Legislature(2007 - 2008)CAPITOL 106
04/17/2007 03:30 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR4 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HCR 1 | TELECONFERENCED | |
| + | SCR 4 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
April 17, 2007
3:37 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Bob Roses, Vice Chair
Representative Anna Fairclough
Representative Mark Neuman
Representative Paul Seaton
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE CONCURRENT RESOLUTION NO. 4
Relating to public health and a health compact.
-HEARD AND HELD
HOUSE CONCURRENT RESOLUTION NO. 1
Relating to public health and a health compact.
-SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: SCR 4
SHORT TITLE: PUBLIC HEALTH AND HEALTH COMPACT
SPONSOR(s): HEALTH, EDUCATION & SOCIAL SERVICES
02/21/07 (S) READ THE FIRST TIME - REFERRALS
02/21/07 (S) HES
03/19/07 (S) HES AT 1:30 PM BUTROVICH 205
03/19/07 (S) Moved CSSCR 4(HES) Out of Committee
03/19/07 (S) MINUTE(HES)
03/21/07 (S) HES RPT CS 4DP 1NR SAME TITLE
03/21/07 (S) DP: DAVIS, ELTON, THOMAS, DYSON
03/21/07 (S) NR: COWDERY
03/28/07 (S) BEFORE THE SENATE IN FINAL PASSAGE
03/28/07 (S) TRANSMITTED TO (H)
03/28/07 (S) VERSION: CSSCR 4(HES)
03/29/07 (H) READ THE FIRST TIME - REFERRALS
03/29/07 (H) HES
04/17/07 (H) HES AT 3:30 PM CAPITOL 106
WITNESS REGISTER
DON BURRELL JR., Staff
to Senator Bettye Davis
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SCR 4, on behalf of Senator
Davis, Chair of the Senate Health, Education and Social Services
Committee, sponsor.
REPRESENTATIVE SHARON CISSNA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on SCR 4, as
the sponsor of the companion resolution, HCR 1.
KARLEEN JACKSON, Commissioner
Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of SCR 4.
BONNIE MURPHY, Fitness Professional
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SCR4.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:37:42 PM.
Representatives Seaton, Fairclough, Gardner, Neuman, Roses,
Cissna, and Wilson were present at the call to order.
SCR 4-PUBLIC HEALTH AND HEALTH COMPACT
[Contains discussion of HCR 1.]
3:38:24 PM
CHAIR WILSON announced that the only order of business would be
SENATE CONCURRENT RESOLUTION NO. 4, Relating to public health
and a health compact.
3:39:34 PM
DON BURRELL JR., Staff to Senator Bettye Davis, Alaska State
Legislature, introduced SCR 4 by paraphrasing from the sponsor
statement, which read as follows [original punctuation
provided]:
The Health Compact encourages all Alaskans to:
-Make healthy choices
-Promote their own health and well being
-Share their experiences and ideas on better
health with one another
Alaska faces a multilayered health crisis of growing
proportion. An aging population is growing at a time
when the ranks of our physicians are shrinking. The
cost of medical care continues to rise as the number
of uninsured Alaskans grows.
The Legislature will continue to work to assist in
achieving better health for every man, woman, and
child in the state. Yet there are things that we as
individual Alaskans can do to improve our own health,
thereby minimizing our impact on the health care
system. We put forth as a small step, this simple
tool to help Alaskans help themselves.
The resolution also dedicates the remainder of the
year 2007 as a time to join the Compact, and dedicates
2008 as a year for sharing ideas and taking action.
The cost is free but the rewards are priceless.
3:41:14 PM
REPRESENTATIVE SHARON CISSNA, Alaska State Legislature, spoke to
SCR4 as the sponsor of HCR1. She stated that, through her
experience as a member of this committee and of the Health &
Social Services Finance Subcommittee, she has learned that
health problems are huge and resources are diminishing.
Furthermore, research has shown that most health problems are
caused by personal choices. She explained how difficult it is
for people to change habits and that changes come with the
support of other people. Representative Cissna said that SCR1
is an invitation, from the governor and the legislature, to
Alaskans encouraging them to make changes for better health by
celebrating their personal health with each other. She
expressed her hope that profound changes often come from simple
things; this simple act, to invite people to celebrate and talk
about better health, will influence others to make healthful
choices as well.
3:44:11 PM
REPRESENTATIVE GARDNER asked which state ranks first in the
nation in per capita public health costs. She also questioned
the statement that Alaska ranks poorly in rates of obesity and
lack of physical activity.
REPRESENTATIVE CISSNA said that she did not remember the state
that ranked first. In answer to the second question, her
national research indicated that Alaska's rate of obesity is
steadily increasing. Some of this increase is linked to rural
areas where watching television, sedentary living, and poor
nutrition are becoming more of a habit.
