02/21/2002 03:04 PM House HES
| Audio | Topic |
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
February 21, 2002
3:04 p.m.
MEMBERS PRESENT
Representative Fred Dyson, Chair
Representative Peggy Wilson, Vice Chair
Representative John Coghill
Representative Gary Stevens
Representative Vic Kohring
Representative Sharon Cissna
Representative Reggie Joule
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 411
"An Act relating to physician assistants; providing that a
physician assistant is a health care provider covered by certain
laws relating to medical malpractice actions; adding physician
assistants to the list of providers against whom unfair
discrimination relating to health care insurance is prohibited
and to the list of providers who can provide proof of
disablement or handicap for the purpose of motor vehicle
registration or for the purpose of obtaining a special license
plate or a special parking permit; and providing for an
effective date."
- MOVED HB 411 OUT OF COMMITTEE
HOUSE BILL NO. 352
"An Act extending the dates for assignment of performance
designations of public schools and the dates for reports and
monitoring based on those designations; and providing for an
effective date."
- HEARD AND HELD
OVERVIEW: SEPARATE AGENCY FOR THE BLIND
- HEARD [See 4:10 p.m. minutes for this date]
HOUSE BILL NO. 252
"An Act relating to the construction of certain statutes
relating to children; relating to the scope of duty and standard
of care for persons who provide services to certain children and
families; and providing for an effective date."
- MOVED CSHB 252(HES) OUT OF COMMITTEE
HOUSE BILL NO. 367
"An Act relating to coverage of children and pregnant women
under the medical assistance program; and providing for an
effective date."
- BILL HEARING POSTPONED [but testimony taken]
HOUSE BILL NO. 309
"An Act relating to the Interstate Compact on Placement of
Children."
- SCHEDULED BUT NOT HEARD
PREVIOUS ACTION
BILL: HB 411
SHORT TITLE:PHYSICIAN ASSISTANTS
SPONSOR(S): REPRESENTATIVE(S)FATE
Jrn-Date Jrn-Page Action
02/13/02 2233 (H) READ THE FIRST TIME -
REFERRALS
02/13/02 2233 (H) HES, L&C
02/21/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 352
SHORT TITLE:SCHOOL PERFORMANCE REPORTS
SPONSOR(S): RLS BY REQUEST OF THE GOVERNOR
Jrn-Date Jrn-Page Action
01/23/02 2042 (H) READ THE FIRST TIME -
REFERRALS
01/23/02 2042 (H) EDU, HES
01/23/02 2042 (H) FN1: ZERO(EED)
01/23/02 2042 (H) GOVERNOR'S TRANSMITTAL LETTER
02/13/02 (H) EDU AT 8:00 AM CAPITOL 120
02/13/02 (H) Moved Out of Committee
MINUTE(EDU)
02/13/02 2230 (H) EDU RPT 4DP 3NR
02/13/02 2230 (H) DP: GUESS, JOULE, STEVENS,
WILSON;
02/13/02 2230 (H) NR: PORTER, GREEN, BUNDE
02/13/02 2230 (H) FN1: ZERO(EED)
02/21/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 252
SHORT TITLE:STANDARD OF CARE FOR CINA SERVICES
SPONSOR(S): REPRESENTATIVE(S)COGHILL
Jrn-Date Jrn-Page Action
04/23/01 1136 (H) READ THE FIRST TIME -
REFERRALS
04/23/01 1136 (H) HES
01/17/02 (H) MINUTE(HES)
01/17/02 (H) HES AT 3:00 PM CAPITOL 106
01/17/02 (H) Heard & Held
MINUTE(HES)
02/07/02 (H) HES AT 3:00 PM CAPITOL 106
02/07/02 (H) <Bill Canceled>
02/12/02 (H) HES AT 3:00 PM CAPITOL 106
02/12/02 (H) Heard & Held
MINUTE(HES)
02/13/02 2257 (H) COSPONSOR(S): DYSON
02/14/02 (H) HES AT 3:00 PM CAPITOL 106
02/14/02 (H) Heard & Held
MINUTE(HES)
02/21/02 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE HUGH FATE
Alaska State Legislature
Capitol Building, Room 416
Juneau, Alaska 99801
POSITION STATEMENT: Presented HB 411 as the bill's sponsor.
ED HALL, Physician Assistant
Alaska Academy of Physician Assistants
13601 Windward Circle
Anchorage, Alaska 99516
POSITION STATEMENT: Briefed members on resolutions passed by
the academy in support of provisions in HB 411.
MARY MARSHBURN, Director
Division of Motor Vehicles
Department of Administration
3300B Fairbanks Street
Anchorage, Alaska 99503
POSITION STATEMENT: During hearing on HB 411, testified in
support of the inclusion of physician assistants in the list of
practitioners eligible to sign certificates of disability.
SUSAN MASON-BOUTERSE, Executive Director
Sunshine Clinic
P.O. Box 787
Talkeetna, Alaska 99676
POSITION STATEMENT: Testified in support of HB 411.
JESSICA STEVENS, Medical Director
Physician Assistant
Sunshine Clinic
P.O. Box 787
Talkeetna, Alaska 99676
POSITION STATEMENT: Testified in support of HB 411.
ED McLAIN, Ph.D., Deputy Commissioner of Education
Office of the Commissioner
Department of Education and Early Development
801 West Tenth Street, Suite 320
Juneau, Alaska 99801-1894
POSITION STATEMENT: Presented HB 352 to the committee.
MARK LEAL, Director of Assessment
Teaching and Learning Support
Department of Education and Early Development
801 West Tenth Street, Suite 200
Juneau, Alaska 99801-1894
POSITION STATEMENT: Provided information on HB 352 to the
committee.
SUSAN COX, Chief Assistant Attorney General
Civil Division (Juneau)
Department of Law
P.O. Box 110300
Juneau, Alaska 99811-0300
POSITION STATEMENT: Testified briefly on HB 352 and HB 252.
NATE MOHATT, Staff
to Representative Sharon Cissna
Alaska State Legislature
Capitol Building, Room 420
Juneau, Alaska 99801
POSITION STATEMENT: Presented rationale for and answered
questions pertaining to amendments to HB 252.
LYNNE KORRAL, President
Alaska Independent Blind
(Address not provided)
POSITION STATEMENT: Presented information during overview.
ELMER LINDSTROM, Deputy Commissioner
Department of Health and Social Services
P.O. Box 110601
Juneau, Alaska 99811-0601
POSITION STATEMENT: Presented information during overview;
testified on the fiscal note accompanying the proposed committee
substitute for HB 252.
WILLIAM CRAIG
Alaska Independent Blind
(Address not provided)
POSITION STATEMENT: Presented information during overview.
SANDY SANDERSON
Alaska Independent Blind
(Address not provided)
POSITION STATEMENT: Presented information during overview.
