Legislature(1995 - 1996)

03/28/1995 02:09 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
           HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                         
                       STANDING COMMITTEE                                      
                         March 28, 1995                                        
                           2:09 p.m.                                           
 MEMBERS PRESENT                                                               
 Representative Cynthia Toohey, Co-Chair                                       
 Representative Con Bunde, Co-Chair                                            
 Representative Al Vezey                                                       
 Representative Gary Davis                                                     
 Representative Norman Rokeberg                                                
 Representative Caren Robinson                                                 
 Representative Tom Brice                                                      
 MEMBERS ABSENT                                                                
 COMMITTEE CALENDAR                                                            
 * HB 214:  "An Act relating to the maintenance by health care                 
            providers of medical records in an electronic format."             
            PASSED OUT OF COMMITTEE                                            
 * HB 274:  "An Act relating to the state's tuberculosis control               
            program, including provisions for certain penalties; and           
            providing for an effective date."                                  
            PASSED OUT OF COMMITTEE                                            
   HB 226:  "An Act permitting the provision of different retirement           
            and health benefits to employees based on marital                  
            HEARD AND HELD                                                     
 (* First public hearing)                                                      
 WITNESS REGISTER                                                              
 GARY PESKA, Representative                                                    
 Alaska State Hospital and Nursing Home Association                            
 P.O. Box 240185                                                               
 Douglas, AK  99824                                                            
 Telephone:  (907) 586-1790                                                    
 POSITION STATEMENT:  Testified in support of HB 214.                          
 CHAR THOMPSON, President                                                      
 Alaska Health Information Management Association                              
 HC01, Box 6201-AB                                                             
 Palmer, AK  99645                                                             
 Telephone:  (907) 762-0273                                                    
 POSITION STATEMENT:  Testified in support of HB 214.                          
 ELMER LINDSTROM, Special Assistant to Commissioner Perdue                     
 Department of Health and Social Services                                      
 Alaska Office Building                                                        
 350 Main Street, Room 229                                                     
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-3030                                                    
 POSITION STATEMENT:  Testified in support of HB 214.                          
 DR. PETER NAKAMURA, Director                                                  
 Division of Public Health                                                     
 Department of Health and Social Services                                      
 350 Main Street, Room 403                                                     
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-3090                                                    
 POSITION STATEMENT:  Testified in support of HB 274.                          
 KRISTEN BOMENGEN, Assistant Attorney General                                  
 Criminal Division                                                             
 Department of Law                                                             
 Room 200, Fuller Building                                                     
 4th and Harris                                                                
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-3600                                                    
 POSITION STATEMENT: Testified on HB 274.                                      
 REPRESENTATIVE PETE KELLY                                                     
 Room 513, State Capitol                                                       
 Juneau, AK  99801                                                             
 Telephone:  (907) 465-2327                                                    
 POSITION STATEMENT: Presented sponsor statement for HB 226.                   
 MILDRED BOESSER, Representative                                               
 Parents, Families and Friends of Lesbians and Gays                            
 City and Borough of Juneau Human Rights Commission                            
 17585 Lena Loop                                                               
 Juneau, AK  99801                                                             
 Telephone:  (907) 789-1445                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 MARGARET BERCK, Attorney                                                      
 American Civil Liberties Union                                                
 227 7th Street                                                                
 Juneau, AK  99801                                                             
 Telephone:  (907) 586-3309                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 TALMADGE W. BAILEY, Board Member                                              
 Southeast Alaska Gay and Lesbian Alliance                                     
 P.O. Box 34542                                                                
 Juneau, AK 99803                                                              
 Telephone:  (907) 790-2519                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 MARK TUMEO, Professor                                                         
 University of Alaska Fairbanks                                                
 1324 Summit Drive                                                             
 Fairbanks, AK  99712                                                          
 Telephone:  (907) 474-6090                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 SARAH BOESSER, Board Member                                                   
 Committee for Equality                                                        
 P.O. Box 34542                                                                
 Juneau, AK  99803                                                             
 Telephone:  (907) 789-9604                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 DANIEL COLLISON, Vice President                                               
 Southeast Alaska Gay and Lesbian Association                                  
 P.O. Box 21466                                                                
 Juneau, AK  99802                                                             
 Telephone:  (907) 789-5001                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 JOHN GAGUINE, Assistant Attorney General                                      
 Governmental Affairs Section, Civil Division                                  
 Department of Law                                                             
 P.O. Box 110300                                                               
 Juneau, AK  99811                                                             
 Telephone:  (907) 465-2127                                                    
 POSITION STATEMENT:  Testified on HB 226.                                     
 MARYLOU BURTON, Director                                                      
   of Statewide Budget                                                         
 University of Alaska                                                          
 Juneau, AK  99801                                                             
 Telephone:  (907) 463-3086                                                    
 POSITION STATEMENT:  Testified in support of HB 226.                          
 MARY GRAHAM, Interested Citizen                                               
 235 5th Street, Number 2                                                      
 Juneau, AK  99801                                                             
 Telephone:  (907) 586-4938                                                    
 POSITION STATEMENT:  Testified against HB 226.                                
 PREVIOUS ACTION                                                               
 BILL:  HB 214                                                               
 SPONSOR(S): REPRESENTATIVE(S) G.DAVIS                                         
 JRN-DATE     JRN-PG                  ACTION                                   
 03/01/95       530    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 03/01/95       530    (H)   HEALTH, EDUCATION & SOCIAL SERVICES               
 03/28/95              (H)   HES AT 02:00 PM CAPITOL 106                       
 BILL:  HB 274                                                               
 SHORT TITLE: TUBERCULOSIS CONTROL                                             
 SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR                                  
 JRN-DATE     JRN-PG                  ACTION                                   
 03/22/95       852    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 03/22/95       853    (H)   HES, JUDICIARY                                    
 03/22/95       853    (H)   4 ZERO FNS (2-ADM, LAW, DHSS) 3/22/95             
 03/22/95       853    (H)   GOVERNOR'S TRANSMITTAL LETTER                     
 03/28/95              (H)   HES AT 02:00 PM CAPITOL 106                       
 BILL:  HB 226                                                               
 SPONSOR(S): REPRESENTATIVE(S) KELLY, Rokeberg                                 
 JRN-DATE     JRN-PG                  ACTION                                   
 03/03/95       565    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 03/03/95       565    (H)   STATE AFFAIRS, HES, JUDICIARY                     
 03/18/95              (H)   STA AT 10:00 AM CAPITOL 102                       
 03/18/95              (H)   MINUTE(STA)                                       
 03/20/95       808    (H)   STA RPT 4DP 1AM                                   
 03/20/95       808    (H)   DP: JAMES, PORTER, GREEN, IVAN                    
 03/20/95       808    (H)   AM: ROBINSON                                      
 03/20/95       808    (H)   ZERO FISCAL NOTE (ADMIN/ALL DEPTS)                
 03/20/95       808    (H)   REFERRED TO HES                                   
 03/28/95              (H)   HES AT 02:00 PM CAPITOL 106                       
 ACTION NARRATIVE                                                              
 TAPE 95-28, SIDE A                                                            
 Number 000                                                                    
 CO-CHAIR CYNTHIA TOOHEY called the meeting of the House Health,               
 Education and Social Services Standing Committee to order at 2:09             
 p.m.  Present at the call to order were Representatives Davis,                
 Bunde, Toohey and Robinson.  She announced a quorum was present to            
 conduct business, and read the order of the bills to be heard.  At            
 2:10 p.m. Representative Rokeberg joined the meeting.                         
 HB 214:  MEDICAL RECORDS IN ELECTRONIC FORM                                 
 Number 087                                                                    
 REPRESENTATIVE GARY DAVIS, sponsor of the bill, said HB 214 will              
 clarify that electronically stored medical records on computer                
 terminals are legally acceptable in lieu of records on paper.                 
 Hospitals and nursing homes are moving toward paperless offices in            
 an effort to promote efficiency.  However, some providers are                 
 hesitant to implement the electronic retention and maintenance of             
 medical records without a hard copy back up, due to the lack of               
 explicit legal authority.                                                     
 REPRESENTATIVE DAVIS continued that the current statute relating to           
 medical records neither prohibits nor permits them to be kept                 
 electronically.  A legal memorandum from Legislative Legal Services           
 indicative of health care providers concerned the ability to                  
 maintain medical records which is not clearly defined in statute or           
 REPRESENTATIVE DAVIS said HB 214 would lend clarity to the medical            
 records statute.  The current statute just says medical records               
 will be kept.  That could be interpreted to mean records can be               
 kept electronically or the old-fashioned way, on paper.  Some                 
 institutions are hesitant to utilize the new and expanding                    
 technology of computer storage.                                               
 REPRESENTATIVE DAVIS said this bill makes it legal and clarifies              
 the statute.  This is not a mandate, it only says records may be              
 stored in this manner should the institution decide to do so.                 
 Number 236                                                                    
 CO-CHAIR CON BUNDE assumed where the bill says, "maintain and                 
 preserve," it means all facilities for backup will be available.              
 This is in case the system crashes.  In such a case, information              
 will still be available somehow.                                              
 REPRESENTATIVE DAVIS said the whole system would be in place to               
 protect confidentiality through computer access.  In addition,                
 backup, the current required length of time to maintain records,              
 and security will all be included.                                            
 CO-CHAIR BUNDE said he has heard stories about hackers who                    
 challenge systems because they are there.  Co-Chair Bunde assumes             
 these systems would not be on-line and, therefore, accessible to              
 hackers.  He asked if Representative Davis had an idea about how              
 systems might be designed to thwart hackers.                                  
 REPRESENTATIVE DAVIS said discussions he has had in that regard               
 relate to various methods of maintaining confidentiality.  There              
 are different ways to access records.  There is fingerprint                   
 identification access and other types of technology available.  It            
 is the understanding of Representative Davis that since this is               
 such a critical area in which to maintain security, the regulations           
 would mandate the highest form of security available.                         
 REPRESENTATIVE TOM BRICE joined the meeting at 2:12 p.m., and                 
 applauded the bill.                                                           
 Number 411                                                                    
 REPRESENTATIVE NORMAN ROKEBERG asked if the provision for mandating           
 tape backups and copies of data would be perhaps micromanagment.              
 Representative Rokeberg asked if Representative Davis would be                
 willing to consider that possibility.                                         
 REPRESENTATIVE DAVIS thought existing regulations concerning how a            
 hospital or nursing home keeps records are already stringent.  The            
 paperwork done now would simply be done electronically.  This would           
 include backup and all the other proper requirements.  There are              
 those who are testifying on this bill who could properly address              
 those questions.                                                              
 CO-CHAIR BUNDE spoke to clarify his own understanding.  Nothing in            
 this bill would absolve the medical industry from the current                 
 provisions for guaranteeing privacy.                                          
 REPRESENTATIVE DAVIS said that is the intent of this bill.                    
 CO-CHAIR BUNDE asked if it would be the responsibility of the                 
 hospital to design a system that is safe and private to insure                
 REPRESENTATIVE DAVIS reiterated that is the intent of this bill.              
 Number 530                                                                    
 REPRESENTATIVE BRICE said he believes that considering the                    
 advancements that take place in computer technology, to put into              
 statute specifically how this storage will be accomplished as far             
 as backup information would be inefficient.  Any such provisions              
 would be outdated very quickly.  Considering the speed of                     
 technology development, it is probably best to leave well enough              
 alone and understand that general computer practices dictate                  
 confidentiality to begin with.                                                
 Number 598                                                                    
 GARY PESKA, Representative, Alaska State Hospital and Nursing Home            
 Association (ASHNHA), said his organization supports HB 214 for all           
 the reasons stated by Representative Davis in his sponsor                     
 statement.  Mr. Peska offered to answer any questions HESS                    
 Committee members may have.                                                   
 Number 630                                                                    
 CHAR THOMPSON, President, Alaska Health Information Management                
 Association, which was previously known as the Alaska Medical                 
 Records Association, said the AKHIMA totally supports HB 214.  Ms.            
 Thompson has provided written testimony in support of this                    
 legislation, and has listed some of the reasons her association               
 considers this legislation to be necessary.                                   
 MS. THOMPSON said computer-based patient records are being used               
 throughout the country to improve the quality of patient care and             
 to improve the documentation of patient care.  It is necessary to             
 provide the legal authority in this state to allow health care                
 providers to maintain and preserve the medical records in an                  
 electronic format.  However, currently, as Representative Davis               
 noted, there is some confusion about whether or not it is legal to            
 maintain records in an electronic format without also maintaining             
 paper-based records also.                                                     
 MS. THOMPSON said computer-based records are essential to                     
 supporting the clinical decision-making process in patient care.              
 Maintaining information in an electronic format will allow health             
 care providers quicker access to essential information when a                 
 patient walks into the door of a medical facility.                            
 Number 724                                                                    
 MS. THOMPSON was sure all HESS Committee members were aware of the            
 scenario of a patient coming into the emergency room and their                
 records are not available for five minutes to 30 minutes.                     
 Meanwhile, the medical personnel must treat that patient without              
 knowing, for example, that they are diabetic or have special                  
 medical conditions that need attention.                                       
 MS. THOMPSON said relying on paper-based records means personnel              
 must wait for the records to arrive in the emergency room, or there           
 must be a reliable way to store the records in the facility, or the           
 patient must be aware enough to provide their medical history.                
 There are times, perhaps, when care suffers because the records are           
 not available.  Also, paper-based records rely on prompt filing of            
 diagnostic tests.  There are different case scenarios where                   
 diagnostic tests are not filed promptly, and physicians have to               
 reorder a lab test to get the results he or she needs.                        