3:46:08 PM
REPRESENTATIVE ROSES stated that if the intent of the resolution
is to create the Alaska health pact, so information can be
shared for long term benefits, the "whereas" that talk about the
state's current response to issues are unnecessary. Issues such
as the state's rank and the number of uninsured residents are
not related to the sharing of information about heart disease
and diabetes. Representative Roses explained his concern that
these statements identify areas where the state may be deemed
deficient in what is provided to its residents. He referred to
a current inadequacy lawsuit against the state for not
sufficiently funding education. He suggested that these
statements will provide grounds for social service and health
care agencies to sue.
REPRESENTATIVE CISSNA replied that all of these statements are
public information and have already been published.
Furthermore, each statement is necessary to address the varied
goals. She pointed out that the language section is part of the
resolution because of the need to effectively communicate with
non English speaking residents to help them change their habits.
This is one of the important parts of the resolution; that
people who speak a common language and are part one's culture
will help one to understand and achieve goals. She concluded by
saying that the intent is to encourage everyday conversation to
include good health and supporting each other's good health
through relationships. Making health a conversation point will
result in richer friendships and closer relationships.
3:51:48 PM
REPRESENTATIVE ROSES agreed. However, he questioned how it will
diminish the intent of this resolution to remove the statement
regarding the rising demand for financing of costly treatment.
He asked, "How does that change my ability to go to a group and
talk about diabetes, or heart disease, or smoking, or alcohol
abuse, or mental illness, or any of the other concerns we have
around the health care?" He explained that it is the financial
obligation and financial diminishment addressed in the
resolution that is causing his concern. Outlining all of the
financial costs that the state is obligated to may lead to
serious problems if this resolution is passed and then
appropriations to address these problems are not passed.
3:53:55 PM
REPRESENTATIVE CISSNA acknowledged that the last two paragraphs
may have been sufficient for the resolution. However, she said
that she felt that the enormity of the problem, and the
possibility of a simple fix, is compelling to others.
3:55:14 PM
REPRESENTATIVE NEUMAN expressed concerns similar to those of
Representative Roses. He then recognized Representative Cissna
for her work on health care issues over the years. He opined
that several items in the resolution seem to be negative and
there needs to be some balance.
3:56:38 PM
KARLEEN JACKSON, Commissioner, Department of Health and Social
Services, informed the committee that the concept of this
resolution is important to the people of Alaska. She agreed
with some of the reservations raised by Representatives Roses
and Neuman and she noted that the resolution lacks a statement
that good health is a common goal for all of the people of our
state. Commissioner Jackson suggested that with a simple
statement: "Whereas experts point to personal lifestyle choices
as having a significant impact on a person's health" the
resolution can avoid listing statistics. She agreed that there
must be footnotes to support each statement and suggested
keeping the statements on a broad, conceptual level.
Commissioner Jackson repeated her support for promoting the
health of Alaskans through talking about what each is doing to
be healthy.
3:58:46 PM
REPRESENTATIVE FAIRCLOUGH asked whether there has been time to
organize events and declare 2008 a year of good health. She
observed that this is polar year and next year Alaska will be
celebrating its 50th birthday. She suggested that if the
sponsors want to designate a year of health, events with
municipalities, cities, and nonprofit partners may be needed to
develop broad support for the resolution. She encouraged the
sponsors to consider many options for activities and to allow
time for planning statewide events.
4:01:25 PM
REPRESENTATIVE CISSNA relayed her experience as an activist
during the 60s and 70s, which was a time of minimal government
[support] and grant opportunities. She pointed out that the
resolution is an invitation given by the governor, without a
fiscal note attached, or the complications that follow the costs
of a big event. She cautioned that events require coordinators
and expense. She expressed her belief that changing culture
will not come from the state spending money, but from people
willingly making a choice.
4:03:39 PM
REPRESENTATIVE FAIRCLOUGH clarified that if a year is dedicated
there should be some coordination; she was not suggesting
requesting money or grants. More planning time may result in
more interest and more participation by Alaskans.
4:04:42 PM
REPRESENTATIVE CISSNA stated that this resolution does not have
a specified date or time. The senate sponsor may have had a
date in her statement but it does not appear in the resolution.
4:05:26 PM
CHAIR WILSON referred to the governor's Health Care Strategies
Council and asked Commissioner Jackson whether recommendations
from that event will pertain to this resolution.
COMMISSIONER JACKSON answered that the Health Care Strategies
Council is charged with looking at plans that are available in
the state and what can be recommended to the legislature for the
short and long term that will balance quality, access, and cost
of health care. She advised that this resolution could be
passed without fanfare or a time line, as an encouraging
statement; or it could be expanded to be part of the Health Care
Strategies Council agenda to promote health for a year.
4:07:04 PM
REPRESENTATIVE NEUMAN asked the commissioner to comment on
whether this resolution could bring the state into a lawsuit to
try and force increased funding of health and social services.
COMMISSIONER JACKSON stated that she is not an attorney, but
opined that unintended consequences can occur in a litigious
environment. She recommended framing the resolution in a manner
to prevent possible litigation.
