that the hold           
 harmless clause of the permanent fund dividend will not exists next           
 year.  One question is whether there should be a separation of                
 welfare recipients between those who are disabled and those who are           
 able-bodied.  Co-Chair Bunde hopes that Ms. Perdue is preparing for           
 the possibility that the Hold Harmless clause will not be part of             
 the welfare system.                                                           
                                                                               
 Number 1410                                                                   
                                                                               
 MS. PERDUE said that the issue will warrant much administrative               
 thought because each individual case will have to be looked at.               
 That is where the expenses will lie.  The hold harmless clause is             
 one of the first waivers that DHSS negotiated with the federal                
 government because the DHSS was looking at a nightmarish                      
 administrative process if they had to look at all 13,000 AFDC cases           
 and all 12,000 public assistance cases.                                       
                                                                               
 MS. PERDUE disagreed with the idea of not holding people harmless             
 for that activity if they are not going to be held harmless for               
 other state subsidies.  However, that issue will be played out in             
 the policy arena.  The administrative issue is a real issue.  The             
 DHSS will have to have the resources to comply with the federal               
 law.  If it does not, the state will be paying error rates and                
 penalties.  This can get very expensive very quickly.                         
                                                                               
 MS. PERDUE explained that the federal government samples Alaska's             
 cases.  If there is one error in that sample, they will prevalence            
 that error across the case load.  So one small error of $100 can              
 mean a penalty of $1 million.  Currently, Alaska is a shining star            
 because it does not make those errors.  It has not paid penalties             
 since the late 1970s, when Alaska had 28 percent error rates.                 
 Therefore, there could be some financial issues which arise if the            
 state is not very careful beyond the policy issues of what dropping           
 the hold harmless clause may mean to individuals.                             
                                                                               
 Number 1491                                                                   
                                                                               
 CO-CHAIR BUNDE felt it was safe to say that the vast majority of              
 Alaskans have a philosophical difference about the hold harmless              
 clause, and so those administrative issues may simply be a fact               
 that must be dealt with.  If all 12,000 must be studied                       
 individually, welfare may be put on less of an automatic cycle and            
 more of an ongoing evaluation process.  But those issues will have            
 to be played out.                                                             
                                                                               
 REPRESENTATIVE ROBINSON said that in reference to those with able-            
 bodies and those who are disabled, there is currently a direction             
 in the legislature to possibly exempt those who are developmentally           
 disabled from losing their PFDs.  Representative Robinson said that           
 many times there is a misunderstanding that a lot of people on                
 welfare are not working.  She asked if Ms. Perdue had statistics on           
 how many people on military bases were receiving food stamps.                 
 Representative Robinson speculated that may be because of the low             
 military pay.  She asked Ms. Perdue how those people who are                  
 working would fit into the discussion.                                        
                                                                               
 Number 1554                                                                   
                                                                               
 MS. PERDUE said that if the 12,000 seniors, blind people and others           
 with disabilities were exempted from the hold harmless repeal,                
 those left are members of the AFDC population.  This includes                 
 13,000 families and 25,000 kids.  About 50 percent of those                   
 families only have one child, so they receive a $2000 check each              
 month.  A small percentage of those AFDC families have many                   
 children.  Two months of hold harmless is equal to their assistance           
 check.  A good majority of those families have children under six             
 years old.  That is a large issue that needs to be noticed.                   
                                                                               
 MS. PERDUE felt that the loss of the medical support included in              
 the hold harmless clause is as dangerous as the loss of the cash.             
 Ms. Perdue wondered what that would mean to a person who was in the           
 process of receiving care.  The cash will have to be spent                    
 immediately, and Ms. Perdue felt that was a very poor habit to                
 teach people.  The cut in the continuity of medical coverage is a             
 very serious issue.                                                           
                                                                               
 Number 1633                                                                   
                                                                               
 CO-CHAIR BUNDE asked how many of the 12,000 to which Ms. Perdue               
 referred were senior citizens and how many were disabled.                     
                                                                               
 MS. PERDUE answered that the numbers were basically split down the            
 middle.  Approximately 4,500 are seniors, roughly 4,500 are                   
 developmentally disabled, and there is a fairly stable caseload of            
 individuals who are blind, about 200 to 300 people.  She stated               
 that those areas have the largest caseload growth.  People in                 
 Alaska are living longer, particularly in rural areas.  This is a             
 testament to Alaska's health care system.                                     
                                                                               