CHRIS DEVLIN, Executive Director
Eastern Aleutian Tribes
1600 A Street
Anchorage, Alaska 99501
POSITION STATEMENT: Testified in opposition to HB 367.
ACTION NARRATIVE
TAPE 02-14, SIDE A
Number 0001
CHAIR FRED DYSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:04 p.m.
Representatives Dyson, Wilson, Coghill, Stevens, and Kohring
were present at the call to order. Representatives Cissna and
Joule arrived as the meeting was in progress.
HB 411-PHYSICIAN ASSISTANTS
Number 0186
CHAIR DYSON announced that the first order of business would be
HOUSE BILL NO. 411, "An Act relating to physician assistants;
providing that a physician assistant is a health care provider
covered by certain laws relating to medical malpractice actions;
adding physician assistants to the list of providers against
whom unfair discrimination relating to health care insurance is
prohibited and to the list of providers who can provide proof of
disablement or handicap for the purpose of motor vehicle
registration or for the purpose of obtaining a special license
plate or a special parking permit; and providing for an
effective date."
Number 0190
REPRESENTATIVE HUGH FATE, Alaska State Legislature, presented HB
411 as its sponsor. He indicated HB 411 was introduced upon
request of the [Alaska Academy of Physician Assistants]. The
bill provides equity to the physician assistants (PAs); he
stated that when the list of medical health providers was
established in statute, PAs were not listed. He attributed this
omission to the small numbers of PAs in practice when this list
was established; he noted the growing numbers of PAs as health
providers in the state.
REPRESENTATIVE FATE offered that HB 411 seeks to accomplish
three things. First, it places PAs on the list of health care
providers in statute. Second, it gives PAs equal footing under
insurance programs for both payment and liability purposes.
Third, HB 411 allows PAs to authorize license plates for
disabled veterans or handicapped persons. Presently, physicians
and nurses can authorize these plates, but PAs cannot, he
explained. In both urban and rural Alaska, PAs fill an
important role for disabled veterans and disabled persons.
REPRESENTATIVE FATE noted that the [Division of Insurance,
Department of Community & Economic Development] is neutral on HB
411. He offered that the Division of Insurance had made a point
about which office the [insurance] payment is sent to. He
indicated he'd responded to the Division of Insurance that the
receipt location is determined by either the office under which
the PA works or by regulation of the Division of Insurance. He
also indicated Division of Insurance personnel would concur with
this statement.
Number 0380
CHAIR DYSON offered his understanding that PAs work under the
supervision of a medical doctor (MD).
REPRESENTATIVE FATE explained that this supervision by a
physician need not be direct; this physician needs to be
licensed in Alaska. In response to a further question from
Chair Dyson, he indicated that under certain circumstances,
insurance payments could go directly [to the supervising
physician's office]; this is determined by the office and the
insurance company, or by Division of Insurance regulations.
CHAIR DYSON drew attention to a proposed amendment to HB 411
that defines "unfair discrimination" in existing law. [The
amendment had been provided by Jerry Reinwand, Lobbyist for Blue
Cross Blue Shield of Alaska.] The amendment read [original
punctuation provided]:
Page 2, Line 12, replace current language with the
following:
*Sec. 2. AS 21.36.090(d) is amended to read:
"(d) Except to the extent necessary to comply
with AS 21.42.365 and AS 21.56, a person may not
practice or permit unfair discrimination against a
person who provides a service covered under a group
health insurance policy that extends coverage on an
expense incurred basis, or under a group service or
indemnity type contract issued by a nonprofit
corporation, if the service is within the scope of the
provider's occupational license. In this subsection,
(1) "provider" means a state licensed physician,
physician assistant, dentist, osteopath, optometrist,
chiropractor, nurse midwife, advanced nurse
practitioner, naturopath, physical therapist,
psychologist, psychological associate, or licensed
clinical social worker, or direct-entry midwife.
(2) "unfair discrimination" does not include
requirements imposed by a health insurer for purposes
of utilization review, cost containment and medically
recognized standards of clinically appropriate health
care services."
REPRESENTATIVE FATE declared that he hadn't read the amendment.
He said he didn't object to cleaning up language in legislation
by using a "rider" attached to HB 411. He pointed out that an
opportunity for a committee substitute will exist in the House
Labor and Commerce Standing Committee hearing on the bill, and
he said he'd like time to review the proposed amendment. He
offered that his first impression of the amendment was that he
didn't anticipate objecting to it.
CHAIR DYSON indicated his wish to receive input from Department
of Law personnel.
Number 0559
ED HALL, Physician Assistant, Alaska Academy of Physician
Assistants, testified via teleconference. He stated that his
goal in testifying was threefold. First, he wanted to elaborate
on the academy's resolution[s], but he said Representative Fate
had sufficiently spoken to the issues. Second, he wanted to
respond to members' questions. And third, he offered assurance
that it isn't the goal of the Alaska Academy of Physician
Assistants to seek independence [from physicians].
MR. HALL noted that by definition, PAs are required to work with
a collaborative physician. The State of Alaska upholds laws
pertaining to this. This physician is usually responsible for
billing issues when the PA and supervising MD work in the same
office, he offered. If a PA establishes a clinic under the
direction of a collaborating MD, however, billing becomes the
responsibility of the PA. That may give the appearance that PAs
are independent, Mr. Hall noted, but this is not the case.
MR. HALL referred to Section 1 of the bill and said:
This was brought to our attention a couple of years
ago by an attorney who indicated that they had had
problems in the past whenever they were involved with
any litigation with a physician assistant. ... An
arbitration board can appoint an expert advisory
panel, ... [which] usually consists of ... the
[providers] that are defined in this section.
Number 0803
MR. HALL pointed out that the list of health care providers in
AS 09.55.560 doesn't include PAs; therefore, they don't have the
ability to serve on the advisory panel or be assessed by their
peers. He referenced the second resolution, titled "Resolution
to Amend AS 21.36.090(d) to Protect Physician Assistants From
Unfair Discrimination." He offered that a clinic in Healy has
several examples of cases for which it was not reimbursed by an
insurance company. While this doesn't happen frequently, one
instance of nonpayment because a PA is not a recognized provider
in the state is too often, he offered.
MR. HALL noted that the third resolution pertains to the
[Division] of Motor Vehicles; because PAs are not specified in
statute, patients have been denied temporary or permanent
disability parking permits due to the signature of a PA on the
application. He offered his opinion that these state laws were
not created to exclude PAs; rather, the laws were written before
PAs were numerous in the state. Noting that he had a copy of
the aforementioned amendment, he said, "Because it's going to
probably change the language in the law, ... it may very well be
that this ... would not pass. And I would hate for that to
hinder what seems ... to be a straightforward parity." He noted
his preference for the amendment to be part of a separate bill.
