Legislature(1993 - 1994)

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

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