 MS. THOMPSON continued that electronic patient records allow health           
 care providers to utilize clinical management computer systems                
 which will automatically alert them if there are any drug allergies           
 when they prescribe a medication.  That will lead them to a new               
 method of treatment.  To utilize those clinical management                    
 programs, the patient's medical history must be input into the                
 Number 822                                                                    
 MS. THOMPSON added currently, health information management                   
 professionals are required to print out all information for                   
 computers and have the health care providers sign that form in                
 order to file it in the paper-based medical records.  This is a               
 very time consuming and expensive process which does nothing to add           
 to the quality of patient care or add to the quality of the                   
 MS. THOMPSON said proponents of health care reform stress it is               
 imperative to reduce health care costs.  Instead, when confined to            
 using electronic records and then also printing the reports, having           
 them signed and then filed, costs are added.                                  
 MS. THOMPSON said there is also an increasing move toward                     
 communication between health care systems.  One patient may go from           
 a hospital to a clinic to a nursing home.  Each of those facilities           
 and health care providers keep their own paper-based records.  As             
 patients move between health care systems, electronic patient                 
 records will facilitate the continuity of medical care throughout             
 each provider.  This will be without the necessity of duplicating             
 assessments, diagnostic tests and medical records in each facility.           
 This will be by allowing the transfer of electronic patient                   
 information with the patient.                                                 
 Number 918                                                                    
 MS. THOMPSON noted that all of this can only come about in an                 
 efficient and effective way if the need to also maintain a paper-             
 based medical record system can be eliminated.  There were concerns           
 expressed earlier by Co-Chair Bunde regarding the security and the            
 access of those records.  Ms. Thompson assured him she was very               
 concerned about this also.  Not only is she a proponent for                   
 electronic patient records, but she is also probably the best                 
 advocate for patient confidentiality.  Her organization has worked            
 with the Department of Health and Social Services (DHSS), Health              
 Facility Licensing and Certification Division, to develop                     
 regulations for electronic medical records.  These regulations are            
 in draft format currently.                                                    
 MS. THOMPSON said these draft regulations will allow for patient              
 information to be maintained in electronic format and provide                 
 adequate security and backup to ensure the proper retention of                
 medical record data.  There will also be provisions regarding                 
 confidentiality of patient information.  Draft regulations have               
 been developed which address essential issues relating to authentic           
 identification, confidentiality, access, retention and security.              
 Ms. Thompson agrees, however, that these provisions should not be             
 in statute.  As things change in the electronic industry, new                 
 technology and programs become available.  She said she would like            
 the ability to update regulations to reflect the current                      
 technology.  It is much easier to update regulations than statutes.           
 Number 1019                                                                   
 CO-CHAIR TOOHEY said Ms. Thompson covered that very well.  Co-Chair           
 Toohey, who is not a computer wizard, said it is a little                     
 frightening to think medical records are going to be possibly lost            
 in cyberspace.  However, Ms. Thompson has allayed those fears.                
 MS. THOMPSON said one of the recommendations that has been made is            
 for backup to be maintained off-site.  This is in case there is an            
 internal disaster.  In such a case, a backup copy will be available           
 off-site.  One of the things that it will also do is provide more             
 security than is currently available.  Currently, if a medical                
 record is lost due to a fire or other disaster in the hospital,               
 there is no way of retrieving that medical record.                            
 Number 1059                                                                   
 CO-CHAIR TOOHEY asked if back-up material was currently kept in a             
 fire-proof container at the hospitals.                                        
 MS. THOMPSON did not exactly remember the exact regulations, but              
 felt that was the normal procedure for a health information                   
 management organization services.                                             
 Number 1096                                                                   
 ELMER LINDSTROM, Special Assistant to Commissioner Perdue, DHSS,              
 said the department has reviewed HB 214 and believes that allowing            
 health care providers to maintain medical records in an electronic            
 format is desirable for a number of reasons.  The department has              
 noted that increasingly, health care providers are maintaining                
 patient records, billing information and other medical records in             
 automated systems.                                                            
 MR. LINDSTROM said the electronic format allows for increased                 
 productivity in updating and maintaining the records, and it also             
 allows for multiple-site access to medical records.  This has                 
 applications to tele-medicine.  For those reasons, the DHSS feels             
 this is a desirable development.                                              
 MR. LINDSTROM said the DHSS will be charged under the bill with               
 developing regulations to implement the potential law.  The DHSS              
 would be addressing the issues that have previously come up which             
 relate to patient informed consent and records in that area, some             
 federal records requirements, record keeping for vaccines, and so             
 forth.  However, the DHSS is confident these regulations can be               
 promulgated to everyone's satisfaction.  The DHSS appreciates the             
 flexibility to take that approach.                                            
 Number 1163                                                                   
 REPRESENTATIVE DAVIS said the development and cost of developing              
 regulations is a big concern to everyone.   The state watches every           
 fiscal note that comes along.  He noted that Char Thompson has some           
 draft regulations available, and asked if those could be used on a            
 professional consulting basis.  Representative Davis asked Mr.                
 Lindstrom if he saw those draft regulations as expediting the DHSS            
 process of promulgating regulations.                                          
 MR. LINDSTROM said the DHSS did submit a zero fiscal note for this            
 bill.  There are costs associated with developing regulations, but            
 those can be accommodated with the existing budget.  The DHSS will,           
 of course, take advantage of every resource in the community.  The            
 resources of the association and others will be most helpful as the           
 DHSS drafts its regulations.                                                  
 CO-CHAIR TOOHEY closed the meeting to public testimony and asked              
 for the wish of the committee.  She also announced that                       
 Representative Vezey had joined the meeting at 2:30 p.m.                      
 Number 1210                                                                   
 CO-CHAIR BUNDE made a motion to move HB 214 from committee with               
 accompanying fiscal notes and individual recommendations.  Hearing            
 no objection, the bill passed from committee.                                 
 HB 274:  TUBERCULOSIS CONTROL                                               
 Number 1279                                                                   
 CO-CHAIR TOOHEY indicated HB 274 was sponsored by the Rules                   
 Committee by request of the Governor's Office.                                
 DR. PETER NAKAMURA, Director, Division of Public Health, DHSS, said           
 he was very happy to present HB 274.  Tuberculosis (TB) is a                  
 recurring problem, and has been receiving increased attention.  In            
 addressing the most recent outbreak of TB in this state, the DHSS             
 encountered a number of issues that led it back to the original               
 statutes on TB.  Those statutes were found to be inadequate and in            
 need of revision.  One of the major issues that needed to be                  
 revised was to assure that as the isolation of recalcitrant                   
 patients is addressed, due process is not overlooked.  It is                  
 important patients' rights are adhered to and recognized in that              
 DR. NAKAMURA asked to run through HB 274 by sections, and highlight           
 the key issues within each section.  Section 1 is basically a                 
 definition of what is needed to protect the public health from                
 persons with TB who pose a threat.  These are individuals who are             
 recalcitrant, and are either unable or unwilling to conform to the            
 recommendations for treatment.  This section also addresses                   
 voluntary care and monitoring to assure a system is in place in the           
 state for identifying patients who are diagnosed as having TB, and            
 assuring that their treatment is monitored until the point of                 
 Number 1367                                                                   
 DR. NAKAMURA said if a patient goes from place to place, their                
 records should follow them so providers in the new communities will           
 be able to address their problems.                                            
 DR. NAKAMURA said the special concern of his division is that if              
 there are patients who are identified and begin treatment,                    
 subsequently stop treatment, start again, and stop again, there is            
 a very real danger of developing a drug-resistant strain of TB.               
 Once that happens, the cost of care and the management is                     
 significantly increased.                                                      
 Number 1396                                                                   
 DR. NAKAMURA continued with Section 2.  He said it is reminiscent             
 of a previous bill, but with some amendments.  The amendments are             
 just to some of the terms.  For instance, "sanitorium" is changed             
 to "facilities."  Section 3 also refers to some amendments in the             
 existing bill.  Again, there are wording changes.  One term used is           
 "tuberculars."  This is replaced with "persons with tuberculosis."            
 DR. NAKAMURA said Section 4 refers to the reporting of new cases              
 and the cessation of treatment.  This goes back to the issue of               
 patients who are first diagnosed and records are placed into a                
 system which documents the disease.  It relates to the existence of           
 a system which follows up and contacts the patient periodically.              
 This is to make sure that when a patient is on treatment, that                
 treatment is carried out to completion.                                       
 DR. NAKAMURA noted there is a requirement that there be written               
 documentation in adherence to records that the State Medical                  
 Officer will have access to the patients records for                          
 epidemiological purposes.  It is also required that there is                  
 contact follow up, and there is reporting of the disease to the               
 State Medical Officer.  Examinations of suspected cases is also               
 Number 1468                                                                   
 DR. NAKAMURA said Section 5 has an amendment changing the                     
 examination and reporting of those with TB from licensed physicians           
 in the state to those "who may lawfully practice" in the state.               
 The key in that issue is there are physicians who are with the                
 federal health care system who lawfully can practice in the state,            
 but who are not necessarily licensed in the state.                            
 DR. NAKAMURA continued that Section 6 repeals a section and re-               
 enacts portions of it.  This section refers to the ability to                 
 isolate or quarantine individuals who are less than willing to                
 follow the recommended therapy.  Recently, there was a situation in           
 an Alaskan community where a patient was infected and infectious,             
 and did not wish to or could not conform to therapy.  The                     
 requirement was that he be isolated in the quarantine state to                
 assure that treatment was administered.                                       
 Number 1523                                                                   
 DR. NAKAMURA said this section also gives assurance of due process.           
 If a patient is isolated or quarantined through the order of a                
 medical officer of the State Health Department, this patient has a            
 right to ask for a repeal of that isolation within five days.                 
 There has to be a review of the issue.  Within 60 days, there has             
 to be a type of court hearing on the case, and a determination must           
 be made whether the patient is to be retained in isolation or not.            
 DR. NAKAMURA explained that basically, this assures due process for           
 the patient.                                                                  
 Number 1550                                                                   
 CO-CHAIR BUNDE had a question about the isolation process.  He                
 asked if patients are isolated in a hospital, in their own homes,             
 or where.                                                                     
 DR. NAKAMURA said the language is written such that if it is                  
 feasible to isolate the individual at his or her home, that can be            
 done.  However, the isolation can also take place at a medical                
 facility or, in some situations where neither of the two are                  
 available, the patient could be quarantined in any other facility             
 that could provide the necessary isolation.                                   
 CO-CHAIR BUNDE asked if a correctional facility could be used.                
 DR. NAKAMURA said yes.                                                        
 Number 1584                                                                   
 DR. NAKAMURA said Section 7 allows the emergency detention of a               
 patient, and provides for due process rights.  Section 8 is an                
 extension of Section 6, which allows for the quarantine/isolation             
 of a patient, and the due process.  Section 9 allows for the                  
 treatment of patients who have strong religious convictions.                  
 Section 9 allows this to be taken under consideration, but with the           
 assurance that the public is protected from this individual in some           
 setting that would limit public exposure.                                     
 CO-CHAIR TOOHEY asked if that meant unless there is a miracle as TB           
 is not going to cure itself, people of a certain religious order              
 will have to be confined for the rest of their lives.                         
 DR. NAKAMURA said the wording is such that the special needs of               
 those people can be considered.  It does not say the state is                 
 mandated to excuse them from necessary treatment, if that is felt             
 to be necessary.                                                              
 Number 1659                                                                   
 CO-CHAIR TOOHEY said that in many Asian countries, people riding              
 bicycles wear surgical-style masks.  She asked if those masks have            
 any deterrent on TB at all.                                                   
 DR. NAKAMURA replied that the masks could have some degree of                 
 deterrent if the mask is of such a nature that it can catch most of           
 the droplets.  This is an airborne disease, and many of the                   
 organisms are transmitted through droplets.  This is not a foolish            
 precaution, it is definitely a measure of protection.                         
 DR. NAKAMURA continued with Section 10.  It is an amendment for the           
 protection of school children.  Basically, it says teachers should            
 be skin tested annually.  In the case the teacher already skin                
 tests positive, other examinations be administered.  These could              
 include either chest X-rays or sputum samples.                                
 Number 1701                                                                   
 CO-CHAIR BUNDE said that was the practice at one time in Alaska,              
 but those requirements were dropped.  Now they are going to be                
 DR. NAKAMURA said at least within the school setting, those are               
 going to be reinstated.  There is already a requirement that                  
 children in the rural areas be tested on an annual basis.                     
 CO-CHAIR BUNDE asked if Dr. Nakamura or the state has ever found a            
 teacher with active TB.                                                       
 DR. NAKAMURA did not have an answer to that question, but he                  
 offered to get it for Co-Chair Bunde.                                         
 CO-CHAIR BUNDE knows they have tested for TB for years, and he                
 didn't know if it was for the protection of teachers or children.             
 DR. NAKAMURA said it is a system of identifying cases of TB that              
 may be recurring in a community that previously was free of TB.               
 One of the sentinel events can be a child who turns positive.  This           
 allows the medical agencies to try and find the source of the                 
 Number 1742                                                                   
 DR. NAKAMURA summarized Section 11.  It is the last amendment, and            
 it is an inclusion of what was in the previous bill.  It allows for           
 penalties for violations of the aforementioned requirements.  Such            
 violations would be a misdemeanor.                                            
 CO-CHAIR TOOHEY asked what the penalties were for such a                      
 Number 1795                                                                   
 REPRESENTATIVE VEZEY asked what class the misdemeanor would fall              
 under, or if it was unclassified.                                             
 CO-CHAIR TOOHEY said it was a class A misdemeanor.                            
 REPRESENTATIVE VEZEY that would carry a six-month penalty.  A                 
 person could be confined for six months, whether in a jail or                 
 Number 1795                                                                   
 REPRESENTATIVE VEZEY thought TB had been eradicated from Alaska a             
 few generations ago.  He wondered how he is going to explain to               
 people in Fairbanks and the North Pole area that people are being             
 incarcerated or confined because they are ill.  He asked Dr.                  