 Number 1669                                                                   
                                                                               
 MS. PERDUE wanted to discuss one more issue.  There are rules built           
 upon rules of the hold harmless clause.  Right now if a person is             
 a recipient of Indian Health Services (IHS), and they are currently           
 receiving medical care through this service, they can bill MedicAid           
 at 100 percent federal funds.  The DHSS is working very hard to               
 increase that so state money is saved--up to 50 cents on every                
 dollar.  Right now, that amount equals about $14 million saved.               
 Plans are in the works to perhaps double that amount by next year             
 through working with the travel corporations.                                 
                                                                               
 MS. PERDUE said that if MedicAid eligibility is affected for that             
 population, those people will be denied their federal claim for               
 their care.  The person would have to be actively receiving care,             
 either in the hospital or using an outpatient service.                        
                                                                               
 Number 1718                                                                   
                                                                               
 CO-CHAIR BUNDE told the committee that a form would be passed                 
 around to HESS Committee members for them to sign to pass the                 
 appointment of Karen Perdue on to the Speaker of the House.  He               
 reminded the committee that signing the form does not reflect any             
 intention to vote for or against Ms. Perdue during further                    
 confirmation sessions.  He asked HESS Committee members if there              
 were any objections to this appointment being sent to the Speaker.            
 Hearing no objection, he thanked Ms. Perdue.                                  
                                                                               
 HHES - 02/14/95                                                               
 CONFIRMATION HEARINGS FOR THE PROFESSIONAL TEACHING PRACTICES                
 COMMISSION                                                                   
                                                                               
 Number 1756                                                                   
                                                                               
 CO-CHAIR BUNDE announced that the committee would move forward to             
 the Professional Teaching Practices Commission (PTPC) appointments.           
                                                                               
 CHRISTINE NIEMI, Administrator for Teacher Education and                      
 Certification in the Alaska Department of Education (DOE), said she           
 has been at the DOE since 1983.  She was formally in the                      
 Educational Program Support Division in the special education area            
 until 16 months ago, when she was moved into her present position.            
 About a year ago, she was appointed to the PTPC to fill a term for            
 someone who was unable to complete their term.                                
                                                                               
 MS. NIEMI then offered to answer questions for the HESS Committee             
 members.                                                                      
                                                                               
 Number 1796                                                                   
                                                                               
 CO-CHAIR BUNDE said that he has had the good fortune to work with             
 Ms. Niemi on a teacher certification project which spanned about              
 three years.  He expressed his confidence in her abilities and her            
 professional contributions to that endeavor.                                  
                                                                               
 REPRESENTATIVE ROBINSON asked what the PTPC does.                             
                                                                               
 Number 1820                                                                   
                                                                               
 MS. NIEMI answered that the PTPC is a group of professional                   
 educators who are appointed to represent different groups.  There             
 are five teacher representatives, a member representing                       
 institutions of higher education, a representative of the DOE (Ms.            
 Niemi), a member of the Principals' Association and a member of the           
 Superintendents' Association.  This group acts in disciplinary                
 cases for teachers and administrators.  For example, at the last              
 meeting, two teacher's certificates were revoked for individuals              
 who were involved with child abuse-type circumstances.                        
                                                                               
 CO-CHAIR BUNDE said that working with the PTPC was an important but           
 probably not the most enjoyable job in education.                             
                                                                               
 REPRESENTATIVE ROBINSON noted that the HESS Committee members                 
 always hear concerns regarding the tenure policies.  One of the               
 main issues people have concerns about is that there is no way to             
 remove a teacher who is not doing his or her job.                             
                                                                               
 Number 1877                                                                   
                                                                               
 CO-CHAIR BUNDE thought that Representative Robinson was asking                
 about the district's policy for the removal of teachers.  The                 
 members of the PTPC revoke the license of a teacher.                          
                                                                               
 REPRESENTATIVE ROBINSON wondered if a parent who had serious                  
 problems with a teacher could contact the PTPC.                               
                                                                               
 MS. NIEMI answered that the PTPC hears complaints.  The executive             
 director of the PTPC does investigate complaints, and some                    
 complaints come before subcommittees of the PTPC.  Decisions are              
 made on those complaints as well.  However, the PTPC tries not to             
 get involved in the hiring and general evaluation processes of                
 teachers, administrators and school districts.                                
                                                                               