Number 0898
CHAIR DYSON inquired how PAs practicing in a remote location
know when they are getting beyond the procedures they are
authorized by law to perform. He asked, "Do you have a spelled-
out protocol for what you can do and what you can't?"
MR. HALL replied that PAs are trained to recognize their
limitations. In the collaborative agreement between the
physician and the PA, the law allows PAs to do whatever the
supervising physician feels comfortable with, based on the
skills the PA has developed. For example, a family-practitioner
PA is not typically skilled in surgery; PAs are trained in
surgical procedures, but most do not practice these skills
frequently enough. Whereas minor procedures can be done in an
office, general surgery cannot be performed unless the PA has
been trained by a general surgeon up to a level of competence to
which the PA would be authorized. This is not to say that a PA
is performing surgeries in rural areas, Mr. Hall added; most PAs
in rural areas are in a family-practice setting.
Number 0999
CHAIR DYSON queried, if a medical emergency occurs and a PA is
the only medical practitioner in town, whether a PA can give the
situation his/her best effort.
MR. HALL answered, "Absolutely." Physician assistants go
through extensive training programs, so they are prepared to
handle acute emergencies. Like physicians, PAs practice with
the intent to do no harm.
Number 1054
MARY MARSHBURN, Director, Division of Motor Vehicles (DMV),
Department of Administration, testified via teleconference. She
pointed out that Section 3 affects the division; it will allow
PAs to sign the certificates of disability. She concluded that
this is a good addition.
Number 1080
SUSAN MASON-BOUTERSE, Executive Director, Sunshine Clinic,
testified via teleconference. She explained that Sunshine
Clinic is a midlevel clinic with four PAs who provide primary
care. These PAs work under a collaborative agreement with a
physician in Wasilla. She said:
These providers are critical to the ongoing health
care of residents in the community we serve, as well
as to the ongoing functioning of this health center.
Because our current state statutes ... do not include
[physician] assistants in the listing of health care
providers, we periodically have our billing for
medical services denied by third-party payers ....
MS. MASON-BOUTERSE stated that anytime this happens to rural
clinics that are struggling to maximize revenues, it becomes a
problem. She added that it also becomes a significant barrier
to health care for individuals with health insurance; they have
to drive somewhere else to receive health care. Small, rural
health clinics need to be able to explore every potential
revenue source to support clinic operations. She urged members
to support HB 411.
Number 1177
JESSICA STEVENS, Medical Director, Physician Assistant, Sunshine
Clinic, testified via teleconference. She emphasized her
support for HB 411. She pointed out that this is a huge issue
for rural communities that struggle to provide comprehensive
health care. Often PAs are providing this care instead of
physicians; the compensation and living situations are often not
conducive to physicians moving into rural Alaska.
MS. STEVENS mentioned the importance of having health care in
rural areas in emergencies. She offered her belief that the
exclusion of PAs was not deliberate, but an oversight that does
great damage to the PA-patient relationship in the community.
She noted that the many disabled veterans in her area have full
faith in PAs' ability to provide health care; they expect that
PAs will be able to sign disabled parking permits. Sometimes
these patients have to drive two hours to repeat an exam to get
someone to sign the forms. She added that insurance companies
have, relatively frequently, denied [payment for services
provided by PAs]. She urged members to pass HB 411.
Number 1297
[Chair Dyson asked Jerry Reinwand, Lobbyist for Blue Cross Blue
Shield of Alaska, if he was comfortable dealing with the
amendment in the House Labor and Commerce Standing Committee; he
received confirmation from Mr. Reinwand that he was amenable to
this proposal.]
REPRESENTATIVE WILSON commented that having worked in a small,
rural clinic, she has experienced the difficulties encountered
in recruiting and retaining a physician. Advanced nurse
practitioners and PAs worked in this clinic; without these
practitioners, people would have been required to drive 250
miles to Fairbanks for health care. She emphasized the
importance of [mid-level care providers] in rural areas. She
added that she is a registered nurse (RN); if RNs can sign the
handicapped parking permits, then surely PAs should be able to.
REPRESENTATIVE WILSON moved to report HB 411 out of committee
with individual recommendations and the accompanying zero fiscal
note. There being no objection, HB 411 was reported out of the
House Health, Education and Social Services Standing Committee.
HB 352-SCHOOL PERFORMANCE REPORTS
CHAIR DYSON announced the next order of business to be HOUSE
BILL NO. 352, "An Act extending the dates for assignment of
performance designations of public schools and the dates for
reports and monitoring based on those designations; and
providing for an effective date."
Number 1392
ED McLAIN, Ph.D., Deputy Commissioner of Education, Office of
the Commissioner, Department of Education and Early Development
(EED), presented HB 352 to the committee. He offered that HB
352 changes the effective date for the school [designations].
He noted that HB 352 had been heard by the [House Special
Committee on Education] earlier, and that he was available to
answer questions.
CHAIR DYSON inquired, "Why do we need to change the date?"
Number 1421
DR. McLAIN replied that the [governor's] letter of transmittal
offers three reasons for the change of date. First, the change
will allow EED to gather "growth scores" in addition to the
status scores. Only status scores - student test scores -
currently exist; the School Designator System (SDS) Committee
strongly recommends that the system accounts for both status and
growth. He offered that this would be a way to adjust for a
school that has low [status scores] but is making good progress.
This would prevent that school from automatically being
penalized as a school that is "deficient" or "in crisis"; the
progress the school is making with its students would be
recognized. This use of growth requires EED to gather data to
establish a growth line. The state has been conducting
assessments for a number of years, he noted, but the assessment
instruments have changed over the years, and no "apples-to-
apples" comparison exists.
DR. McLAIN noted that the second reason for the request is that
the change will allow EED to align the state's program with
United States HR 1 [the reauthorization of the Elementary and
Secondary Education Act (ESEA)]. United States HR 1 is a
comprehensive education reform bill, he stated; at the heart of
the resolution is a school [designation] component. He said,
"It has in it the expectation that there be one system; we fully
support the idea of one system." He spoke against having both a
state designation and a federal designation. Two systems would
be confusing. He said EED wants to work with the federal system
to ensure full alignment, which will take additional time.
Number 1503
DR. McLAIN stated that the third objective is "capacity
building" at the district level, the [assessment materials]
provider level, and the state level. The department fully
supports [the designation system's] becoming data-driven; this
will require capacity building, he said. Many districts do not
have the in-house capacity to do some of the necessary analysis;
this was evidenced as the disaggregated data [was reported] in
the past year. He concluded that these were the three primary
goals in the request for the date change.