 Nakamura what he would tell them if he were Representative Vezey.             
 DR. NAKAMURA replied he would tell them that the patients are not             
 being incarcerated.  In fact, most patients with TB will not be               
 placed in such facilities.  It is only patients who are                       
 recalcitrant, and who refuse to conform to the necessary public               
 health practice to avoid infecting the rest of the public.  Those             
 patients who are more than willing to take their medications and              
 follow the recommended therapies would never be affected by this              
 REPRESENTATIVE VEZEY said therefore, if a person is diagnosed with            
 infectious TB, as long as that person is following medical                    
 treatment, there is no reason to isolate that person from society.            
 DR. NAKAMURA said that was true.  There may be a need to initially            
 keep the patient from exposing the rest of the public to TB until             
 the medication has taken effect to the point that the patient is no           
 longer infectious.                                                            
 Number 1664                                                                   
 REPRESENTATIVE VEZEY asked how long that would take.                          
 DR. NAKAMURA said the time can vary from a period of one to two               
 weeks to a period of several months depending on the degree of the            
 REPRESENTATIVE VEZEY noted that any person under medical treatment            
 can possibly expose other members of society for about two weeks.             
 However, this bill is not targeted toward those people.                       
 DR. NAKAMURA said this bill is really targeted to those who refuse            
 to conform to therapy.  For example, his office encountered a                 
 person during the most recent outbreak of TB who refused to take              
 medication until he was quarantined and put under direct observed             
 therapy.  There are some individuals who are just unable to manage            
 their own destiny.  This may be because of substance abuse or for             
 other reasons.  These individuals either cannot or will not conform           
 to therapy.                                                                   
 Number 1908                                                                   
 REPRESENTATIVE VEZEY said therefore, it appears there are two                 
 classes of people that are involved here.  There are those who do             
 not have the faculties to conduct themselves in a responsible                 
 manner, and there are those who might, for some reasons of                    
 conviction, not want medical treatment.                                       
 DR. NAKAMURA agreed.  He said there is a need to make sure others             
 are not exposed to that individual without some sense of                      
 REPRESENTATIVE VEZEY asked about the TB cycle.  He asked how long             
 a person lives with disease.                                                  
 DR. NAKAMURA said that varies.  TB can manifest itself in many                
 different ways.  A person can be exposed to TB, get an infection,             
 and have nothing more than a converted skin test.  Those people               
 never actually get the disease to the point they are infectious.              
 There is always a possibility, about an 18 percent chance, that if            
 you are not treated at that point, you could break down and become            
 infectious with TB.                                                           
 DR. NAKAMURA explained there are others who, especially if they are           
 weakened by other diseases or illnesses, can have the TB infection            
 spread through their blood.  The TB can infect their brain, the               
 kidneys, the heart, the bones, etc.  There are many ways that TB              
 can present itself.  How it presents itself and what other                    
 underlying conditions the patient has can determine the length of             
 Number 1976                                                                   
 REPRESENTATIVE VEZEY resolved that there was no absolute mortality            
 table.  One cannot predict how long the disease will run.                     
 DR. NAKAMURA said no.  Some people will have the disease their                
 whole life, and have the continual potential to infect others, but            
 they will not progress to the point where they will die from the              
 REPRESENTATIVE VEZEY asked if anyone who tests positive for TB                
 could conceivably develop the symptoms of the disease at any time.            
 DR. NAKAMURA said TB is a funny disease.  When a person is                    
 initially infected, almost everyone has the ability to control and            
 confine that infection in a way that the disease does not become              
 active.  The disease can then progress or spread to others.  One              
 may find out he or she had the disease, and never knew it until a             
 chest X-ray showed calcification.  Or, perhaps a person was                   
 actually infected in the past but they never really got sick.  A              
 certain percentage of these people will then either break down or             
 progress to an active disease.  A person can either eventually die            
 from the disease or be severely impaired.                                     
 Number 2032                                                                   
 REPRESENTATIVE CAREN ROBINSON asked how long after a person begins            
 medication they are no longer infectious.                                     
 DR. NAKAMURA said that depends on a number of issues.  One is the             
 degree of the illness to which the person already has progressed              
 before treatment began.  If there is a cavity in a significantly              
 progressive disease, they may have to undergo treatment for weeks             
 or months before they are no longer infective.  There are others              
 who have a very minor infection and can be non-infectious in one to           
 two weeks.  It varies.  Plus, there are some organisms that are               
 resistant to medications used.  Until that is discovered through              
 lab tests, the patient may be on an ineffective drug.                         
 REPRESENTATIVE ROBINSON asked for clarification on the quarantine             
 provision.  They could be isolated at their house, a health                   
 facility or a correctional institution.  She asked why the state              
 would ever want to quarantine someone at a correctional                       
 DR. NAKAMURA said there are situations, for instance, of an                   
 individual in a rural community or village where the home setting             
 may not be ideal because of the many people in the home who may be            
 continually exposed to that person.  In addition, that would be an            
 option only if the patient were not willing to wear a mask and                
 cooperate in other protective measures.  There is no medical                  
 facility in which such an individual can be placed.                           
 Number 2091                                                                   
 DR. NAKAMURA noted that yet, the community members may be willing             
 to have that person stay within their community as long as they are           
 taking the medication and treatment.  The only place where that               
 isolation may take place may be in a correctional facility in that            
 REPRESENTATIVE ROBINSON said there has been some concerns and                 
 arguments regarding contract jails.  Therefore, isolation in a                
 correctional facility would concern her.  She has not seen some of            
 those facilities, but some of the comments made on the floor of the           
 House leads her to believe that some of those facilities are not              
 fit for animals.  Therefore, she is concerned that someone would be           
 placed into an unfit facility.                                                
 DR. NAKAMURA said he cannot give her the assurance she desires                
 because he does not know each facility.  However, he would                    
 obviously try to avoid that type of situation.                                
 Number 2130                                                                   
 CO-CHAIR TOOHEY surmised that Representative Robinson was looking             
 at a very tiny percentage.  Perhaps one infected person every five            
 years would be in that situation.  The average person with TB is              
 very willing to undergo treatment.                                            
 REPRESENTATIVE ROBINSON realized that.  However, she was wondering            
 if it should be clear that facilities should be up to standards.              
 That may mean more work from the DHSS.  However, if this is a very            
 small number of cases, it may be worth it.  Representative Robinson           
 was curious whether there have been any such cases from the most              
 recent outbreak in which someone had to be isolated in the jails.             
 DR. NAKAMURA said there was one case in which there was a very                
 rapid turnaround.  This was because the state had the ability to              
 confine that individual.  Reality therapy comes into play when it             
 is known that the state will take action if the patient is not                
 responsible.  In that case, it may take no more than one day to               
 bring about that reality.                                                     
 Number 2180                                                                   
 REPRESENTATIVE ROBINSON was under the impression that a class A               
 misdemeanor can result up to one year in jail.  Since it can take             
 up to a few weeks for a patient to receive medication and be                  
 allowed back on the street, why would the state want to inflict a             
 penalty that could possibly lock up someone with TB for up to one             
 CO-CHAIR BUNDE interjected that two different things were being               
 spoken of in this case.  One situation refers to isolating people             
 for their own protection and the public health.  The other                    
 situation refers to penalizing people who would knowingly infect              
 others.  The case that brought this up was the person who was aware           
 he was very infectious, and insisted on getting on an airplane and            
 infecting seven or eight other people in the two or three hour                
 flight to Anchorage.  That person could easily be incarcerated.               
 However, it would not be based on their own protection but on                 
 public health.                                                                
 DR. NAKAMURA corrected the last statement.  He said there was a               
 patient who did get on the plane and traveled against advice.                 
 Fortunately, no one was infected.  There was the potential for                
 infection, however.                                                           
 Number 2239                                                                   
 REPRESENTATIVE ROBINSON said on that issue, she understands there             
 are already adequate laws on the books which stipulate that if a              
 patient was to deny treatment, the Department of Law would be able            
 to charge them with other crimes such as reckless endangerment.               
 Therefore, perhaps more laws do not have to be added in this bill,            
 since such laws are already on the books.                                     
 CO-CHAIR BUNDE said it is his understanding that the state could              
 not prevent this person from getting on the airplane simply because           
 he was infectious.                                                            
 CO-CHAIR TOOHEY believes there is a law to stop a person from                 
 getting on an airplane.  Co-Chair Bunde said it did not stop the              
 patient in question at the time.                                              
 Number 2274                                                                   
 KRISTEN BOMENGEN, Assistant Attorney General, Criminal Division,              
 Department of Law (DOL), said she was present at the meeting to               
 address any of the legal concerns that may arise.  She asked to               
 briefly speak about what current law provides, and what went into             
 the process of recommending to the department that some change in             
 that law would help enable the department to more effectively carry           
 out its purpose in preventing the transmission of TB.                         
 MS. BOMENGEN explained that current statutory provisions provide              
 for the issuance of an examination order and the issuance of                  
 quarantine orders.  Those can be issued by the DHSS.  The law then            
 provides, if someone does not comply with those orders, that the              
 person be reported to a peace officer that a violation is                     
 occurring.  Criminal charges must also be filed in order to enforce           
 what is a public health order and what is an effort to assist a               
 person in obtaining medical care while protecting the public's                
 MS. BOMENGEN said this law was put into place in 1984.  Things                
 subsequently went fairly well because the department worked with              
 people and found that they were agreeable and compliant.  Problems            
 did not occur.  In this last year, some circumstances arose in                
 which people objected to the orders the department issued.                    
 Therefore, the DOL Law had to file criminal charges in a case.                
 Number 2335                                                                   
 MS. BOMENGEN said it became apparent that the DOL may have been               
 missing some due process requirements by jumping immediately into             
 criminal sanctions when someone had a reason to object to the order           
 of a public health official.                                                  
 TAPE 95-28, SIDE B                                                            
 Number 000                                                                    
 MS. BOMENGEN said that is what is behind the orders from the DOL.             
 The orders are meant to fill in the gaps between the issuance of an           
 examination order/quarantine order, and the criminal sanction that            
 may be at the other end.  This bill, as Dr. Nakamura addressed,               
 sets out the other steps that may be necessary to all the                     
 department to be effective in this pursuit, and to allow for due              
 process protections.                                                          
 MS. BOMENGEN continued that this legislation will allow a                     
 medication order, for instance, so the department can issue a                 
 treatment order which the patient would be required to follow.  The           
 detention orders that are anticipated address circumstances in                
 which a person may be immediately infectious, and it is necessary             
 to take them out of the public.  This is because they may transmit            
 the disease through airborne droplets.  The detention order is also           
 designed to deal with someone who has demonstrated by previous                
 behavior that they will not comply with a medication order or a               
 treatment plan.                                                               
 Number 094                                                                    
 MS. BOMENGEN allowed that she is a lay person, and she does not               
 have thorough medical knowledge of TB.  However, during the course            
 of the case she was dealing with, there was a serious danger that             
 the person had not complied with the medication regimen.  As a                
 result, the medical dose they were receiving was possibly having              
 the effect of creating a drug-resistant strain in that person that            
 could then be transmitted.  Therefore, for public health reasons it           
 is necessary to perhaps detain a person who is not capable, for               
 their own reasons, of following the drug regimen in order to assure           
 that a more virulent, drug-resistant strain is not created.                   
 MS. BOMENGEN said the detention orders in this bill also anticipate           
 that someone may be detained in their own home.                               
 Number 161                                                                    
 CO-CHAIR TOOHEY said HESS Committee members are going to be hearing           
 a bill concerning HIV.  In that context, she asked Ms. Bomengen how           
 HB 274 addresses HIV.  She asked if testing was mandatory.  If                
 someone is walking around unbeknownst to him/her that they have TB,           
 can the department, on their own volition, say it is going to test            
 everybody in the village.  Co-Chair Toohey asked if that was legal.           
 MS. BOMENGEN replied that under this bill, it is anticipated that             
 if the department receives information that someone has been                  
 exposed to TB, the department may take appropriate action to                  
 determine whether TB has been transmitted to others in the area.              
 This bill, however, does not relate to HIV at all.                            
 CO-CHAIR TOOHEY said this bill gives the state the tools to mandate           
 a test.  Would not HIV testing also fall into that jurisdiction?              
 Number 249                                                                    
 MS. BOMENGEN was unaware of any reason that it would be comparable            
 to HIV.  TB is transmitted through airborne droplets, and there is            
 a known treatment and cure for TB.  Those factors distinguish TB              
 from HIV.  Again, Ms. Bomengen noted that she knows legal matters,            
 and she is not necessarily an expert on medical matters.  However,            
 because HIV and TB are so different, they would warrant different             
 treatment on that premise.                                                    
 CO-CHAIR BUNDE noted, regarding mandatory testing, that HB 274 says           
 mandatory testing exists for people in the school system.  How that           
 would be different from someone who is living in a small community            
 where there is a high possibility of widespread infection, Co-Chair           
 Bunde cannot imagine.  Testing is mandated in the school system               
 because there is a great number of people who are in close                    
 proximity where more contamination is possible.                               
 CO-CHAIR TOOHEY asked Ms. Bomengen if there is an "opt-out" for               
 testing in schools for a child and for other members of a                     
 community, if the tests are against religious convictions.                    
 Number 355                                                                    
 MS. BOMENGEN said this bill provides for consideration of religious           
 belief.  In order to assure that due process protections are                  
 recognized within the statute if a religious belief objection is              
 raised, the department, if it felt it was necessary to test                   
 someone, would issue an order and the objection may be raised under           
 this provision to allow for the practice of religion.  There would            
 then be an appropriate response to those concerns.  Ms. Bomengen              
 said she does not know what the outcome would be when it went                 
 before the court.  It would depend on the facts that were before              
 the court.                                                                    
 REPRESENTATIVE ROKEBERG said Section 10 requires the testing of               
 public and private school employees.  Representative Rokeberg asked           
 Dr. Nakamura if it was true that in the past, food service handlers           
 and other people with public contact also had mandatory testing for           
 TB.  If that is the case, Representative Rokeberg asked why those             
 tests were not being currently required.                                      