 REPRESENTATIVE ROBINSON surmised that there has probably been a               
 criminal action before a case comes before the PTPC.  The PTPC then           
 determines whether or not an educator's license should be                     
 suspended.                                                                    
                                                                               
 Number 1906                                                                   
                                                                               
 MS. NIEMI responded that was generally true, but the PTPC also                
 hears.                                                                        
                                                                               
 CO-CHAIR BUNDE asked if some disciplinary action has usually taken            
 place before an educator would appear before the PTPC.                        
                                                                               
 MS. NIEMI said that generally, Co-Chair Bunde was correct.                    
 However, within the last year there was a case in which an                    
 individual was applying for a teacher's certificate and the PTPC              
 investigated the individual.  In this person's history was                    
 impropriety involving children.  The PTPC subcommittee suggested              
 that a certificate not be issued in this case.                                
                                                                               
 CO-CHAIR BUNDE asked how the PTPC knew this person had been                   
 involved in inappropriate activities with children.                           
                                                                               
 Number 1955                                                                   
                                                                               
 MS. NIEMI explained that in the code of ethics there is a statement           
 which requires a person to report to the PTPC any knowledge of a              
 teacher or individual in a teaching profession who has or is                  
 harming a child.  Often the executive director of the PTPC will               
 hear from a person who has such information.  The reporting                   
 individual may call Ms. Niemi and she either reports the incident             
 to the executive director or she encourages the reporting                     
 individual to contact the executive director.                                 
                                                                               
 CO-CHAIR BUNDE asked for clarification on whether those reports are           
 simply allegations or have they been investigated or looked at                
 legally.  He also asked if the PTPC was expected to act as a court            
 of law.                                                                       
                                                                               
 Number 2007                                                                   
                                                                               
 MS. NIEMI said that sometimes the report involves a conviction.  In           
 other cases, the PTPC has held a hearing in which evidence is                 
 submitted and a determination is made.  A hearing officer is also             
 there in such a situation to provide some guidance.  The PTPC also            
 has an attorney which advises the commission.                                 
                                                                               
 REPRESENTATIVE BRICE asked in what other circumstances is a                   
 certificate pulled or revoked.                                                
 MS. NIEMI answered that in one case, a police officer reported that           
 an individual had a large marijuana garden, grown for more than               
 personal use.                                                                 
                                                                               
 REPRESENTATIVE BRICE asked if the police officer was unwilling to             
 prosecute the individual for that offense.  Ms. Niemi did not know            
 such extenuating details.  Representative Brice understood that               
 there was a code of ethics to be enforced, and that a teacher's               
 certificate could be revoked for statute violations.  He asked what           
 other information is used when determinations are made.  He was               
 unclear as to what processes were used to make allegations that               
 brings the teacher before the PTPC, and under what instances does             
 the PTPC act.  Do they act only for ethics and statute violations,            
 or are there other instances where the PTPC revokes a license.                
                                                                               
 Number 2097                                                                   
                                                                               
 MS. NIEMI said that it was a very serious thing to revoke a                   
 license, so the allegations would have to be very serious, such as            
 a conviction.  In the case of person who grew marijuana, the                  
 evidence provided by the officer provided a preponderance of                  
 evidence.  Therefore, the evidence must be substantial and                    
 substantiated.                                                                
                                                                               
 CO-CHAIR BUNDE stated that the discussion was straying from her               
 qualifications for appointment.  Representative Brice said that it            
 was pertinent to know what Ms. Niemi's beliefs are, the role of the           
 PTPC, and the process by which licenses are revoked.  Co-Chair                
 Bunde agreed that her beliefs are very pertinent, but he felt                 
 perhaps the process of the PTPC could be explored at anther time.             
                                                                               
 Number 2139                                                                   
                                                                               
 BRIAN CARTER, Interim principal and teacher in the North Star                 
 School District, on teleconference from Salcha, said that he will             
 still represent the PTPC in the role of teacher.  He has served on            
 the PTPC since fall, 1992.                                                    
                                                                               
 CO-CHAIR BUNDE asked Mr. Carter if he encountered a conflict                  
 between his roles as teacher and principal while representing                 
 teachers for the PTPC.                                                        
                                                                               
 MR. CARTER answered no, that experiences have allowed him to                  
 experience somewhat of an administrative internship for the last              
 few years.  He is still a legal representation of a teacher.  Until           
 the district hires him as an administrator he will represent                  
 teachers.  Most of his experience has been as a teacher.  He                  
 continued that his previous years' experiences have been very                 
 rewarding.                                                                    
                                                                               