Number 1550
MARK LEAL, Director of Assessment, Teaching and Learning
Support, Department of Education and Early Development, added
that the state doesn't have a statewide database of assessment
data; EED is currently establishing this. The State Board of
Education and Early Development passed regulations this year to
allow for the assigning of unique student identifiers, so EED
can manage student test scores. The old system required
districts to report test data to EED for the school report card
and other purposes, he said. A statewide database with unique
student identifiers will allow EED to obtain test data directly
from the test contractor and to verify this [data] with
districts. Time is required to build this capacity, he
concluded.
CHAIR DYSON asked whether 16 months - a delay to 2003 - is
enough time to accomplish these goals.
Number 1600
DR. McLAIN responded that the proposed date aligns with the
implementation of the High School Graduation Qualifying Exam
(HSGQE); EED believes this to be appropriate. The rulemaking
committee process for U.S. HR 1 will take another [congressional
legislative] session for establishment. If there is no delay,
only status scores will be used. He offered that it is EED's
best recommendation to be able to incorporate the growth data;
this will give a much better picture. Status scores are
currently [available to the public]. Some schools are already
under Title I improvement plans, he noted. He emphasized that
this delay is not a matter of doing nothing for the next two
years; a variety of pieces are in place. The department wants
to do this right, he concluded.
Number 1650
MR. LEAL added that 2004 is the targeted date because the
state's assessments end at the tenth grade; students who pass
the HSGQE in the tenth grade don't have to retake the test.
Students who don't pass continue to take the test. He noted
that EED is planning to capture that information in the
percentage of students graduating; by aligning the date with the
HSGQE implementation, the [indicator] number will include the
later years of high school.
Number 1687
CHAIR DYSON inquired about the length of time needed to build
the necessary capacity apart from the alignment with other
dates.
MR. LEAL responded, "We can do pieces of it right now." He
indicated that certain pieces could be in place in 16 months.
He added, "It just depends on what ... pieces of it ... we're
willing to live with, or live without."
Number 1709
CHAIR DYSON expressed his understanding that many schools don't
have the necessary capacity to do what the state requires
regarding analysis. He asked whether 16 months isn't adequate
time to build the necessary capacity in terms of staff skill
levels.
DR. McLAIN replied that it is not a matter of skills alone. The
individual student identifiers are being established; some
natural difficulties will be encountered in this process, he
offered. He said, "There will be the kicking in of the waiver
process and getting those pieces put on line with the high
school qualifying [exam]. None of these happen in isolation."
The request for the delay to build capacity will allow for these
pieces to be built up together as a unified piece. He noted
that an earlier date will allow for the inclusion of different
components [in the school designation]; because of the high-
stakes nature of this, however, EED prefers to [include growth
data].
Number 1770
CHAIR DYSON offered his understanding that EED is seeking to
rate schools using one-third [of the designation], based on the
scores, with another portion showing improvement.
MR. LEAL referred to the sample Alaska School Report Card
prepared by EED. He explained that the school designation
portion will include one-third based on status and [two-thirds]
based on growth; this is the recommendation of the SDS
Committee. He added that this is a value-added kind of system.
Number 1810
CHAIR DYSON inquired what will prohibit a principal or
superintendent from intentionally lowering the initial scores to
ensure that the growth scores will be high.
DR. McLAIN replied that the status scores are already being
published. He offered his opinion that a school that would
intentionally lower scores would subject itself to public
scrutiny. He stated that published status scores are carefully
reviewed [by the public]. Added impetus [for having accurate
status scores] is furnished by Title I schools' reporting
requirements and identification of schools in need of
improvement. Some Alaskan Title I schools are currently on
school improvement plans, he said. He offered his understanding
that Title I [designations] are based solely on status scores.
Title I schools would be ill-served to "muck around" with [test
scores]; he said "school improvement site" schools would be the
primary schools looking at this new system.
Number 1880
CHAIR DYSON sought confirmation that Dr. McLain had said a
baseline score already exists and would therefore be impossible
to tamper with.
DR. McLAIN responded, "They have the status scores."
Number 1889
REPRESENTATIVE COGHILL asked if federal money is designated for
Title I schools in need of improvement.
DR. McLAIN replied yes; there are requirements for how that
money is spent. Results of these expenditures for improvement
plans are monitored.
REPRESENTATIVE COGHILL mentioned the establishment of a fund
[for Title I schools in need of improvement]; he expressed his
understanding that there is no money currently in the fund. He
acknowledged the current debate over rewarding schools for poor
performance and asked how the Title I system encourages schools
to improve rather than simply take money.
Number 1925
DR. McLAIN stated that this is the very issue he addressed with
Title I federal personnel upon discussing the consequences and
incentives for Title I schools. He offered that he was not
prepared to fully outline those steps for the committee, but
said these schools do have an obligation to show progress.
Without appropriate progress, these schools will lose some
[autonomy].
Number 1951
REPRESENTATIVE COGHILL observed that there is [a zero] fiscal
note for extending the date. He asked whether there is a cost
for not allowing for the extension, or any savings by not
extending it.
DR. McLAIN replied that there is certainly no cost in extending
the date. He suggested it could be argued - although he is not
extending this as a reason for passage - that any fiscal impact
might be a savings. One of the reasons for the delay is the
alignment of designations with federal requirements. He offered
that EED doesn't want to have to backtrack in its planning as
the federal rulemaking committee establishes rules. To the
degree that this backtracking is avoided, a savings will be
realized in money, time, and [effort]. He pointed out that Mr.
Leal works with the SDS Committee; the committee and EED
assessment personnel are constructing regulations in the event
that the designations are implemented in 2002. If the delay is
granted, then the committee can redirect its efforts and public
relations toward the new date.
REPRESENTATIVE COGHILL stated, "I don't want the discussion
relaxed on what do we do next once the [designation] hits. I
think that's going to be one of the fears as we look at
extending the date. ... I want to know how you're going to
aggressively take that discussion on."
Number 2020
DR. McLAIN noted that he shares that concern; he identified the
details of the [designation] as being his focus. He stated that
if no delay is granted, the designations will be based on status
scores that are already published. Those scores will be part of
the state's implementation of the federal requirement for
adequate yearly progress. Everyone will know the stakes
involved with the adequate yearly progress designations, he
said. No one will be able to claim a lack of understanding of
the process or of the importance of the achievement scores.
REPRESENTATIVE COGHILL stated his intention of staying aware of
this discussion.
Number 2072
REPRESENTATIVE WILSON asked for clarification regarding the
weight given to status scores and growth scores in the school
designation.
MR. LEAL clarified that status scores represent one-third and
growth scores represent two-thirds of the designation.
Number 2093
REPRESENTATIVE CISSNA referenced discussions with property
owners in her district who are concerned about the impact of the
school designations on property values. She said, "I have
proud, older neighborhoods ... [that] are very diverse." She
stated that as far as she is concerned, these neighborhoods get
high ratings for neighborliness, but they have some challenges.