 DR. NAKAMURA said he is not quite sure of the answer to that                  
 question.  However, in this case, the purpose is to protect the               
 school children.  They comprise a large population of susceptible             
 children, exposed to a teacher.  The doctor is not aware of any               
 requirements for the TB testing of food handlers.                             
 Number 468                                                                    
 CO-CHAIR TOOHEY was not sure of the exact date, but she did know a            
 few years ago that became an obsolete requirement for food                    
 REPRESENTATIVE ROKEBERG said given the situation, perhaps that                
 requirement should not be obsolete.                                           
 CO-CHAIR TOOHEY said TB cases occur mainly in very isolated                   
 villages, not in Anchorage.                                                   
 CO-CHAIR BUNDE said TB cases may be very isolated.  However, the              
 last briefing on TB stressed that foreigners may be bringing in               
 drug resistant strains of the disease.  Even one case of this would           
 be totally devastating because it is so difficult to treat.                   
 However, who is tested, why, and where leads Co-Chair Bunde to his            
 question.  There is a zero fiscal note, yet the state is going to             
 mandate testing and there may be people who must be quarantined               
 someplace other than their own house.  Co-Chair Bunde said it                 
 sounds like that would cost money.                                            
 Number 547                                                                    
 DR. NAKAMURA asked to respond to Representative Rokeberg's question           
 first, and then to answer Co-Chair Bunde's.  One of the reasons the           
 department is focusing on the testing of teachers is because part             
 of the transmission of the disease is based on the period of                  
 exposure.  In schools, there may be a teacher who is exposing a               
 group of children on a daily basis.  This is different than a food            
 handler exposing an individual who has a very quick, transient                
 exposure to the disease.  There must be a significant period of               
 exposure to catch TB.                                                         
 DR. NAKAMURA spoke of the people who were in the airplane with the            
 infectious individual.  Those people were in the airplane and were            
 exposed for a significant duration of time, however, there was no             
 transmission of the disease.  Part of this is related to the period           
 and degree of exposure.                                                       
 REPRESENTATIVE ROKEBERG said people are creatures of habit.  He               
 said there is a restaurant he frequently visits in Anchorage.                 
 Representative Rokeberg said he does not want to hold up the bill,            
 however, he thinks this should be looked at in the next committee             
 of referral.  Representative Rokeberg hopes there will be a good,             
 epidemiological answer for his question before the bill goes                  
 CO-CHAIR TOOHEY said that is a valid point, and asked Dr. Nakamura            
 to find out why food handlers are no longer required to be tested             
 for TB.                                                                       
 DR. NAKAMURA said it very well may be due to the success in dealing           
 with disease.  The state has been successful to the point that it             
 brought the actual rate of infection in Alaska to about 9.5 per               
 100,000.  This is an amazing control of the disease.  The chance of           
 exposure has been significantly decreased.  Probably, the rates are           
 still very low.  That rate has decreased from 1993, when the rate             
 was about 12.5 per 100,000.  There is a very low probability of               
 Number 680                                                                    
 CO-CHAIR BUNDE asked Dr. Nakamura to address the fiscal note                  
 DR. NAKAMURA explained the statutes allow the state to assume the             
 cost of treatment, but it does not mandate the state to assume the            
 cost of treatment.  The numbers of individuals that would actually            
 require isolation or quarantine are very low.  The state could very           
 well be responsible for an individual who has not insurance and has           
 a very low income.  However, overall the numbers of individuals the           
 state would encounter in this type of situation would be quite low.           
 The financial risk to the state would therefore also be quite low.            
 CO-CHAIR BUNDE understood that.  However, he was still concerned              
 about the zero fiscal note.  He said that even if the cost to the             
 state is $10, a fiscal note should still reflect that.  More                  
 importantly, will not testing in schools involve a lot of                     
 materials, qualified people, and travel?                                      
 CO-CHAIR BUNDE stressed that he was not speaking against the school           
 testing.  It is something that should be done.  However, Co-Chair             
 Bunde thinks there is a larger possibility that the teacher will be           
 infected by the child than vice versa.  There is some expense                 
 involved, and Co-Chair Bunde asked Dr. Nakamura to speak to that.             
 Number 777                                                                    
 DR. NAKAMURA believes most of the expense encountered would be                
 covered by an individual's medical insurance.  It would not                   
 necessarily be an expense to the department or to the state.                  
 CO-CHAIR BUNDE said to set up program testing at a school, someone            
 will have to do tine tests.  The school nurse may do those tests              
 are part of her regular duties.  But Co-Chair Bunde wanted to know            
 how much it costs, just for the materials if nothing else, for 50             
 or 100 people to perform a tine test.  If that cost is then                   
 magnified by the 50,000 students in Alaska, the cost can be                   
 DR. NAKAMURA said he would have to go back and check with the                 
 department.  However, he anticipates that the state would not be              
 using state staff to administer the tests or to make the materials            
 available.   This would be part of the health care requirements of            
 any individual who is working as a teacher, etc.  The assumption is           
 that the tests would be covered by medical insurance and health               
 Number 840                                                                    
 CO-CHAIR BUNDE asked if only teachers, and not the children, were             
 going to be tested.                                                           
 DR. NAKAMURA said only the testing of the teachers is required.               
 CO-CHAIR BUNDE thought all the children were going to be tested,              
 like was done previously.                                                     
 DR. NAKAMURA said the children are already being tested under the             
 present treatment protocols.                                                  
 CO-CHAIR TOOHEY said under Section 3, line 1, it reads, "The                  
 department, in establishing a comprehensive program for the control           
 of tuberculosis in the state, shall cooperate with state, federal             
 and local agencies...."  She said the bill goes on to read "a                 
 health care provider who treats a person with TB shall examine all            
 other persons in the household who have had contact with the                  
 patient...."  Co-Chair Toohey felt there is going to be a cost to             
 this bill.  It is not wise to pass the bill without the money it              
 will take to implement the program.                                           
 DR. NAKAMURA said there are not that many new impositions in this             
 bill that are not being currently done.  This bill is actually                
 revising the language and stating much of what is already taking              
 Number 935                                                                    
 REPRESENTATIVE VEZEY asked Dr. Nakamura to further explain the                
 disease.  He said someone can be exposed to the disease, and still            
 not contract TB.                                                              
 DR. NAKAMURA said the person can either not get infected, become              
 infected but not ill, or they can become infected and become ill.             
 Many factors will determine which of those three situations will be           
 REPRESENTATIVE VEZEY said therefore, a person can have contact with           
 the disease but not become infected.  Representative Vezey asked              
 what a positive skin test means.                                              
 DR. NAKAMURA replied that a positive skin test means a person is              
 infected with the TB organism.  However, it does not tell the                 
 person whether he or she is actually ill, or when he/she was                  
 infected.  The skin test only shows that somewhere in the course of           
 his/her life, the TB organism was picked up and it settled                    
 somewhere in the body.  He/she is infected, but not necessarily               
 Number 1000                                                                   
 REPRESENTATIVE VEZEY said therefore, once one tests positive for              
 TB, he/she will always test positive?                                         
 DR. NAKAMURA said yes.  It takes a few more steps to determine                
 whether one is actually ill from the disease.  One test is the                
 sputum test.   It shows whether there are TB organisms in a                   
 person's sputum.  If organisms are present, the person has gone               
 beyond the point of a simple infection.  A chest X-ray will also              
 show that the disease has advanced.                                           
 CO-CHAIR TOOHEY said unless a person is showing symptoms of the               
 disease, such a fever, coughing, etc., there is no need to get an             
 X-ray.  However, if one is feeling poorly, and one has tested                 
 positive, he or she should be thoroughly examined.  She noted that            
 once a person skin tests positive, he/she should always assume that           
 somewhere along the line there has been exposure to TB.                       
 Number 1056                                                                   
 REPRESENTATIVE ROBINSON asked why, in the drafting of the bill,               
 class A misdemeanor was chosen instead of class B or class C.  She            
 asked why it was felt the misdemeanor had to be class A.                      
 MS. BOMENGEN said the misdemeanor is not different from the current           
 provisions in the bill.  In putting the bill together, the steps              
 between actions were filled in.  The initial steps were decided,              
 and the final criminal penalty has always been there.  It has now             
 been placed in Section 11.  However, AS 18.15.138 is being repealed           
 by this bill.  That is actually an identical provision.  Nothing              
 has changed in that regard.                                                   
 MS. BOMENGEN said a number of intermediate steps have been put in             
 place, however.  These steps can achieve the purpose of                       
 enforcement.  These make the final eventuality highly unlikely                
 because there is even an emergency detention order that is provided           
 for earlier in the bill.   Again, there are intermediate steps to             
 be taken if someone is not complying with the department.  It is              
 not necessary to immediately resort to criminal sanctions in order            
 to enforce the statute.                                                       
 MS. BOMENGEN wanted to mention something in response to earlier               
 testimony about detainment in correctional facilities.  She does              
 not believe it is written anywhere that is the type of facility               
 that is intended.  In the emergency detention order section,                  
 Section 7, the bill reads of a "health care facility or another               
 location."  That is merely to leave the options available to the              
 department in circumstances where there may not be a health care              
 facility available, yet there is an immediate need to act to                  
 protect the public health.                                                    
 Number 1150                                                                   
 MS. BOMENGEN stressed it is not intended for a correctional                   
 facility to be used as a standard place for isolation.                        
 REPRESENTATIVE ROBINSON said there are two areas Ms. Bomengen                 
 should look at as the bill moves through the committees.                      
 Representative Robinson wanted to know if the penalty had to be so            
 stiff.  Representative Robinson knows that there have been very few           
 cases that would warrant such a penalty in the past, and the cases            
 have involved people who were not only were ill with TB, but also             
 had possible drug and alcohol addiction.  It seems to                         
 Representative Robinson, therefore, that the penalty is a little              
 REPRESENTATIVE ROBINSON also believes strongly, in reference to               
 Section 7, that the first attempt for detainment should definitely            
 be in a health care facility.  Representative Robinson can see it             
 being more expedient to take someone to a correctional facility               
 instead of going through the problems of trying to find appropriate           
 health care.                                                                  
 Number 1222                                                                   
 CO-CHAIR TOOHEY closed the bill to public testimony and asked for             
 the wish of the committee.  Representative Vezey made a motion to             
 move HB 274 from the HESS Committee with individual recommendations           
 and attached fiscal notes.  There were no objections, and the bill            
 passed out of committee.                                                      
 HB 226:  MARITAL STATUS AND RETIREMENT BENEFITS                             
 Number 1306                                                                   
 REPRESENTATIVE PETE KELLY, sponsor of HB 226, urged HESS Committee            
 members to adopt HB 226.  The superior court recently decided                 
 unmarried couples are entitled to the same employment benefits as             
 married couples.  This decision was the result of a broad                     
 interpretation of language found in the Human Rights Act which                
 prohibits discrimination based on marital status.  The court                  
 concluded the human rights directive was violated by the University           
 of Alaska when it refused health benefits to the unmarried partner            
 of a university employee.                                                     
 REPRESENTATIVE KELLY said it is feared this decision will have a              
 far-reaching impact as a trickle of grievances at the University of           
 Alaska becomes a flood in other agencies and in private industry as           
 well.  It is not a stretch to imagine Alascom, the National Bank of           
 Alaska or the AFL-CIO being sued in the near future for failing to            
 recognize domestic partners in their benefits packages.  However,             
 because the definition of domestic partner is not grounded in                 
 contract or tradition as is marriage, it is a moving target and,              
 therefore, impossible to predict what future relationship will                
 qualify under this umbrella.                                                  
 REPRESENTATIVE KELLY continued that the superior court decision               
 targets workers' benefit packages for distribution to an unknown              
 panoply of partners who are able to attach themselves to state                
 employees.  HB 226 intends to reduce this uncertainty as employers            
 try to create their compensation packages.  It also attempts to               
 pre-empt the possible onslaught of domestic partner relationships             
 created solely to gain access to potential benefits.                          
 REPRESENTATIVE KELLY said the court offers little solace in its               
 decision document when it advises the university to just                      
 discontinue benefits to families as an option to stay in compliance           
 with the decision.                                                            
 Number 1385                                                                   
 REPRESENTATIVE KELLY said the anti-discrimination laws based on               
 marital status are meant to prevent such things as an employer                
 hiring only married men or married women because they are somehow             
 more stable and more desirable as employees or vice versa.  HB 226            
 will continue to offer this much needed protection, while closing             
 this expansive loophole.  Moreover, HB 226 clearly draws a                    
 distinction between the housekeeping arrangements of a domestic               
 partnership and the legal bond of marriage, credentialed by society           
 through thousands of years of tradition and cultural experience.              
 REPRESENTATIVE KELLY said as the peoples' representatives,                    
 legislators have a compelling interest in protecting the                      
 institution of marriage as the only vehicle capable of providing              
 civilization with a future generation of citizens.                            
 Number 1417                                                                   
 REPRESENTATIVE KELLY wanted to send a clear message that the                  
 institution of marriage and the families it produces are worthy of            
 special recognition.  It is for this reason that he requests the              
 passage of HB 226.                                                            
 REPRESENTATIVE VEZEY asked if the only change in existing law                 
 provided for in Section 1 of the bill is the spelling of the word             
 "it."  He cannot see the changes in Section 1.                                
 REPRESENTATIVE KELLY explained that in current statutes, there is             
 a prohibition against discrimination.  Representative Kelly pointed           
 to number 1, under AS 18.80.220.  He said this was the current                
 statute and it reads of prohibition of discriminatory practices.              