4:08:00 PM
REPRESENTATIVE ROSES expressed his agreement with the intent of
the resolution: to encourage conversation. He re-stated his
objection to the statistics presented in the "whereas"
statements. He opined that using the statistics does not
encourage conversation or create the health pact. Furthermore,
if he supports the resolution, his constituents may question why
there are not appropriations to do what is needed. The
statistical references will not allow him to support the
resolution as written.
4:11:10 PM
REPRESENTATIVE SEATON agreed with Representative Roses and
Representative Neuman on the wording of the legislation.
Additionally, he encouraged further re-writing of the "resolved"
and "further resolved" section.
4:12:42 PM
CHAIR WILSON announced that the resolution would be held with
the intent of improving the language. She encouraged committee
members to contribute suggestions so SCR4 can be moved at a
future meeting.
4:13:34 PM
BONNIE MURPHY, Fitness Professional, said that, in her
experience with mature women, speaking about their health in a
positive way would be helpful. She said that she supports
talking about preventive measures before one's health declines.
4:15:55 PM
CHAIR WILSON closed public testimony.
4:16:08 PM
REPRESENTATIVE ROSES asked where to send his suggestions for a
committee substitute.
CHAIR WILSON asked to have them come to her office as well as to
the bill sponsors.
4:16:46 PM
REPRESENTATIVE FAIRCLOUGH asked for copies of the changes to the
language suggested by Commissioner Jackson, Representative
Roses, and Representative Seaton.
[SCR 4 was held over for further discussion]
4:17:18 PM
CHAIR WILSON announced that the April 26, 2007, and April 28,
2007, meetings are cancelled and that the committee will hear
further discussion on SCR 4 during the meeting of May 1, 2007.
She requested that, within the next two weeks, committee members
generate health care improvement ideas for consideration during
the next session. Chair Wilson suggested that one problem the
committee can address is that of doctors who are not taking
Medicare or Medicaid patients. Two other issues are: support
for pharmacists in small towns and transparency in hospital
billings. She charged members to work on bills, during the
interim, in order to make progress toward improving the health
care situation across the state.
4:22:21 PM
REPRESENTATIVE NEUMAN stated that he has asked his doctors what
the legislature could do to help them, and what their opinions
are on health care in Alaska.
CHAIR WILSON added that, during the interim, key people may be
invited to address this committee.
4:23:43 PM
REPRESENTATIVE ROSES asked whether the committee is duplicating
the work of the governor's Health Care Strategies Planning
Council.
4:24:06 PM
REPRESENTATIVE CISSNA stated that she would like to review the
recommendations from last year's interim work on using health
care dollars wisely.
4:24:34 PM
REPRESENTATIVE FAIRCLOUGH observed that members of the Health
Care Strategies Planning Council may want to address this
committee. She noted that a task force needs legislative
support to make progress. She expressed her interest in seeing
SCR4 re-worked and made successful.
4:26:33 PM
REPRESENTATIVE SEATON recalled past interim meetings and the
task force. He said that he would like this to be a process
that does not sit on a shelf. The suggestions from the interim
committee's meeting with Commissioner Jackson and DHSS can be
brought back as a starting point for further study.
CHAIR WILSON said that she will provide new copies of those
suggestions.
REPRESENTATIVE FAIRCLOUGH asked whether there are health
indicators or a data base to use as a starting point. The
committee can then measure the success of its accomplishments.
4:28:15 PM
CHAIR WILSON noted that the recommendations developed during the
interim contain a section that identified the source of the
information gathered by the committee.
4:29:09 PM
REPRESENTATIVE ROSES stated that he had attended a National
Conference of State Legislatures (NCSL) conference on health
care, and that the NCSL has a wealth of information from other
states on this topic. Other states have made major changes in
their health care programs; the most important are best practice
issues including: downsizing hospitals and encouraging people
to go to regional clinics and the establishment of strict
protocols to eliminate unnecessary testing. He suggested that
NCSL staff be invited to speak with the committee and provide
data that would be helpful to Alaska. Representative Roses said
that he spoke to a physician who was responsible for saving
millions of dollars for the state of Utah; this physician may be
available for a consultation. He said that he attended the
conference with Senator Thomas and they will be sharing
information with the governor, Commissioner Jackson, and the
Health Care Strategies Planning Council. He recommended
replicating or modifying what has been successful in other
states.
4:34:11 PM
REPRESENTATIVE NEUMAN suggested that the committee obtain
research on past legislation, that is similar to SCR4, to see
whether there has been a positive effect on health.
4:34:53 PM
REPRESENTATIVE CISSNA opined that that type of analysis needs to
begin at the implementation of the legislation. She supported
the idea of requiring assessments of any legislation that is
passed. She reminded the committee that the Anchorage Health
Summit will bring speakers from the NCSL to participate; she
suggested that the committee attend as many local conferences as
possible.
4:36:41 PM
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:36 p.m.
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