Administrators have commented, she said, that these schools in
older neighborhoods are experiencing decreasing student
populations. This gives these schools more room, which then is
used to house special-education programs. The presence of these
students, while welcome in the school, affects the school
designation. She asked how EED was planning to address this
concern.
Number 2159
MR. LEAL replied that EED is still working on that. One way to
address that concern is by looking at growth; there is the
expectation that all students will grow. He acknowledged that
EED hasn't yet dealt as effectively as it would like with the
issue of special schools that serve as magnets for special
programs. The committee is still wrestling with how to address
these schools; he has been working with the designator committee
since August, Mr. Leal said, and has been struck with how fair
the committee wishes this process to be. He offered that the
biggest cost incurred without the delay is the cost associated
with the integrity of the system. Components to assure fairness
would not be in place, he added.
Number 2204
CHAIR DYSON pointed out that he has received comments from
people in real estate that these designations will cause
property values to fall, with an ensuing decline in the
salability of homes. He observed that when moving, most
families want to know about the quality of the schools in a
prospective community. He asked for comments on this.
DR. McLAIN said this issue is being addressed nationwide. This
is why Alaska and other states are seeking a value-added
component to show the effectiveness of a school program without
penalizing it for its current status. This is one reason for
more complexity in the designation, rather than simply
publishing student scores. He noted that the correlation
between [test] scores and socioeconomic status is such that it
necessitates a need to show the impact a program [is having on
its student population]. He added:
It is exactly when we say "we don't yet have the
answers" that we ask for the delay. This is a very
complex [issue]. Not only in our state, but across
the country, this is ... a million-dollar question.
We [have] ... some of those same questions and
concerns. It's a reason for really wanting to do it
right. It is a piece that the committee is aware of;
... it's a piece that our consultants - who are
national on this - are aware of, and it's a piece that
we're working on. That would be ... the best that we
can do for you right now.
Number 2285
CHAIR DYSON noted that during his years serving on the Anchorage
assembly, he witnessed the city being sued due to planning
personnel's knowledge of natural hazards in a particular area
without public disclosure of this information. He asked: If a
school is still deemed to be in crisis with the inclusion of
growth scores, and the state has knowledge of this but does not
publicly disclose this information, is the state failing in its
responsibility to tell the truth? And could parents who had
invested in $150,000 homes there make an issue of it because
they hadn't been told about the scores?
Number 2338
DR. McLAIN suggested the reverse could happen where the state
has published the designations and property values have
decreased. He said that in the upcoming overview of U.S. HR 1
[in the House Special Committee on Education on February 27],
members will be informed of a component of the federal
legislation that makes this piece look "relatively tame." There
is a requirement in U.S. HR 1 to designate dangerous schools.
He said, "You can only imagine the reaction of people around the
nation as they're trying to figure out both the liability and
the technical challenges ... of doing that."
CHAIR DYSON asked if personnel from the Department of Law had
any light to shed on this matter.
SUSAN COX, Chief Assistant Attorney General, Civil Division
(Juneau), Department of Law, offered that she has not seen this
arise as a liability issue in Alaska. It would be a long shot
to blame the state, but efforts are always afoot to identify
regulations affecting property values, she stated.
TAPE 02-14, SIDE B
Number 2450
MS. COX told members she was unfamiliar with HB 352. She noted
that it is possible for someone to blame public authorities for
the diminution of his/her property value based on governmental
action. In cases where zoning and other regulations have
resulted in this decrease, people have wanted the government to
reimburse them for that loss. She offered her understanding
that pending legislation in the House addresses this topic. It
is an open question whether the labeling of a school could
result in liability for the state.
Number 2358
CHAIR DYSON inquired who in the Department of Law could advise
members [on this matter].
MS. COX replied that the Department of Law has two attorneys who
work full-time on EED matters; she expressed uncertainty about
whether these attorneys had yet explored this issue. She said
that they would be the people to whom she would turn [for
answers to these questions].
Number 2347
CHAIR DYSON said, "The question is: When the government has a
bunch of information and does not give it out, ... when do we
incur liability?"
MS. COX offered that part of this [liability question] would
depend on what is mandated by statute. If a statute requires
disclosure and that disclosure is not given, that makes a
difference. If the government accumulates information and there
is no requirement to give it out, then there is not necessarily
any liability incurred. Obviously, the government is required
by law to give public access to information; it does not
necessarily have a duty to disclose unless the legislature
requires it, she concluded.
Number 2320
MR. LEAL explained that status information is currently
published in the school report card. The disaggregated test
results are published for districts; EED is publishing the
information that it has. He clarified that growth will be used
to show a school's effectiveness; it is not being used to hide a
school's inadequacy. A school would need to have a certain
level of status and a certain element of growth to be considered
an adequate school, he stated. By the same token, a school
would be in crisis if it were "off the chart" in status; it
would take an unimaginable amount of growth to transcend the "in
crisis" designation, he said. He noted that this was discussed
in the [House Special Committee on Education hearing on HB 352].
Growth is not being used to mask something but to make something
fair, he concluded.
Number 2270
REPRESENTATIVE COGHILL referenced AS 14.03.120. He said this
mandates annual reporting to the legislature, the governor, and
the public; it also encourages students and parents to be
involved in that discussion. He offered his opinion that [HB
352] would not change that in any way, and that the public
discussion would remain at a high level.
Number 2255
REPRESENTATIVE WILSON asked how EED justifies using only one-
third for status scores for the school designation and using
two-thirds for growth scores. "Why isn't it reversed?" she
queried.
MR. LEAL answered that this is because status results are
strongly correlated with low socioeconomic status. Many times
schools in poorer areas have lower status scores; it isn't that
these students are unable to learn. He said the message [EED]
wants to send schools is that schools should take students where
they are, and add value to their education. He offered to work
on a more polished answer to this question; the consultants with
whom the SDS Committee is working have had success in other
states to focus the issue on helping all students grow, rather
than focusing on simply raising the average.
Number 2161
CHAIR DYSON turned attention to an amendment and asked if EED
concurred with it. [He received an off-microphone comment from
EED personnel indicating the department's concurrence and that
this amendment corrects a typographical error.] He said, "This
is the department's amendment. ... For the record, the
department approves of this and requests this?" [Department
personnel answered yes.]
REPRESENTATIVE WILSON moved to adopt Amendment 1, which read:
Page 2, line 11:
Delete "AS 14.23.123(f)"
Insert "AS 14.03.123(f)"
There being no objection, Amendment 1 was adopted.
Number 2062
CHAIR DYSON called an at-ease a 3:59 p.m. He called the meeting
back to order at 4:03 p.m.
CHAIR DYSON offered Amendment 2, which read:
Sec. 14.33.110. Purpose of school disciplinary and
safety program.