 An employer cannot discriminate based on sex, age, marital status,            
 etc.  However, in (c), Section 2, an employer may refuse to provide           
 benefits to a person because the person is not legally married to             
 an employee of the employer without violating this chapter.                   
 REPRESENTATIVE KELLY said the bill also says that labor                       
 organizations may negotiate the same kind of agreement.                       
 Essentially, the bill is currently what's in place, and there is no           
 prohibition against a state agency or anyone negotiating a domestic           
 partner arrangement.  It just says the organization is not guilty             
 of discrimination should it not choose to provide those benefits.             
 Number 1520                                                                   
 REPRESENTATIVE VEZEY said so the only change in Section 1 is the              
 addition of the exception clause.  Representative Kelly said he was           
 REPRESENTATIVE BRICE provided an example of an unmarried couple who           
 has been living together for the last 18 years.  One partner is the           
 breadwinner, and the other partner stays at home.  They are not               
 legally married in terms of Justice of the Peace or religious                 
 ceremonies.  Considering the fact that the second person has no               
 income, is he/she going to be eligible for state medical                      
 assistance, such as MedicAid or MediCare, whereas otherwise,                  
 without HB 226, private insurance would pay for care?  In other               
 words, isn't this bill simply shifting cost away from private                 
 insurance organizations onto the state?                                       
 REPRESENTATIVE KELLY said there would be qualifications for                   
 MediCare, AFDC, etc., that provide relief.  There are                         
 qualifications that must be met.  Representative Kelly said he is             
 not an expert on the exact qualifications for MedicAid, but for               
 many of the other services, one cannot live with someone and                  
 collect those benefits.  It is required that the person live in               
 state housing, and the person would be required to give up certain            
 amounts of property.  Therefore, Representative Kelly does not see            
 the bill as shifting costs any more than costs are now shifted.               
 Number 1629                                                                   
 REPRESENTATIVE BRICE said therefore, in other words, Representative           
 Kelly does not view the state as picking up these individual's                
 costs.  It may be something the Division of Medical Assistance                
 might be able to answer more clearly.  Representative Brice asked             
 if it was the understanding of Representative Kelly that those                
 dependent individuals would not fall under MedicAid.                          
 REPRESENTATIVE KELLY did not know.  If the point is the legislature           
 is trying to require that the state is somehow responsible for                
 these people, or the person with whom they live is responsible,               
 Representative Kelly does not know if this bill necessarily                   
 addresses that.  That is not the purpose of this bill.  That might            
 be an issue that is better addressed in the statutes that enable              
 Number 1663                                                                   
 REPRESENTATIVE BRICE said people will be taken care of in one way             
 or another--whether they walk in off the street into an emergency             
 room to place the burden on the facility (which eventually places             
 the burden on the state), or whether private insurance pays for               
 that help.  Representative Brice said he wants to be very certain             
 HB 226 will not shift costs back to the state.  It might be a                 
 question that the Division of Medical Assistance (DMA) should                 
 REPRESENTATIVE KELLY was not sure of the point Representative Brice           
 was trying to make.  However, he thought the state cannot be held             
 hostage to someone who says, "If you do not provide me with medical           
 insurance through my spousal equivalency arrangement, I will now go           
 and cost you money at the emergency room."  Representative Kelly              
 did not want to hold the state hostage in such a way.                         
 REPRESENTATIVE BRICE felt Representative Kelly was missing what he            
 was trying to get at.  The couple consists of Partner A and Partner           
 B.  Partner A works, Partner B does not.  They are not married, but           
 they have a well-established, long-term relationship.  They live              
 together and share many things.  Partner A is the only one in this            
 relationship that is capable of receiving benefits because of this            
 bill.  Partner B is not.  Partner B gets deathly ill, but is not              
 covered by Partner A's benefits.  Therefore, Partner B is eligible            
 to go and receive state help, versus having the insurance company             
 pay for the care.  That is the concern of Representative Brice.               
 Number 1772                                                                   
 CO-CHAIR TOOHEY asked if Representative Brice was assuming the only           
 way someone is eligible for MedicAid is because of an economic                
 REPRESENTATIVE BRICE said yes, and Partner B would have no income             
 CO-CHAIR TOOHEY said that is being assumed, because Partner B may             
 be the co-owner of the house or something.                                    
 REPRESENTATIVE BRICE said it may be that Partner B is the co-owner            
 of the house.  In that case, however, Partner B would probably be             
 working and bringing in income.  However, if Partner A is the sole            
 provider, and Partner B brings in no income and has no legally                
 recognizable assets, Partner B becomes eligible for the state's               
 money.  Maybe this is a discussion that needs to be had with                  
 someone from the DHSS that understands medical assistance issues              
 better.  This might help clarify some of this.                                
 Number 1824                                                                   
 CO-CHAIR TOOHEY said several people from the Department of Law were           
 present to answer his questions.                                              
 REPRESENTATIVE KELLY wanted to note that when the court decision              
 came about, the judge in the case said there was no legislative               
 intent, and the statute stood as an absolute prohibition against              
 discrimination based on marital status.  The fact is that there are           
 plenty of examples of legislative intent.  Throughout the statute,            
 there is exactly what Representative Kelly has put in the bill.               
 REPRESENTATIVE KELLY said for example, in AS 39.30.090, it says               
 "the Department of Administration may obtain a policy or policies             
 of group insurance covering state employees.  Persons entitled to             
 the coverage under AS 39.35 or employees of other participating               
 government units are subject to the following conditions...."                 
 REPRESENTATIVE KELLY said the document from which he was reading              
 goes on to read, "Each eligible employee of the state, the spouse,            
 and the unmarried children chiefly dependent upon the eligible                
 employee for support, and each eligible employee of another                   
 participating governmental unit shall be covered by the group                 
 policy unless exempt under regulations adopted by the                         
 REPRESENTATIVE KELLY said that is one example.  The document, as              
 far as legislative intent, does not say anything about anyone who             
 is financially dependent on the employee, anyone in a marriage-like           
 relationship, or anyone who signs an affidavit of spousal                     
 equivalency.  Likewise, in Section 14.25.168 of the medical                   
 benefits section, which will be provided to HESS Committee members,           
 it reads, "The following persons are entitled to major medical                
 insurance coverage...."  Representative Kelly said it is the spouse           
 of a person or the natural or adopted child, etc.                             
 REPRESENTATIVE KELLY said the document also goes into the medical             
 benefits for public employees, retirement, teachers' retirement,              
 etc.  The statutes are full of examples where the state currently             
 has in statute exactly what Representative Kelly is trying to put             
 into the Human Rights Act.  Representative Kelly feels it is                  
 interesting that the judge in the University of Alaska case, Judge            
 Greene, was completely unaware of those statutes when she was                 
 trying to determine legislative intent.                                       
 Number 1938                                                                   
 REPRESENTATIVE KELLY submitted that legislators stand on the                  
 shoulders of all who have preceded them.  There is plenty of                  
 legislative intent to say that in fact, the state or other                    
 organizations can discriminate when determining who is eligible for           
 benefits.  This is as long as those discriminations meet a certain            
 test.  Representative Kelly said he feels that is clearly in                  
 statute, but it appears that the Human Rights Act needs to be                 
 tweaked a bit.                                                                
 REPRESENTATIVE VEZEY said he knew Representative Kelly spent a lot            
 of time looking into this bill.  The question that keeps coming to            
 Representative Vezey's mind is that Alaska has never had a common             
 law marriage statute.  Would Representative Kelly say, should the             
 Judge Greene's decision be allowed to stand, that there will be in            
 effect a common law marriage statute?                                         
 REPRESENTATIVE KELLY could not comment on that question.                      
 Number 1982                                                                   
 REPRESENTATIVE ROKEBERG said he may have an answer to that                    
 question.  He passed out a document.  It was a page from the                  
 judge's decision, telling of her finding as to marital status in              
 the state.  The page said accordingly the court determines that               
 Tumeo and Wattum, the plaintiffs in the case against the University           
 of Alaska, have proven their allegation of discrimination based on            
 marital status.  That was the finding of the case.                            
 REPRESENTATIVE ROKEBERG asked Representative Kelly if that was why            
 he was bringing this bill forward, to clarify the statute as                  
 presently interpreted by the state of Alaska and enforced by the              
 state of Alaska.                                                              
 REPRESENTATIVE KELLY said Representative Rokeberg was exactly                 
 right.  There is possibly a slight flaw in the current statue.                
 Everyone knows what marriage is.  There is no one in this room that           
 does not understand what marriage is.  Apparently, however, the               
 statutes were written in such a way that a loophole has been                  
 created that a judge was able to "drive a freight train through."             
 That is the reason Representative Kelly wanted to change the                  
 statute.  If this problem is not fixed, an administrative nightmare           
 is going to be created.                                                       
 REPRESENTATIVE KELLY said that an amendment offered by                        
 Representative Robinson will create an administrative nightmare.              
 It clearly discriminates, and it is going to require an                       
 administrator to sit there and decide which of these spousal                  
 equivalency agreements are legitimate.  It is going to require home           
 investigation to determine whether these people are eligible for              
 benefits that they would certainly be eligible for should they                
 choose to get married.                                                        
 REPRESENTATIVE KELLY said no one is barring them from getting                 
 married, and they have the opportunity to do so, just as anyone               
 else does, and they can receive these benefits.  Once it has been             
 determined that spousal equivalency is equal to marriage, the only            
 way that can be enforced is through the creation of another entity            
 within the body of law, that is like "marriage-lite."                         
 REPRESENTATIVE KELLY continued that the only way to do that,                  
 because the state has a clear definition of what marriage is but it           
 does not have a clear definition of what domestic partnerships are,           
 is to come up with what can be found in Representative Robinson's             
 amendment.  Such an amendment states that a domestic partnership is           
 based on economic considerations.  That clearly discriminates.                
 Number 2111                                                                   
 REPRESENTATIVE KELLY noted that the amendment goes on to define a             
 domestic partnership, and how one would set up a domestic                     
 partnership.  All it really does is discriminate.  It does the same           
 thing that the Tumeo-Wattum case accuses the University of Alaska             
 of doing.                                                                     
 CO-CHAIR TOOHEY interjected that the amendment was not before the             
 HESS Committee at that time.                                                  
 REPRESENTATIVE ROKEBERG asked if, in the Tumeo-Wattum case, if                
 Judge Greene suggested what she purported to be some                          
 recommendations or fixes to her decision.  He asked if                        
 Representative Kelly could tell HESS Committee members what those             
 recommendations were.  Representative Rokeberg also asked if                  
 Representative Kelly's bill was not simply just a technical                   
 correction to the way the law is worded, and if Representative                
 Kelly could comment on the opinion of the State Human Rights                  
 Number 1216                                                                   
 REPRESENTATIVE KELLY said the State Human Rights Commission is in             
 full support of HB 226.  Representative Kelly has a letter from the           
 commission to that effect.  One slight change has been suggested in           
 the wording.  This is a technical change to a law that is currently           
 functioning and functioning very well.  It needs a technical change           
 in it to prevent this type of problem from happening in the future.           
 REPRESENTATIVE KELLY continued that the judge in the Tumeo-Wattum             
 case said essentially that how the university can deal with her               
 decision is to stop giving people benefits to spouses.  This way,             
 the university would not be charged with discrimination.                      
 Representative Kelly does not think that is a good idea.  He likes            
 the marketplace to be able to determine those kinds of things.                
 REPRESENTATIVE KELLY asked to go back to the intent of his bill.              
 The bill in no way is a prohibition of any kind on any kind of                
 activity.  It simply says that an organization is not guilty of               
 discrimination should it want to go to the marketplace to negotiate           
 health benefit packages with employees.                                       
 Number 2214                                                                   
 REPRESENTATIVE ROBINSON said she would not get into a debate right            
 now about her amendment, but she had copies of it and passed it               
 out.  She simply wanted to make sure it was understood that HB 226            
 relates only to retirement and health insurance benefits for                  
 employed people.  That is who is being affected by the bill--                 
 employed people.  She asked if she was correct, and Representative            
 Kelly said that was a fair assumption.                                        
 REPRESENTATIVE ROBINSON said therefore, she will deal with the                
 debate over discrimination and non-discrimination when the                    
 amendment is brought before the HESS Committee.                               
 REPRESENTATIVE ROKEBERG asked Representative Kelly if Judge Greene            
 indicated that an affidavit of domestic responsibility, or some               
 similarly named document, would also be another fix to the problem.           
 REPRESENTATIVE KELLY said that was true.  There were several                  
 suggestions of that sort made by Judge Greene.  Representative                
 Kelly did not address that option because that is the heart of the            
 issue.  HB 226 is trying to fix that very problem, of saying that             
 these types of agreements have to be recognized.  Judge Greene did            
 recommend that is one of the ways to comply with her decision.                
 Representative Kelly simply did not find that as disturbing as the            
 other options.  She said spousal agreements can be recognized, or             
 organizations can simply stop giving health benefits to spouses of            
 Number 2285                                                                   
 REPRESENTATIVE ROKEBERG suggested that this point is the crux of              
 the whole case.  The court is making public policy, and that is               
 actually the job of the legislators.                                          
 Number 2315                                                                   
 MILDRED BOESSER, Representing Parents, Families and Friends of                
 Lesbians and Gays (PFLAG)...                                                  
 TAPE 95-29, SIDE A                                                            
 Number 001                                                                    
 MS. BOESSER continued...and the City and Borough of Juneau (CBJ)              
 Human Rights Commission (HRC) opposes HB 226, which is legislation            
 which permits employers to deny benefits to an employee's domestic            
 partner other than a spouse, and permits labor unions to negotiate            
 such a denial of benefits.                                                    
 MS. BOESSER said this bill amounts to discrimination on the basis             
 of marital status.   The CBJ HRC is charged with addressing                   
 unwarranted discrimination.  It opposes the discrimination on the             
 basis of marital status inherent in this bill.  If this bill is               
 intended to encourage people to make lifelong commitments, its goal           
 is laudable.  But its aim is off-target.                                      