 MR. CARTER wanted to publicly commend the efforts of the executive            
 director of the PTPC and her secretary.                                       
                                                                               
 Number 2256                                                                   
                                                                               
 CO-CHAIR TOOHEY agreed with Mr. Carter on the capabilities of the             
 executive director of the PTPC.  She is a hero of Co-Chair                    
 Toohey's.                                                                     
                                                                               
 REPRESENTATIVE ROBINSON prefaced her comments by saying that her              
 question may be somewhat uncomfortable for Mr. Carter.  She said              
 that unfortunately, his name is not on the list that was given to             
 the legislature by Governor Knowles.  She asked Mr. Carter how he             
 felt about that, and if he planned on keeping his name on the                 
 confirmation list although his name was not picked by the Governor.           
                                                                               
 MR. CARTER answered that he wanted to remain on the list, and that            
 this was the first he had heard of his absence from the list.  He             
 knew that there was a nontransmittal letter for all appointees when           
 the hearings were before the Senate HESS Committee.                           
                                                                               
 TAPE 95-7, SIDE B                                                             
 Number 085                                                                    
                                                                               
 WILLIAM McCAIN, teacher, Chugiak Elementary School, made his                  
 statements via teleconference from Chugiak Elementary School.  He             
 has been in the Anchorage School District as a Physical Education             
 teacher for 14 years.  He has spent 24 years total in the education           
 profession at all levels.  He has taught kindergarten to high                 
 school.  He taught in Washington state for many years and taught in           
 Australia for three years.                                                    
                                                                               
 MR. McCAIN stated that he was on his second term with the PTPC.  He           
 joined the commission in the fall, 1992.  Although the PTPC deals             
 with some very troubling cases at times, the work is very                     
 interesting and satisfying because you do feel like you are                   
 "policing the ranks."  With 30,000 certified teachers in Alaska, of           
 which 8,000 are active, the job is formidable.                                
                                                                               
 MR. McCAIN also commended the executive secretary of the PTPC and             
 her staff.  He offered to answer questions on how cases are given             
 to the PTPC.                                                                  
                                                                               
 CO-CHAIR BUNDE declined the offer, and asked instead for responses            
 to specific questions.  He suggested, however, that Mr. McCain                
 contact Representative Brice's office to answer questions that                
 Representative Brice may have.                                                
                                                                               
 Number 160                                                                    
                                                                               
 MARY LOU MADDEN, Provost and Vice President of Sheldon Jackson                
 College, testified via teleconference from Sitka.  She is a new               
 appointee to the PTPC.  She has 20 years of experience in Alaskan             
 education, with everything from preschool to graduate work in both            
 the public and private sector.  She wants to be on the PTPC because           
 she is interested in professional ethics.  These issues are                   
 important not only for the teaching profession but also (indisc. -            
 coughing).  She is interested in being a part of holding teachers             
 to the standards of professional behavior that benefit not only               
 students but the educational system in general.                               
                                                                               
 CO-CHAIR BUNDE congratulated Ms. Madden on her appointment at                 
 Sheldon Jackson College.  He asked if her work on the PTPC would              
 interfere with her work as Provost and vice versa.  Ms. Madden said           
 there would be no interference.  As a matter of fact, there is a              
 teacher education program at the college which she feels will help            
 her.  Her positions can also help the teacher education program by            
 her insuring that ethics are a part of teacher rating.  She sees              
 her two appointments as working hand in hand.                                 
                                                                               
 Number 261                                                                    
                                                                               
 CO-CHAIR BUNDE thanked and commended the appointees for taking on             
 the difficult task of cleansing the profession of those who would             
 weaken it.  Co-Chair Bunde then reiterated that if the names are              
 passed forward it does not reflect the intent of any member to vote           
 for or against a nomination.                                                  
                                                                               
 CO-CHAIR BUNDE asked if there were any objections to the                      
 appointments being sent to the speaker.                                       
                                                                               
 REPRESENTATIVE ROBINSON asked if the individuals could be taken one           
 at a time.                                                                    
                                                                               
 CO-CHAIR BUNDE said yes.  There were no objections to sending forth           
 the names Christine Niemi, Mary Lou Madden or William McCain.                 
 Representative Robinson objected to Brian Carter.  A roll call vote           
 was asked for.  Voting yes for the passage of Brian Carter were               
 Representatives Bunde, Vezey, Rokeberg and Toohey.  Voting no were            
 Representatives Robinson and Brice.                                           
                                                                               