The purpose of AS 14.33.110 - 14.33.140 is to
(1) implement and maintain community-based
standards of school behavior that are developed by
students, parents, teachers, school administrators,
and the community;
(2) facilitate the creation of a standard of
school behavior and safety by local communities for
the schools in those communities;
(3) protect and support teachers who enforce
standards of student behavior and safety in the
classroom established under AS 14.33.120; and
(4) ensure that all schools and school districts
receiving state funds, that may not have already done
so, implement and maintain an effective school
disciplinary and safety program.
Sec. 14.33.120. School disciplinary and safety
program.
(a) Each governing body shall adopt a written
school disciplinary and safety program. The program
required under this subsection must include written
(1) standards for student behavior and safety
that reflect community standards and that include, at
a minimum, basic requirements for respect and honesty;
standards required under this paragraph must be
developed and periodically reviewed with the
collaboration of members of each school, parents,
teachers, and other persons responsible for the
students at a school; a governing body may require
that standards developed under this paragraph be
consistent for all schools in an attendance area or
the district; and
(2) standards relating to when a teacher is
authorized to remove a student from the classroom for
(A) failure to follow student behavior and safety
standards; or
(B) behavior described under AS 14.30.045 (1) or
(2);
(3) procedures for notifying teachers of dangerous
students consistent with AS 47.12.310(b);
(4) standards relating to when a teacher,
teacher's assistant, or other person responsible for
students is authorized to use reasonable and
appropriate force to maintain classroom safety and
discipline as described under AS 11.81.430(a)(2);
(5) policies necessary to comply with provisions
of state and federal law, including 20 U.S.C. 1400 -
1485 (Individuals with Disabilities Education Act);
(6) standards to address needs of students for
whom mental health or substance abuse may be a
contributing factor to noncompliance with the school
disciplinary and safety program;
(7) policies for implementing a student conflict
resolution strategy, including the nonviolent
resolution or mediation of conflicts and procedures
for reporting and resolving conflicts;
(8) procedures for periodic review and revision of
the school disciplinary and safety program.
(b) A school district shall report information
relating to school district disciplinary and safety
programs as required by the department, including
incidents of disruptive or violent behavior.
Sec. 14.33.130. Enforcement of approved program;
additional safety obligations.
(a) A teacher, a teacher's assistant, a principal,
or another person responsible for students may not be
terminated or otherwise subjected to formal
disciplinary action for lawful enforcement of an
approved school disciplinary and safety program,
including behavior standards, adopted under AS
14.33.120.
(b) A teacher, a teacher's assistant, a principal,
or another person responsible for students who
(1) receives information about a student under AS
47.12.310 (b) or receives information that may affect
the safety of students or staff shall notify the
student's teacher or a school administrator; and
(2) in the course of employment, observes a
student committing a crime shall report the crime to
the local law enforcement agency; in this paragraph,
"crime" has the meaning given in AS 11.81.900.
Sec. 14.33.140. Civil liability for enforcing
disciplinary and safety program.
A teacher, a teacher's assistant, a principal, or
another person responsible for students is not liable
for civil damage resulting from an act or omission (1)
arising out of enforcement of an approved school
disciplinary and safety program adopted under AS
14.33.120; and (2) arising out of and in the course of
employment unless the act or omission constitutes
gross negligence or reckless or intentional
misconduct.
------------------------------
Sec. 14.03.120. Education planning.
(a) A district shall annually file with the
department, and make available to the public, a report
that
(1) establishes district goals and priorities for
improving education in the district;
(2) establishes community based behavior
standards developed under 14.33.120
(3) [(2)] includes a plan for achieving district
goals and priorities and behavior standards; and
(4) [(3)] includes a means of measuring the
achievement of district goals and priorities and
behavior standards; and
(5) includes a plan for achieving broader
community and parent participation in the development
of goals, priorities, and behavior standards.
(b) The department shall summarize the reports
submitted under (a) of this section as a statewide
report, provide a copy to the governor, and notify the
legislature that the report is available.
(c) A district shall make efforts to encourage
students, parents, teachers, and other members of the
community to participate in the preparation of the
report submitted under (a) of this section.
(d) Annually, before the date set by the district
under (e) of this section, each public school shall
provide, in a public meeting of parents, students, and
community members, a report on the school's
performance and the performance of the school's
students. The report shall be prepared on a form
prescribed by the department and
must include
(1) information on accreditation;
(2) results of norm-referenced achievement tests;
(3) results of state standards-based assessments
in reading, writing, and mathematics;
(4) a description, including quantitative and
qualitative measures, of student, parent, community,
and business involvement in student learning and
maintenance of student behavior standards;
(5) a description of the school's attendance,
retention, dropout, and graduation rates, including
the number and percentage of students who received a
diploma under a waiver from the competency examination
required under AS 14.03.075 (a), as specified by the
state board;
(6) the annual percent of enrollment change,
regardless of reason, and the annual percent of
enrollment change due to student transfers into and
out of the school district;
(7) if Native language education is provided, a
summary and evaluation of the curriculum described in
AS 14.30.420; and
(8) the number and percentage of students in each
school who take and who successfully complete an
alternative assessment program in reading, English, or
mathematics; and the number and percentage of pupils
in each school who successfully complete the
alternative assessment program but who do not reach
the state performance standards at the competency exam
level in reading, English, or mathematics; a school
may not report results under this paragraph unless the
school complies with the family educational rights and
privacy requirements of 34 C.F.R. 99.
(e) By a date set by the district, each public
school in the district shall provide the report
described in (d) of this section to the district's
governing body. Along with the report, each public
school shall submit a summary of comments made on the
report by parents, students, and community members. By
July 1 of each year, beginning in 2000, each district
shall provide to the department a report on the
performance of each public school and the public
school students in the district. The district's
report must
(1) be entitled "School District Report Card to
the Public"; and
(2) include
(A) copies of the reports and summaries of
comments submitted under this section by each public
school in the district; and
(B) a compilation of the material described in (A)
of this paragraph by each public school in the
district.
(f) By January 15 of each year, beginning in 2001,
the department shall provide to the governor and make
available to the public and the legislature a report
on the performance of public schools in this state.
The report must be entitled "Alaska's Public Schools:
A Report Card to the Public." The report must include
(1) comprehensive information on each public
school compiled, collected, and reported under (d) and
(e) of this section for the prior school year;
(2) a summary of the information described in (1)
of this subsection; the summary must be prepared in a
manner that allows school performance to be measured
against established state education standards; and
(3) for a report due by or after January 15, 2003,
the performance designation under AS 14.03.123(b)
received by each public school during the prior school
year.
(g) In this section, "district" has the meaning
given in AS 14.17.990 .
Sec. 14.03.123. School accountability.