 MS. BOESSER said society benefits from the formation of unions                
 between committed adults.  Commitment, not marriage, is the                   
 hallmark of these unions, which can also entail shared finances,              
 mutual dependency, and responsibility for children.  The                      
 characteristics of a committed adult union do not depend on a                 
 marriage license.                                                             
 MS. BOESSER said Alaska is a state of individuals.  When these                
 independent people create a household that often does not match a             
 1950s picture of the family, many couples, in spite of their                  
 commitment to, and dependence upon one another, are not married.              
 Number 097                                                                    
 MS. BOESSER noted in some cases these couples are not free to                 
 marry.  For example, one member of a couple may remain bound by law           
 to a former spouse who will not cooperate or cannot be located to             
 dissolve the marriage.  If the remaining partner is unable to                 
 afford a lawyer to prosecute a default divorce, he or she remains             
 married indefinitely.  Likewise, same sex couples are unable to               
 marry, regardless of the level of their mutual commitment and                 
 financial dependence.                                                         
 MS. BOESSER continued that if the state of Alaska is looking for              
 ways to encourage committed unions between adults, it should not              
 place undue emphasis on the legal fact of marriage.  Doing so poses           
 a barrier to the many unmarried partners who wish to take personal            
 responsibility for their domestic partners.  The very first                   
 paragraph of Alaska's Constitution guarantees all of us equal                 
 rights, opportunities and protection under the law.  The CBJ HRC              
 opposes HB 226 because it discriminates against committed partners            
 who are not married to the detriment of Alaska and in violation of            
 the constitution.                                                             
 Number 194                                                                    
 MARGARET BERCK, Attorney, American Civil Liberties Union (ACLU),              
 testified that the ACLU is opposed to HB 226 and is in favor of the           
 amendments that have been proposed by Representative Robinson.                
 Since there are others present to testify, Ms. Berck declined to              
 take up further time since the amendments were not before the                 
 committee for discussion.                                                     
 REPRESENTATIVE ROKEBERG asked if Ms. Berck was familiar with the              
 case Lilly vs. the City of Minneapolis.  She said she is not.                 
 Number 274                                                                    
 TALMADGE W. BAILEY, Board Member, Southeast Alaska Gay and Lesbian            
 Alliance (SEAGLA), read a prepared statement from the                         
 "Dear Committee members, the Southeast Alaska Gay and Lesbian                 
 Alliance urges you to stop HB 226, and not pass this bill out of              
 your committee, as we do not believe that it is in the best                   
 interest of the state of Alaska to move this bill forward in its              
 present form.                                                                 
 "We could support the bill if it is amended to include domestic               
 partnership language.  If passed as is, this bill would become part           
 of a non-discrimination statute, and yet clearly set up an illegal            
 and discriminatory situation.  Both legally married individuals and           
 "domestic partners" are in family situations, which involve                   
 financial and emotional interdependency.  It is currently illegal             
 to discriminate on the basis of marital status, and should continue           
 to be so.  We believe that all of Alaska's families should be                 
 treated equally.                                                              
 "Benefits provided by the State to employees are tangible                     
 compensation, and are calculated as part of the total compensation            
 package given to an employee.  It is discriminatory practice to pay           
 some individuals more for equal work, just because they have                  
 entered into "the only acceptable" legal contract.  Both marriage             
 contracts and spousal equivalency contracts set up financial                  
 interdependency,  and are legally binding upon individuals.  Both             
 of these situations represent a strong commitment between                     
 individuals, and are not lightly entered into.                                
 "We fully support Representative Caren Robinson's proposed                    
 amendment to HB 226, which involves meeting stringent criteria in             
 order to qualify for joint benefits.  This may help to allay fears            
 of the "rush" of individuals who would sign up for those benefits.            
 This amendment would easily help distinguish between those who are            
 truly domestic partners, and eliminate those who attempt to                   
 establish frivolous claims.                                                   
 "We do not believe it is legal for the state to pick and choose               
 among legal civil interdependency contracts, and determine which              
 ones are "better" than others.  Employers should have the option to           
 pay benefits to all those who have entered into this contract                 
 solely to employees, and not pay benefits for family members.                 
 Number 455                                                                    
 "Lastly, the financial impact of this bill is important to note.              
 Research conducted by major organizations and employers who have              
 implemented joint benefits programs for domestic partners has                 
 clearly shown that additional cost to the organization is                     
 insignificant.  Highest estimates to date are increases of under              
 five percent of benefits cost.  This should not be a basis for                
 consideration of this bill.                                                   
 "We strongly urge you to carefully consider this bill, and not to             
 pass it out of your committee."                                               
 Number 510                                                                    
 MARK TUMEO, Plaintiff in the case Tumeo and Wattum vs. the                    
 University of Alaska; and Professor, University of Alaska Fairbanks           
 (UAF), thanked the co-chairs for the opportunity to testify in this           
 very important issue.  Over the last two days, Mr. Tumeo had the              
 opportunity to meet with many of the members of this committee.  He           
 apologized to Representative Vezey for not being able to meet with            
 him personally.                                                               
 MR. TUMEO had been discussing several aspects of Representative               
 Kelly's bill that would allow discrimination based on marital                 
 status, and gut the Human Rights Act of Alaska.  Mr. Tumeo had the            
 honor of meeting with Representative Kelly for almost an hour that            
 day on HB 226, and he enjoyed the conversation.  As the sponsor of            
 this legislation, Mr. Tumeo wanted a very clear picture of the                
 concerns that generated the bill's introduction.                              
 MR. TUMEO asked to take a minute to discuss the two main issues               
 that Representative Kelly indicated caused him to introduce this              
 piece of legislation.  First, Representative Kelly claimed an                 
 economic concern.  As Mr. Tumeo has discussed with many members of            
 this committee, and with Representative Kelly, this concern is not            
 founded in facts.  Mr. Tumeo has provided the committee with                  
 information from Harvard University that shows domestic partnership           
 benefits, when offered, result in only a minor increase in                    
 enrollment, and no increase in insurance premiums.                            
 MR. TUMEO continued that such benefits are currently offered in               
 over 60 major universities in the country, including state                    
 institutions such as the University of Iowa, the University of New            
 York, and the University of North Carolina.  Over 100 private                 
 companies and over 60 governmental jurisdictions, including the               
 states of New York, Vermont and Massachusetts, offer domestic                 
 partnership benefits, and have demonstrated that there are no                 
 economic impacts from such actions.                                           
 Number 637                                                                    
 MR. TUMEO said therefore, with respect to the economic concerns of            
 HB 226, the bill is unnecessary.  However, if the members of this             
 committee remain concerned, he would urge them to refer this bill             
 to a subcommittee where all the pertinent facts can be discussed in           
 detail.  The bill is currently on an emotionally-driven fast track.           
 Given the importance of the issue and the high workload the                   
 legislators are under, especially during budget time, it would be             
 wise legislative policy to allow more time for the members of this            
 committee to study the bill and the issues surrounding it.                    
 MR. TUMEO said if, after reflection, the members feel there is                
 still an economic concern (although Mr. Tumeo doubts that would be            
 the case), they would be able to consider Representative Robinson's           
 amendment.  The Robinson amendment clearly draws a tight circle               
 around the number of individuals who would qualify, protects the              
 economic interest of the state and the university, and still                  
 protects the Human Rights Act of the state.                                   
 Number 694                                                                    
 MR. TUMEO recalled that the Robinson amendment was introduced in              
 the State Affairs Committee.  It presents the legislature with a              
 win-win situation.  It addresses perceived economic concern and               
 reinforces the state's law that discrimination based on marital               
 status is neither fair nor legal.  However, Representative Kelly              
 has another reason for introducing this piece of legislation.                 
 MR. TUMEO believed he spoke fairly when he said Representative                
 Kelly's real reason for introducing the bill is to ensure that only           
 those relationships that he feels are "good" are recognized.  This            
 bill, on its face, sets up a special class of citizens--married               
 people.  He confers on this special class special rights, most                
 directly, the right to be paid more for the same work.                        
 MR. TUMEO asked what the basis is for being paid more. He answered            
 only that in Representative Kelly's opinion "good marriages" should           
 be supported.  Would Representative Kelly consider going so far as            
 to legislate between a "good" marriage and a "bad" one to ensure              
 that only those relationships he felt are good get recognition and            
 benefits?  This is clearly not the type of legislation this                   
 committee should be involved in.                                              
 Number 760                                                                    
 MR. TUMEO said the bottom line is that HB 226 is not intended to              
 protect an economic interest.  It is intended to deny equal rights            
 to individuals who are not in the type of relationship                        
 Representative Kelly supports.  Mr. Tumeo believes Representative             
 Kelly has the right to support or argue against whatever types of             
 relationships he wants to.  However, it is not reasonable for this            
 legislature to place the personal moral convictions of                        
 Representative Kelly into law.                                                
 MR. TUMEO felt it was important to reiterate HB 226 is being pushed           
 through the process on red herring emotional issues.  Further,                
 Representative Kelly has totally misrepresented the case of Tumeo             
 and Wattum vs. the University of Alaska.  Mr. Tumeo is very                   
 familiar with this case, as he is the plaintiff.  The law case in             
 which he is the plaintiff against the university is an                        
 administrative lawsuit for public employees.  While the decision              
 sets precedent, it applies directly only to Mr. Tumeo and his co-             
 defendant, Kate Wattum.                                                       
 Number 813                                                                    
 MR. TUMEO noted that additionally, as Representative Kelly has                
 pointed out, the laws in place may already protect the state and              
 the Department of Administration from being forced to provide                 
 domestic partnership benefits.  However, the laws he cited, which             
 those in the court case were made well-aware of, do not apply to              
 the University of Alaska.  They apply to the Department of                    
 Administration (DOA).  The University of Alaska is self insured.              
 It is not under the DOA's insurance policy.                                   
 MR. TUMEO stated furthermore, such rulings as the one issued by               
 Judge Greene and employment laws dealing with the type of                     
 employment and discrimination are not applicable to private                   
 companies.  That is not how the law works.  Representative Kelly's            
 claim that there will be a flood of suits against private companies           
 based on this ruling is wrong.  It is not possible.  Only public              
 employees can be affected by this.                                            
 MR. TUMEO said any other individual who wants benefits may apply              
 through the administrative channels of their agency or the                    
 university.  Once again, while this decision sets precedent, it               
 does not force the giving of the benefits.  Furthermore, the                  
 university has appealed the decision to the Supreme Court.  As a              
 result, Judge Greene's decision is effectively on hold until the              
 Supreme Court rules.  Legislation at this time is not only                    
 unnecessary, it interferes with the process of the courts.                    
 Number 886                                                                    
 MR. TUMEO urged HESS Committee members to direct this bill to a               
 subcommittee to allow calm, rational and detailed analysis of the             
 economic issues.  The members of the committee will find, after               
 reviewing the facts, that at best, HB 226 is an unnecessary bill              
 that, as currently written, only serves to gut the Human Rights               
 Act.  While Representative Robinson's proposed amendment would fix            
 that issue, such an amendment will be opposed by the bill's sponsor           
 because it would not legislate the type of Draconian interference             
 and personal choice which is the true basis of HB 226.                        
 MR. TUMEO concluded by saying upon reflection, he thinks HESS                 
 Committee members will agree that this is a divisive hate bill, and           
 that it would be best left in subcommittee and not take up any more           
 of the legislators' valuable time.                                            
 Number 929                                                                    
 REPRESENTATIVE ROKEBERG thanked Mr. Tumeo for coming, and                     
 recognized that this is an important issue to him.  He asked Mr.              
 Tumeo to tell HESS Committee members what effect the passage of HB
 226 would have on his position with the university and his case, if           
 the bill were to pass.                                                        
 MR. TUMEO answered that if HB 226 were passed as written, it would            
 essentially overturn the court decision as it was issued.  The                
 judge looked at the situation in which Mr. Tumeo's side presented             
 documentation that they have assumed the same legal and financial             
 ties as are conferred by a marriage license.  Given the fact that             
 the university said it determines benefits based on financial                 
 interdependence, and it bases that determination solely on a                  
 marriage license, the court says that is obviously using marital              
 status in determinations.  That is discrimination based on marital            
 status as defined in the law.                                                 
 MR. TUMEO said HB 226 would allow the university to do that.  The             
 argument Representative Kelly makes that Mr. Tumeo could negotiate            
 his benefits is not true for a university professor.  Mr. Tumeo is            
 a university professor and has been for the past ten years.                   
 Professors do not negotiate their benefit packages.  At best, they            
 may be allowed to negotiate the step at which they enter rank.                
 However, now that Mr. Tumeo is a tenured university professor, he             
 does not have the latitude to negotiate benefits, nor is he part of           
 a collective bargaining unit, nor does he ever intend to be a part            
 of one.                                                                       
 MR. TUMEO said therefore, he does not have the right that                     
 Representative Kelly claims he does.                                          
 Number 1024                                                                   
 REPRESENTATIVE ROKEBERG said therefore, Mr. Tumeo has a direct,               
 vested interest in this legislation.  He did not mean to imply that           
 is why Mr. Tumeo is here, Representative Rokeberg feels it is                 
 beyond that.  However, Mr. Tumeo pointed out that this is a                   
 precedent only for the university.  Representative Rokeberg asked             
 if it was not true that even though this is a precedent only for              
 the university it could be taken as a precedent for any other                 
 public employee in the state to bring a cause of action against the           
 State of Alaska for the very same reason Mr. Tumeo did.                       
 MR. TUMEO said no.  It does not imply a cause of action to bring              
 suit.  The only thing that would provide a cause of action to bring           
 suit would be a decision by the administrative body within the                
 employee's agency to deny the benefit.  For example, another                  
 university employee may decide to request benefits from the                   
 University of Alaska system.  That person would then file the                 
 appropriate paperwork.  If the university system determined that it           
 did not want to grant the benefits, it would deny that request.               