 Number 381                                                                    
                                                                               
 REPRESENTATIVE ROBINSON wanted Mr. Carter to know that the "no"               
 votes had nothing to do with his qualifications, they only                    
 reflected dissatisfaction with the process and her beliefs that the           
 appointments the HESS Committee members should be addressing are              
 those that have been sent by Governor Knowles.                                
                                                                               
 CO-CHAIR BUNDE announced that all names will be sent to the Speaker           
 of the House.                                                                 
 HHES - 02/14/95                                                               
 HJR 18 - SUPPORT MEDICAL SAVINGS ACCOUNT LEGISLATION                        
                                                                               
 Number 475                                                                    
                                                                               
 ROD MOURANT, Administrative Assistant to Representative Pete Kott,            
 apologized on behalf of Representative Kott for his absence and               
 thanked the committee for hearing HJR 18.  Mr. Mourant said that              
 all but two of the current members of the HESS Committee saw and              
 voted on this exact legislation last session.  The resolution                 
 passed unanimously from the House, but subsequently died in the               
 Senate Rules Committee at adjournment.                                        
                                                                               
 MR. MOURANT then read the sponsor statement:                                  
                                                                               
 As medical costs nationally and in Alaska continue to rise,                  
 the need for innovative approaches to health care cost                        
 containment becomes more acute.  The concept behind Medical                   
 Savings Accounts is to encourage employees to shop more                       
 carefully for medical services.  It recommends the purchase of                
 high deductible coverage by employers.  The savings realized                  
 by this effort results in reduced health insurance premiums.                  
 These savings are then placed by the employers in individual                  
 employee Medical Savings Accounts.                                            
                                                                               
 Employee Medical Savings Accounts then may be used by                        
 employees to purchase additional, more specific insurance                     
 coverage and to pay deductibles incurred under employer                       
 provided or employee purchased medical coverage plans.                        
                                                                               
 Medical Savings Accounts belong to the individual employee and               
 move with the individual to purchase health insurance when                    
 between jobs or for coverage when re-employed, even when with                 
 a different employer.                                                         
                                                                               
 The additional benefit to Medical Savings Accounts is that                   
 they allow the individual to select and purchase coverage at                  
 reduced cost without a new federal bureaucracy and would be                   
 revenue neutral to employers.  It is compatible with the free                 
 market in that it protects individual freedom and rewards                     
 prudent decision making.                                                      
                                                                               
 HJR 18 urges Congress to enact legislation that will make                    
 Medical Savings Accounts a viable option in the national                      
 effort to reduce and contain health care costs.                               
                                                                               
 Number 620                                                                    
                                                                               
 CO-CHAIR BUNDE asked if there was any current legislation on the              
 national level which would change the need for this resolution.               
                                                                               
 MR. MOURANT said that at this time he is not aware of any                     
 nationally introduced legislation.  However, this certainly is a              
 concept that has been discussed at the national level.  In the                
 resolution packets HESS Committee members could find a series of              
 articles that describe medical savings accounts and their use.                
                                                                               
 MR. MOURANT also pointed out that one recent article, from the Wall           
 Street Journal, says that support for medical savings accounts is             
 growing. Six states, Arizona, Colorado, Mississippi, Idaho,                   
 Missouri and Michigan, have changed their tax structure to                    
 accommodate medical savings accounts.  The United Mine Workers                
 Union has signed a new five year contract with a health plan that             
 includes a $1,000 bonus that workers can use to pay their medical             
 plan's $1,000 deductible.  Mine workers still have first dollar               
 coverage but the first $1,000 they now spend will be their own                
 money, rather than the company's.                                             
                                                                               
 MR. MOURANT concluded that Representative Kott believes that kind             
 of incentive on the part of those covered is a good incentive to              
 reducing the overall costs of health insurance in this country.               
                                                                               
 Number 693                                                                    
                                                                               
 CO-CHAIR TOOHEY asked how Representative Kott will handle the                 
 welfare and MedicAid recipients of Alaska.                                    
                                                                               
 MR. MOURANT answered that this legislation does not address that              
 issue.  It only addresses those who are employed and currently                
 covered.                                                                      
                                                                               