(a) Beginning in August [2002] 2004, and during
each of the following 12-month periods, the department
shall assign each public school in each district the
performance designation of distinguished, successful,
deficient, or in crisis based on multiple student
measures, including student achievement and parent and
community involvement. The state board of education
and early development shall establish this process by
regulation.
(b) A public school assigned a performance
designation of deficient or in crisis shall develop a
school improvement plan under (e) of this section. The
department shall inform the governing body of each
district of the performance designation assigned to
each public school in the district.
(c) The state board shall adopt regulations to
allow a district to appeal the performance designation
assigned to a public school in that district.
(d) The department may establish a program of
special recognition for those public schools that
achieve a distinguished performance designation.
(e) A public school that receives a designation of
deficient or in crisis shall prepare a school
improvement plan to improve student performance based
on a process established by the state board of
education and early development. The public school
shall undertake an improvement process under that plan
to lead to a designation of successful or
distinguished. The school improvement plan must be
prepared with the maximum feasible public
participation of the community, including, if
appropriate, interested individuals, teachers,
parents, parent organizations, students, tribal
organizations, local government representatives, and
other community groups. The district shall consult
with and assist the public school in the preparation
of the school improvement plan. The school
improvement plan must be approved by the local school
board. The commissioner may provide technical
assistance to a public school or the district at any
time during the preparation and implementation of the
school improvement plan on the request of an
interested person and the approval of the district.
(f) Beginning August 1, [2002] 2004, and
periodically during each of the following 12-month
periods, the department shall monitor the progress of
the implementation of each school improvement plan
prepared under (e) of this section.
(g) The department may use existing staff or
contract with one or more qualified persons to assist
a public school that is deficient or in crisis under
this section to improve student performance. Qualified
persons to provide assistance under this section
include educators, business leaders, members of the
governing body of that district, and community
leaders. The provisions of AS 36.30 do not apply to a
contract awarded under this subsection.
(h) Notwithstanding any other provisions in this
title, if the performance designation of a public
school has continued to be deficient or in crisis for
two consecutive school years, the chief school
administrator, if the district employs a chief school
administrator, the president of the governing body,
and the principal of the public school shall, at a
public meeting of the state board of education and
early development, present a written report on the
performance of that public school.
(i) The state board of education and early
development shall develop, by regulation, measures
that may be progressively implemented by the
commissioner to assist a public school to improve
student performance in accordance with this section.
(j) In this section, "district" has the meaning
given in AS 14.17.990.
[End of Amendment 2]
CHAIR DYSON suggested that someone object [for purposes of
discussion].
Number 2050
REPRESENTATIVE CISSNA objected.
CHAIR DYSON announced that it wasn't his intention to have a
vote on Amendment 2 at this hearing. He said he wants members
and [EED personnel] to review it and comment on it [at a later
date]. He said:
Here's what happened. A year or two ago, I got a bill
passed to require each school to go through some
process where they interacted with the community about
what were acceptable behavior standards ... for the
school. So, the community gets input on it - and
safety standards. What does the community want? ...
The second part of that bill said if a teacher
enforces the ... agreed-upon standards and uses the
agreed-upon procedure for enforcing ... the behavior
standards, the teacher can't be penalized - because
we've had some schools where ... powerful school board
members got teachers run out of town or [fired]. ...
What we found out is that we didn't have an adequate
enough ... way of recording and reporting which
schools actually went through the process. So what
I'm laying before you here ... strengthens that the
school has to report that they went through some
process to get community input and agreement on what
the standards are and establishes that as another part
of the criteria for rating schools.... This is ...
certainly in addition to what the bill that's before
us does. And it's curing an old and slight
problem.... So, I wanted to lay this before you so
you both can think about it before we vote on it, and
we can get a chance for input.
CHAIR DYSON acknowledged his uncertainty that Amendment 2 is the
best way to accomplish [the correcting of the aforementioned
problem]. He announced that this would be brought up, at the
earliest, at the March 4 meeting of the House Health, Education
and Social Services Standing Committee. [HB 352 was held over.]
Number 1926
CHAIR DYSON called an at-ease at 4:07 p.m. in order to prepare
for the overview regarding a separate agency for the blind.
[The minutes for the overview can be found under the 4:10 p.m.
minutes for this date. See tape 02-15.]
CHAIR DYSON reconvened the House Health, Education and Social
Services Standing Committee at 4:48 p.m. after an at-ease that
followed the overview.
HB 252-STANDARD OF CARE FOR CINA SERVICES
TAPE 02-16, SIDE A
Number 0001
[Technical difficulties precluded taping the first moments of
the reconvened hearing.]
CHAIR DYSON announced the next order of business, HOUSE BILL NO.
252, "An Act relating to the construction of certain statutes
relating to children; relating to the scope of duty and standard
of care for persons who provide services to certain children and
families; and providing for an effective date." Attention was
drawn to the unresolved issue of whether language in HB 252
creates a liability for the state.
[Taping begins at this point.]
REPRESENTATIVE COGHILL suggested the House Judiciary Standing
Committee (HJUD) should review the bill for this reason.
SUSAN COX, Chief Assistant Attorney General, Civil Division
(Juneau), Department of Law, said it would be fine with her.
Number 0042
REPRESENTATIVE COGHILL moved to adopt the proposed committee
substitute (CS) for HB 252, 22-LS0454\O, Lauterbach, 2/20/02.
There being no objection, Version O was adopted.
REPRESENTATIVE COGHILL moved to adopt Amendment 1, which read
[original punctuation provided]:
Page 6, Line 10:
Delete line 10 and insert:
*Sec. 9. AS 47.10.960 is amended to read:
Sec. 47.10.960. Civil liability [DUTY AND STANDARD OF
CARE] not created. Failure to comply with a provision
of this title or a regulation adopted under this title
is not a basis for civil liability, but may be the
basis for employee discipline or administrative action
authorized by law [NOTHING IN THIS TITLE CREATES A
DUTY OR STANDARD OF CARE FOR SERVICES TO CHILDREN AND
THEIR FAMILIES BEING SERVED UNDER AS 47.10].
REPRESENTATIVE COGHILL explained that this language was
suggested by the Department of Law. The department had
suggested two versions, and he'd selected the one he preferred.
He indicated a HJUD hearing would be requested.
There being no objection, Amendment 1 was adopted.
Number 0105
REPRESENTATIVE CISSNA moved to adopt Amendment 2, which read:
Page 2, lines 8-9:
Delete "available for the purpose"
Insert "identified by the department for the
specific purpose of intensive family preservation
services"
Page 3, lines 26-27:
Delete "the purpose, provide intensive family
preservation services on a statewide basis"
Insert "intensive family preservation services,
develop and implement intensive family preservation
services systematically and over time, with the
ultimate goal of providing intensive family
preservation services on a statewide basis."