 MR. TUMEO explained that the employee would then go through the               
 official grievance process of the university.  These are set up so            
 the university does not have floods in the court.  If, upon                   
 reflection in that grievance process, the university found it was             
 making the proper decision given the policies and laws of the land,           
 they would then deny that benefit.  That would then be the cause of           
 action if so desired by the employee to go forward for a lawsuit.             
 MR. TUMEO said what the employee would have to do is be able to               
 argue that somehow that decision was illegal, unconstitutional or             
 an abuse of discretion of the administrator that made the decision.           
 In Mr. Tumeo's instance, it was the president of the university.              
 What the court decision allows is for the university to now put               
 into place administrative procedures by which they can make                   
 determinations on benefits based on other issues besides marital              
 status.  It cannot be based solely on marital status under current            
 law, and that is what the judge's decision says.                              
 MR. TUMEO noted that several other universities in the country have           
 faced the same situation and have created mechanisms by which there           
 is a simple form which is filled out, presented, certified, and is            
 legally binding and protects both the institution and the employee,           
 and it is not an administrative burden.  That is why there is no              
 cost in implementation in these institutions.                                 
 Number 1155                                                                   
 REPRESENTATIVE ROKEBERG asked to make a statement, and then invited           
 Mr. Tumeo to agree, disagree or comment.  He said he has read Judge           
 Greene's decision, and she made an extremely good case using Alaska           
 statutes.  That is why Mr. Tumeo won the case, and Representative             
 Rokeberg applauds him for that.  But that is why HESS Committee               
 members are present at this meeting, to make that correction in the           
 statute.  It seems to Representative Rokeberg that if anyone is a             
 state employee, having read the case and the plaintiffs' fact                 
 pattern, and they want to assert their rights just as Mr. Tumeo               
 does, there is nothing barring them from doing that.                          
 Representative Rokeberg asked if Mr. Tumeo agreed.                            
 MR. TUMEO said there is one difference in the fact pattern that is            
 of import, and Representative Kelly has accurately pointed that               
 out.  If Representative Rokeberg read the case, he is then familiar           
 with the Phillips vs. Wisconsin Personnel Commission case that is             
 cited in the court case.  To briefly recap that case, in the state            
 of Wisconsin there is a similar situation as was found in Tumeo and           
 Wattum vs. the University of Alaska.  In that case, the state has             
 a non-discrimination law based on marital status.                             
 MR. TUMEO explained that the case involved two women.  One worked             
 for the state, and one did not.  The woman who worked for the state           
 applied for benefits under the state's policy, and requested that             
 her partner be covered.  Failure to do so was a violation of the              
 state's non-discrimination law.  There is a very similar fact                 
 pattern between this case and Mr. Tumeo's case.  However, in the              
 state of Wisconsin, there is also a law that is very similar to the           
 one in the state of Alaska.  That law states, as a legislative                
 mandate to the DOA, what benefits are to be provided.                         
 MR. TUMEO said Representative Kelly quoted that mandate.  It says             
 the state shall provide benefits for spouses, dependents, etc.  The           
 argument that was made successfully in the Wisconsin case was that            
 clear legislative intent was shown in the case of state employees             
 for discrimination in benefits based on marital status.                       
 Number 1250                                                                   
 MR. TUMEO said the court ruled against the plaintiff in that case,            
 and for the state.  The difference between the University of Alaska           
 and an employee of the state of Alaska is that the University of              
 Alaska does not obtain its insurance through the DOA.  It is a                
 self-insured institution.  It is therefore, not subject to that               
 law.  The state, and the legislature, has already made it clear it            
 feels some ability to discriminate or have indicated there is the             
 potential for discrimination.                                                 
 MR. TUMEO said he is not a judge, but he has been to law school.              
 Therefore, he will not say that someone from the state may not make           
 that argument and another judge may not interpret that law                    
 differently.  However, Mr. Tumeo thought a slightly different fact            
 pattern exists for a person who works for an agency of the state.             
 That is one of the reasons, and another example, of why Mr. Tumeo             
 thinks it would be beneficial in this instance to take some time to           
 review this bill and answer some of these questions.                          
 MR. TUMEO therefore suggested that the committee solicit input from           
 a DOA representative and some other lawyers.  He asked that the               
 bill be discussed in great detail.  If that is done, Mr. Tumeo                
 thought HESS Committee members would find that it is not a                    
 necessary piece of legislation.  The state is already pretty clear            
 as far as benefits go.  Mr. Tumeo asked to let his case work its              
 way through.  He felt that would save time for other things.                  
 Number 1320                                                                   
 REPRESENTATIVE ROBINSON said that Mr. Tumeo has some experience               
 regarding the Domestic Partnership Act.  Representative Robinson              
 noted that Representative Kelly commented that he felt her                    
 amendment was discriminatory to people who have low incomes.                  
 Representative Robinson asked Mr. Tumeo to respond to that.                   
 MR. TUMEO felt that interpretation was a misreading and a                     
 mischaracterization of the amendment that was presented in the                
 State Affairs Committee.                                                      
 CO-CHAIR TOOHEY interjected that the amendment was not currently              
 before the committee, and asked that it be discussed at a later               
 time.  She asked that testimony continue.                                     
 REPRESENTATIVE ROBINSON asked if Mr. Tumeo could speak on the                 
 amendment when it is brought before the committee, since                      
 Representative Kelly already brought up the amendment.  She asked             
 that Mr. Tumeo be able to respond since he is somewhat of an expert           
 in that area.                                                                 
 CO-CHAIR TOOHEY said further testimony should be heard first, and             
 given time, the amendment will be brought before the committee.               
 Number 1367                                                                   
 REPRESENTATIVE ROKEBERG asked Mr. Tumeo if he was aware of the                
 Lilly vs. the City of Minneapolis case.                                       
 MR. TUMEO said he was, and the case is currently under appeal.                
 REPRESENTATIVE ROKEBERG said therefore, the Mr. Tumeo's reference             
 to the case in documents he handed out should be scratched.                   
 MR. TUMEO said no, because the case is under appeal.  When a case             
 is appealed, the current law stands until the court proceedings are           
 Number 1426                                                                   
 REPRESENTATIVE ROBINSON asked about the perceived "rush" on the               
 system which some feel may result from Tumeo and Wattum vs. the               
 University of Alaska.  She also asked Mr. Tumeo about his                     
 experience and knowledge on this topic.                                       
 MR. TUMEO has several studies that indicate throughout the United             
 States that there are no skyrocketing costs associated with                   
 domestic partnership benefits.  Enrollment numbers increase                   
 somewhere between .3 percent where they are measurable, to no more            
 on the average than two percent.  There are no increases in premium           
 costs for those that acquire insurance.  In addition, there are no            
 increased costs to the systems for those that are self-insured.               
 MR. TUMEO has copies of those studies if HESS Committee members               
 would like to see them.                                                       
 REPRESENTATIVE ROBINSON asked Mr. Tumeo if, in his studies, he                
 found any facts about common law relationships.  Representative               
 Robinson grew up in Texas, and a couple is considered to have a               
 common law marriage after seven years.  She is curious about the              
 effects of common law marriages across the nation, and what those             
 relationships have done as far as employee benefits.                          
 Number 1450                                                                   
 MR. TUMEO said he has looked somewhat into common law and the                 
 effects on benefits, but he is not an expert in that topic.  The              
 concept of common law marriage is that after a certain amount of              
 time, an individual may claim the right to financial support on the           
 individual with whom they have been living.  Typically, common law            
 marriage claims come up in terms of support cases between                     
 individuals.  Common law is, by definition, law between                       
 MR. TUMEO explained that when common law marriage statutes come               
 into play is when two people live together for over seven years in            
 a state which recognizes common law relationships.  In that seven             
 years, that couple had also presented themselves as married in the            
 way they lived, and in the things they said.  If then one person              
 decided to terminate the relationship, the partner would have,                
 under common law, the right to demand support.  That is where                 
 common law marriage comes in.                                                 
 MR. TUMEO said common law marriage is not a mechanism that has been           
 used in a court cases that he is aware of to access benefits.                 
 Benefits are accessed via contractual agreements between parties              
 that are recognized by the institution or employer offering the               
 Number 1509                                                                   
 MR. TUMEO said common law marriage is only a status recognized by             
 courts in terms of support between individuals.                               
 REPRESENTATIVE ROBINSON asked Mr. Tumeo how anyone would know that            
 two people were actually married and getting benefits.                        
 MR. TUMEO said that is very difficult.  The state director of                 
 benefits at the university has written a letter regarding HB 226,             
 saying there is no way to account for the costs, whether they would           
 rise or fall, because the demographics are not kept.  As an                   
 interesting note, when original benefits were applied for, Mr.                
 Tumeo's co-plaintiff, Kate Wattum, put down "B. McClendon" as the             
 partner to receive benefits.  Benefits were subsequently granted by           
 the university.  It was not until such time that Ms. Wattum                   
 indicated that "B." stood for "Beverly," that benefits were then              
 MR. TUMEO said at no time during the proceedings or during any                
 other proceedings when people apply for benefits at the university,           
 is a marriage license requested.                                              
 Number 1558                                                                   
 REPRESENTATIVE DAVIS said Mr. Tumeo indicated the court case showed           
 that Mr. Tumeo and his partner had established legal and economic             
 bases equal to a marriage.                                                    
 MR. TUMEO said no, it was never stated that he and his partner had            
 a status equal to marriage.  What was stated was that they had                
 legally binding and legally defensible economic ties.  It did not,            
 at any time, state that their relationship was equal to marriage.             
 The claim was that within the university system, benefits are                 
 granted based on the fact that the employee has an economic and               
 legally enforceable economic responsibility for a third party.                
 That is why benefits are given.                                               
 MR. TUMEO continued that the university says the only way it will             
 recognize that legal bind is through a marriage license.  What Mr.            
 Tumeo's case said was that he and his partner have a contract,                
 which is legally executed, that gives Mr. Tumeo, as the employee,             
 the same financial and legal responsibility for his partner as is             
 conferred by a marriage license.  It does not confer all the other            
 associated rights and privileges of a marriage license.                       
 MR. TUMEO has signed a document that states he is legally                     
 responsible for his partner's expenses.  Given that is the                    
 determining factor to the university, it is discrimination based on           
 marital status for it to ignore his contract with his partner,                
 while accepting only a marriage license.                                      
 MR. TUMEO noted there are literally hundreds, and Mr. Tumeo offered           
 to provide a well-documented list, of benefits that his contract              
 could never provide.  No one in the state of Alaska can enter into            
 a contract that provides the same rights and privileges that are              
 provided by a marriage license. Those rights include survivorship             
 rights for property and tax benefits.  There is a whole plethora of           
 benefits and privileges that accrue to a marriage license that in             
 no way can be simulated by contract or enforced by the court for              
 non-married individuals.                                                      
 Number 1655                                                                   
 REPRESENTATIVE DAVIS said therefore, apparently there are benefits            
 that only a marriage license can provide, and there are several               
 differences between the contract Mr. Tumeo has with his partner and           
 a marriage contract.                                                          
 MR. TUMEO said there are several differences, and he would be more            
 than happy to provide the chair with a complete listing of the                
 types of benefits that are provided to married individuals that are           
 denied unmarried individuals and cannot be gained through                     
 contractual relationships.                                                    
 REPRESENTATIVE DAVIS wanted to make clear that those rights and               
 benefits are not also gained by a semi-marriage license, which he             
 determined is the agreement between Mr. Tumeo and his partner.  He            
 asked if it was a "self-made marriage license."                               
 MR. TUMEO said the spousal equivalency form that he and his partner           
 filed in no way simulates a marriage license.  It is only a legal             
 document that indicates he is economically and legally responsible            
 for the bills accrued by his partner.                                         
 Number 1703                                                                   
 REPRESENTATIVE VEZEY asked Mr. Tumeo if Representative Vezey                  
 appears to be an emotional person.                                            
 MR. TUMEO said at the moment Representative Vezey does not appear             
 emotional, however, Mr. Tumeo has seen Representative Vezey very              
 emotional at times.                                                           
 REPRESENTATIVE VEZEY asked Mr. Tumeo why he characterizes HB 226 as           
 an "emotional" bill.                                                          
 MR. TUMEO said that is somewhat from experience.  At the last                 
 committee hearing on this bill, there was quite a bit of emotion              
 and tension present.  The bill touches what is traditionally an               
 emotional issue in many venues of discussion.  There are issues               
 surrounding relationships that people feel very strongly about.               
 People feel strongly about relationships on religious, ethical and            
 moral grounds.  When those are confronted or challenged in any way,           
 it evokes emotion.                                                            
 MR. TUMEO noted that does not necessarily mean all people respond             
 emotionally at the instant the topic arises.  However, there is a             
 building sense that can be seen in many places across the country,            
 that gays and lesbians have gone too far.  Mr. Tumeo disagrees with           
 this.  He believes that it is his responsibility and his moral                
 obligation to ask for equal treatment.  Such requests often evoke             
 a lot of emotion.                                                             
 REPRESENTATIVE VEZEY asked if Mr. Tumeo would characterize this               
 bill as an economic issue.                                                    
 MR. TUMEO replied that if the bill did address an economic issue,             
 Representative Robinson's amendment, as proposed in the State                 
 Affairs Committee, clearly draws the economic tight circle which              
 protects the state, protects the university, and protects the Human           
 Rights Act of the state of Alaska.                                            
 Number 1722                                                                   
 REPRESENTATIVE VEZEY asked Mr. Tumeo if he would not characterize             
 this bill as a basic social issue.                                            
 MR. TUMEO said that depends on what Representative Vezey means by             
 "social issue."  If relationships, the interactions between                   
 individuals, and privacy are social issues valid for legislative              
 intent, then this bill could be characterized as a social issue.              