 Number 714                                                                    
                                                                               
 REPRESENTATIVE AL VEZEY felt that the resolution was excellent.               
 Health care costs are a national problem, driven by the Internal              
 Revenue Service's regulations.  However, there have been a number             
 of companies who provide health care insurance for their employees            
 who have experimented with this.  Those companies have experienced            
 substantial reductions in medical costs as a result of allowing               
 their employees to accrue a medical savings account which is income           
 they can take if they don't use it.                                           
                                                                               
 MR. MOURANT said that Representative Vezey makes a very valid                 
 point.  The resolution seeks not only reduced expense in medical              
 coverage and medical services, but, in addition, the money remains            
 with the individual.  If, at the time of retirement, the individual           
 still has a positive balance in their account, they are able to               
 take that to buy an annuity if they desire, or to help out in their           
 retirement years.                                                             
                                                                               
 CO-CHAIR BUNDE said that a great deal of research shows that people           
 with sick leave on a use-it or lose-it program are ill much more              
 frequently.                                                                   
                                                                               
 Number 791                                                                    
                                                                               
 REPRESENTATIVE ROBINSON asked Mr. Mourant to explain the process to           
 her.  She wondered how this would work for an interested individual           
 and what exactly the steps would be.                                          
                                                                               
 MR. MOURANT answered that a typical state employee pays about $465            
 dollars for health insurance on a monthly basis.  The medical                 
 savings account would allow the employer, the state of Alaska, to             
 purchase a major emergency medical coverage plan at a much reduced            
 premium than the detailed coverage plan that exists today.                    
 Employees would still be covered for catastrophic injury and                  
 emergency care, but because of the reduced premium the state may              
 save between $200 and $300 per employee per year.  That money is              
 placed into an individual account for the employee to use to shop             
 for additional coverage if he or she chooses to have it.  This is             
 much like the option that exists right now for selecting dependent            
 medical coverage.                                                             
                                                                               
                                                                               
 MR. MOURANT continued that the balance can be used to pay any                 
 deductible that might be present in the coverage that the employer            
 buys for the employees.                                                       
                                                                               
 Number 870                                                                    
                                                                               
 MR. MOURANT said that if, through prudent use in health care                  
 coverage selection, the employee still has a savings account                  
 balance upon retirement, he or she can convert that into an annuity           
 or other such account.                                                        
                                                                               
 Number 883                                                                    
                                                                               
 CO-CHAIR TOOHEY commended the bill.  She said that most of us spend           
 about $100 to $200 on medical coverage every year.  Catastrophic              
 coverage will take over if a person gets appendicitis or is hit by            
 a car or some such tragedy.                                                   
                                                                               
 Number 914                                                                    
                                                                               
 REPRESENTATIVE BRICE asked Mr. Mourant if the accounts would be tax           
 deductible.                                                                   
                                                                               
 MR. MOURANT answered that he was not sure what Representative Brice           
 was asking.  He said they would be tax deductible for the employer            
 because the account would be a payroll expense.  For the employee,            
 it would depend on how the code is structured.  Mr. Mourant feels             
 that the accounts are much like the employer match on the                     
 Supplemental Benefits System (SBS).  When an employee starts to               
 receive that employer match, Mr. Mourant assumes that would be                
 taxable income.                                                               
                                                                               
 Number 954                                                                    
                                                                               
 REPRESENTATIVE ROKEBERG'S understanding was that the accounts are,            
 in essence, tax neutral.  The benefit in the end is the savings               
 which is tax free money the employee can have.  It would depend who           
 would make the contribution of the up-front capital.  That would be           
 a taxable event.                                                              
                                                                               
 REPRESENTATIVE VEZEY commented that the plans he has seen would               
 involve a change in Internal Revenue Service codes.  The bank                 
 account is, as Representative Rokeberg said, tax deductible.                  
 Should the employee use it for medical services it is not tax                 
 liability.  If the money is taken for personal income it would be             
 taxable.                                                                      
                                                                               
 Number 995                                                                    
                                                                               
 REPRESENTATIVE VEZEY moved that HJR 18 be passed from the committee           
 with individual recommendations.  There were no objections.                   
                                                                               
 CO-CHAIR BUNDE announced that HJR 18 had been moved from the HESS             
 Committee to the next committee of referral.                                  
 Number 1016                                                                   
                                                                               
 ADJOURNMENT                                                                   
                                                                               
 CO-CHAIR BUNDE adjourned the meeting at 4:10 p.m.                             
                                                                               

Document Name Date/Time Subjects