Page 3, line 31:
Following "awarded", insert "or renewed"
Page 4, line 1-10:
Delete subsections (b) and (c)
Page 5, line 19:
Delete "persistently" and "but provided"
Page 5, lines 26-28:
Delete wording under (v) and replace with "are
provided on a time limited basis by a single
caseworker whose caseload is congruent with the
intensive family preservation services standards
established by the Child Welfare League of America.
Caseloads should be kept low to allow for the
necessary intense level of interaction with the
family. Services should be most intensive at the time
of a crisis."
CHAIR DYSON objected for purposes of discussion.
REPRESENTATIVE CISSNA noted her appreciation for the committee's
willingness to have this discussion. She explained that the
model [called for in Version O] is entirely different from the
one in place. The names sound the same - "family preservation"
and "intensive family preservation" - but the models are
distinctly different. Amendment 2 has six parts. She drew
attention to the first part of Amendment 2, pertaining to page
2, lines 8-9, of Version O. She explained that its purpose is
to ensure that people differentiate between intensive family
preservation services and other types of family preservation
services. She added, "It was told to me it was important to put
this in."
Number 0155
REPRESENTATIVE CISSNA explained that the second part of
Amendment 2 pertains to page 3, line 26-27. The rationale is to
allow the state to systematically put this program in place over
time. The third part of Amendment 2 changes page 3, line 31, of
Version O, "for obvious reasons." The fourth part of Amendment
2, addressing page 4, lines 1-10, streamlines language following
a discussion with the [Department of Health and Social
Services]. The fifth part of Amendment 2 pertains to page 5,
line 19, and is included because "persistently" was legally
troubling and "but provided" needed to be removed.
Number 0393
NATE MOHATT, Staff to Representative Sharon Cissna, Alaska State
Legislature, in response to some confusion, clarified that the
fifth part of Amendment 2 deletes both "persistently" and "but
provided". The amended language would read "offered at the
family's option".
Number 0465
REPRESENTATIVE CISSNA advised members that the sixth part of
Amendment 2, which addresses page 5, lines 26-28, Version O, is
included to bring in national standards.
CHAIR DYSON removed his objection. There being no objection,
Amendment 2 was adopted.
Number 0564
CHAIR DYSON turned attention to a draft fiscal note prepared by
Theresa Tanoury, Director, Division of Family and Youth
Services, Department of Health and Social Services. The fiscal
note included $80,000 for FY 03, and $50,000 for each FY 04 and
FY 05.
Number 0651
ELMER LINDSTROM, Deputy Commissioner, Department of Health and
Social Services, indicated the department could revise the
fiscal note by the morning of February 22. He stated that there
would be some language changes on page 2, related to the
appropriation language, to make the fiscal note consistent with
[Amendment 2]. The amount of the fiscal note will remain
unchanged, he offered.
CHAIR DYSON asked about passing the bill out with a draft fiscal
note pending the approved version.
Number 0651
MR. LINDSTROM replied that Chair Dyson would be given the fiscal
note by the morning of February 22.
CHAIR DYSON stated that he did not want to hold the bill up for
another week.
MR. LINDSTROM suggested language, "[A] fiscal note in the amount
of $80,000 to [be] prepared by the Department of Health and
Social Services and delivered to the committee by 10:00 a.m.
tomorrow."
Number 0668
REPRESENTATIVE COGHILL moved to report CSHB 252 [version 22-
LS0454\O, Lauterbach, 2/20/02, as amended] out of committee with
individual recommendations and the accompanying, pending fiscal
note.
CHAIR DYSON added, "And the understanding that we are asking for
a [House Judiciary Standing Committee] referral, correct?"
REPRESENTATIVE COGHILL replied, "Correct."
There being no objection, CSHB 252(HES) was reported out of the
House Health, Education and Social Services Standing Committee.
HB 367-MEDICAL ASSISTANCE PROGRAM COVERAGE
CHAIR DYSON announced that the committee would take testimony on
HOUSE BILL NO. 367, "An Act relating to coverage of children and
pregnant women under the medical assistance program; and
providing for an effective date."
[Although the hearing on HB 367 had been officially postponed,
Chair Dyson accommodated the following out-of-town witness by
allowing him to testify.]
Number 0754
CHRIS DEVLIN, Executive Director, Eastern Aleutian Tribes,
thanked Chair Dyson for the opportunity to testify. He stated
that HB 367's provision to lower the poverty level from 200
percent to 150 percent is a mistake. He characterized the 200-
percent level as a safety boat; the 150-percent level would
throw people overboard. This causes problems beyond the people
directly affected; he explained that a ripple effect occurs.
Eastern Aleutian Tribes is the first tribal health organization
in the state to apply for community health center funding. He
referenced health centers in Fairbanks and Anchorage. These
community health centers operate very close to the break-even
point; they need the Medicaid funding to continue to provide
service to those who "fall outside the boat," he said.
MR. DEVLIN encouraged members to involve community health
centers in the discussion of the bill, which will have a direct
impact on the centers' ability to provide care. He said, "If
you wanted to work on some creative measures to try to bring
some revenue in, maybe the place to consider would be between
the 200 and the 250 or the 200 and the 300 percent. That's
where some other states have set their target." He offered that
people with incomes of $35,000 to $40,000 are unable to afford
$1,000 a month for health insurance. He advised, "We have to be
very careful when we start lowering that safety net that was
provided, because ... they're going to end up costing the system
more in the long run."
Number 0854
CHAIR DYSON asked Mr. Devlin about his other work experience.
MR. DEVLIN said he had worked in Barrow and Bethel, but this is
his first job as the boss.
CHAIR DYSON asked about a pattern of children's health problems.
MR. DEVLIN replied that care for children is the logical place
to invest funds; keeping children healthy will pay off in the
future. Currently, oral health care is a big concern. He
stated that the children in the Aleutians region are "loaded
with cavities." Denali KidCare has allowed Eastern Aleutian
Tribes to send more people in for dental treatment. He said the
health issues with children are significant. He noted that
lower-middle-class and working poor people are not going to pay
for preventive health care; they will wait until the problem
becomes serious. He indicated Denali KidCare's passage made a
big change in getting more children in for care. He suggested
finding of a different way to save the little that would be
saved by lowering the eligibility percentage. It will cost the
state more in the long run, he concluded.
CHAIR DYSON inquired where children are sent for dental care.
MR. DEVLIN replied that they are sent to Anchorage with a
thousand-dollar airfare bill. He said the Aleutian region
probably has some of the highest airfares. In some instances
when preventative care is not given, the health problem results
in a Medivac, he reported. Adults in his region have been sent
recently via Medivac for dental purposes, which he pointed out
is extremely expensive. [End of testimony on HB 367.]
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:55 p.m.
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