 In fact, at times in the past the country has had legislation                 
 preventing interracial marriages and interfaith marriages.                    
 Therefore, Mr. Tumeo imagines this bill would fall into the social            
 MR. TUMEO said mankind has progressed in society to the extent that           
 determining what type of relationship is good and bad is not                  
 something that is typically left to legislative activities.                   
 However, it is definitely something for social discussion.                    
 Number 1801                                                                   
 CO-CHAIR TOOHEY asked to move on, because other people are                    
 testifying.  She announced the bill would be held over, and asked             
 how long Mr. Tumeo would be in town.  He said he leaves the                   
 following morning, as he has classes to teach.                                
 CO-CHAIR TOOHEY again announced the bill would be held over,                  
 because the HESS Committee members will have to do some work on it.           
 Number 1832                                                                   
 SARAH BOESSER, Board Member, Committee for Equality (CFE), said her           
 organization is statewide.  The CFE askes that this discriminatory            
 bill be stopped or amended to include domestic partners as                    
 suggested by the superior court.  This bill intentionally                     
 undermines the state human rights statute, and that bodes ill for             
 everyone.  If this one exception for marital status is made here,             
 other exceptions may follow.  Upon what basis would these                     
 exceptions be allowed?                                                        
 MS. BOESSER said human rights laws exist in part to educate people            
 as to what practices are discriminatory.  This is so people can               
 avoid illegal actions.  In that light, the proper response to the             
 court ruling would be the exact opposite of this bill.  Lawmakers             
 should be educated by the ruling and should conclude that this is             
 illegal and must stop.  To say instead, "We don't support marital             
 discrimination except in certain cases," is to act in bad faith               
 with regard to the promise of non-discrimination made to the public           
 years ago.                                                                    
 Number 1870                                                                   
 MS. BOESSER said the Juneau Human Rights Commission opposes this              
 bill for just that reason.  Ms. Boesser is sorry the State Human              
 Rights Commissioners were not as protective of the statute.                   
 However, they may be simply acknowledging the legislature's power             
 to amend its own law despite the court's finding that such a                  
 position violates the very statute they were appointed to uphold.             
 MS. BOESSER said her organization supports the Robinson amendment.            
 It does not violate statute since by adding "domestic partners,"              
 financial interdependence, not marital status is the criteria for             
 benefits.  And, as HESS Committee members heard, Harvard University           
 research and other research finds that around the country                     
 enrollment increases of domestic partners is extremely minimal.               
 With limiting guidelines, recognition of domestic partners does not           
 result in increased benefit costs.                                            
 Number 1897                                                                   
 MS. BOESSER concluded by saying thus, the financial impact of this            
 amendment is negligible.  However, if the bill passes without the             
 amendment, the state will certainly suffer ongoing litigation                 
 costs.  HESS Committee members face many important issues.  Going             
 backwards in Human Rights Laws is not one of them.  The session is            
 short, and Ms. Boesser asked HESS Committee members to save the               
 legislature time, unnecessary cost and divisiveness by stopping               
 this bill as written or by amending it to include domestic                    
 Number 1918                                                                   
 REPRESENTATIVE ROKEBERG asked if discrimination concerning employee           
 benefits and domestic relation laws were not important issues.                
 MS. BOESSER said they were very important issues.  That is why they           
 should not be discriminatory on a basis that has been found to be             
 illegal for years.                                                            
 Number 1943                                                                   
 DANIEL COLLISON, Vice President, SEAGLA, said as a representative             
 of that organization he opposes passage of HB 226 which will deny             
 domestic partner benefits to employees of the University of Alaska.           
 Mr. Collison said one of the major arguments put forth by                     
 Representative Kelly in support of his bill is that it would be               
 financially burdensome to the university health care plan if                  
 domestic partner benefits were extended.                                      
 MR. COLLISON said this is the one issue he would like to address in           
 his testimony.  The evidence overwhelmingly suggests otherwise.  In           
 particular, Mr. Collison submitted a letter and attachments from              
 the University of Iowa benefits administrator, a packet containing            
 seven articles on this subject, and a comprehensive listing of                
 corporations, universities and government entities which have                 
 extended domestic partner benefits to their employees.                        
 MR. COLLISON said those who would deny domestic partner benefits              
 predicate a financial burden on three myths.  Myth #1: If the                 
 University of Alaska opens its health care plan to the domestic               
 partners of its employees, the plan will be inundated with new                
 Number 2006                                                                   
 MR. COLLISON explained, however, that the experience of the                   
 university of Iowa counters this myth.  The University of Iowa                
 extended benefits to an employee's common law marriage partner in             
 1953.  In 1992, the same benefits were extended to an employee's              
 same-sex domestic partner.  Currently, the university employs                 
 approximately 26,000 people with 14,000 people eligible for                   
 benefits.  Of this number, only nine-tenths of one percent (.09               
 percent) are in a common law marriage, while only two-tenths of one           
 percent (.02 percent) are covered under the domestic partner                  
 MR. COLLISON continued that the University of Iowa's experience is            
 consistent with that of other employers.  In 1993, the Seagul                 
 Company executive letter reported that in those companies which               
 extend benefits to domestic partners, participation rates are less            
 than five percent of the work force, and frequently less than two             
 percent of the work force.                                                    
 MR. COLLISON presented Myth #2:  Extending health care benefits to            
 the domestic partners of University of Alaska employees will be               
 financially burdensome to the plan.                                           
 MR. COLLISON advised that a study appearing in the June, 1994 CCH             
 Employee Benefits Management Directions find the plans offering               
 domestic partner health coverage to same-sex couples experience               
 about a one percent total increase in health care costs.  Plans               
 offering health care coverage to all domestic partners experience             
 approximately a three percent increase in health care costs.                  
 Number 2070                                                                   
 MR. COLLISON stated Myth #3:  The medical bills of a gay male                 
 domestic partner, with, for example, AIDS-related claims, are more            
 costly than claims of an employee's spouse or dependent.                      
 MR. COLLISON said the authors of an article in "Employee Benefit              
 Practices" report "there is no evidence to indicate the average               
 health care cost of a domestic partner, same sex and/or opposite              
 sex, will be significantly higher than that of a spouse."  For                
 example, the average AIDS-related claim currently figures at                  
 $119,000.  A premature birth, however, can cost as much as $1                 
 million.  Two weeks in intensive care following a heart attack can            
 cost in excess of $50,000.  This figure does not include surgery,             
 related costs and follow up.                                                  
 MR. COLLISON said in fact, the experience of the University of Iowa           
 might suggest that a health plan benefits from enrolling domestic             
 partners rather than spouses of employees.  In 1994, the University           
 of Iowa discovered that claims for persons in domestic partner                
 relationships averaged only $224 per person.  A regular spousal               
 claim averaged approximately $2,700.                                          
 Number 2125                                                                   
 MR. COLLISON stated the facts overwhelmingly suggest that should              
 the University of Alaska extend domestic partner benefits to its              
 employees there would in fact be no significant added financial               
 cost to the university's health plan.  If the committee yet harbors           
 concerns about the cost of such a benefit, Mr. Collison would                 
 suggest they refer the matter to a subcommittee for a thorough                
 examination of all financial considerations.  Furthermore, he would           
 suggest that the Robinson amendment, which strictly defines a                 
 domestic partner relationship, will prevent any abuse of such                 
 benefits and minimize any cost to the university health plan.                 
 MR. COLLISON presented packets of information to HESS Committee               
 Number 2166                                                                   
 JOHN GAGUINE, Assistant Attorney General, Department of Law, said             
 his department is responsible for the tracking of this bill.  He is           
 present at the invitation of Co-Chair Toohey to answer questions.             
 REPRESENTATIVE VEZEY thought the underlying question he has                   
 concerns the fact that the state of Alaska definitely does not have           
 provisions for common law marriage.  Representative Vezey's                   
 understanding of common law marriage is substantially different               
 than what was explained by Mr. Tumeo.  Representative Vezey asked             
 for Mr. Gaguine's definition.                                                 
 MR. GAGUINE said the Alaska Supreme Court has made it very clear              
 that Alaska does not have common law marriage in this state.                  
 Therefore, he is not clear on the concept.  However, his                      
 understanding is that common law marriage exists when a couple has            
 lived together for a certain period of time, and they have                    
 presented themselves as husband and wife.  They are then considered           
 REPRESENTATIVE VEZEY said therefore, Mr. Gaguine's understanding of           
 the concept is the same as his.   He asked if Mr. Gaguine would               
 interpret the new Alaska law as handed down by Judge Greene as                
 establishing a sector of common law marriage.                                 
 Number 2227                                                                   
 MR. GAGUINE said that is a hard question.  To the limited extent              
 that benefits are being conferred, the issue can be looked at in              
 that way.  Mr. Gaguine would, however, say no because common law              
 marriage, in the states that have it, is so much broader than just            
 this limited decision dealing with health care benefits.                      
 CO-CHAIR TOOHEY said going back in Alaska's history, traditionally            
 Native marriages were commitments between two people that said, "We           
 will live together."  The relationships were dissolved equally as             
 efficiently, by saying "We will no longer live together."  She                
 asked if Mr. Gaguine knew anything about that.  He did not.                   
 CO-CHAIR TOOHEY also asked what will happen if Judge Greene's                 
 decision is upheld in the appeal.                                             
 MR. GAGUINE said that would depend on if the decision is made                 
 retroactive.  Given the intent behind HB 226, Mr. Gaguine said the            
 legislature would want to make it clear that the intent is not to             
 change to the law but to restate what the legislature feels the law           
 is.  This is under the assumption that the legislature feels Judge            
 Greene's decision was not correct, and therefore it is not changing           
 the law, it is only restating the existing law.                               
 MR. GAGUINE said again, if the Supreme Court were to uphold Judge             
 Greene's decision, and if the Supreme Court finds the bill is                 
 simply a change in the law and not just a clarification in the law,           
 and it is not made retroactive, then the plaintiffs in that case              
 would be entitled to coverage for a certain period of time.  Again,           
 however, it would seem to Mr. Gaguine that coverage would cease               
 when the bill became effective (if the bill is passed).                       
 TAPE 95-29, SIDE B                                                            
 Number 000                                                                    
 CO-CHAIR TOOHEY asked if the Administration was taking a position             
 on this bill.                                                                 
 MR. GAGUINE said he could not speak to that.  He understands that             
 at the last committee meeting, the director of the Division of                
 Retirement and Benefits spoke in favor of HB 226.                             
 REPRESENTATIVE ROBINSON interjected that the director was not                 
 authorized.  That is the reason he is not present at the current              
 meeting.  She said she could probably get that in writing.                    
 Number 056                                                                    
 REPRESENTATIVE ROKEBERG asked Mr. Gaguine if he was familiar with             
 the case Lilly vs. The City of Minneapolis, and he was not.                   
 Representative Rokeberg said it was published on January 31, 1995.            
 It is in the Minnesota Appeals Court.  Representative Rokeberg                
 asked if Mr. Gaguine was familiar with the Baehr vs. Lewin case               
 from Hawaii, and he was.                                                      
 REPRESENTATIVE ROKEBERG said Mr. Gaguine pointed out that it would            
 be up to the Alaska Supreme Court as to the disposition of the                
 Tumeo-Wattum case.  If the decision were thrown out, there would be           
 no claim on the part of Mr. Tumeo at all.                                     
 MR. GAGUINE answered that would be correct.                                   
 REPRESENTATIVE ROKEBERG said if the decision is upheld, then                  
 according to Mr. Tumeo there would be just a claim on the part of             
 University of Alaska employees versus other state employees.  He              
 asked if that was correct.                                                    
 MR. GAGUINE said that was the key question.  Mr. Tumeo pointed out            
 the statute governing health insurance procured by the DOA which              
 does say, as he indicated, that such insurance must be subject to             
 a provision that it cover each eligible employee, the spouse and              
 the unmarried children chiefly dependent upon the eligible employee           
 for support.  Mr. Tumeo seemed convinced the state would be                   
 protected if it was faced with a suit brought by a state employee             
 along the same lines as Tumeo and Wattum vs. The University of                
 Alaska.  To Mr. Gaguine's knowledge, the state has not been faced             
 with any such claim to date.                                                  
 Number 210                                                                    
 MR. GAGUINE has spoken with a lawyer for the university, and he has           
 not seen a copy of Judge Greene's decision on reconsideration.                
 What was given today is the university's petition for                         
 reconsideration.  Mr. Gaguine did not know whether Judge Greene               
 said, "No, the statute does not protect anybody," or whether she              
 said "No, the statute does not protect the university."                       
 MR. GAGUINE continued that if, in fact, Judge Greene said the                 
 statute does not protect the university and she did not make a                
 decision whether or not it protects the state, then maybe the state           
 may have adequate protection.                                                 
 Number 297                                                                    
 REPRESENTATIVE ROKEBERG asked if any state employee with a fact               
 pattern similar to Mr. Tumeo's or Ms. Wattum's brought a cause of             
 action suit against the state for similar circumstances, given                
 Judge Greene's ruling, is there any precedent set or would that be            
 up to the courts to decide.                                                   
 MR. GAGUINE said obviously, the state is more likely to get sued              
 now than before Judge Greene's opinion.  He reiterated that this              
 issue is whether the other statute provides the state with absolute           
 protection.  The state would hope the court would reach that                  
 Number 362                                                                    
 REPRESENTATIVE ROKEBERG asked if the areas of discrimination, i.e.,           
 employee health benefits and the body of law around domestic                  
 relations are both compelling of state interest and a matter of               
 statewide concern.                                                            
 MR. GAGUINE said that is a policy question that he would rather not           
 REPRESENTATIVE ROKEBERG recalled that Mr. Gaguine said he is                  
 familiar with the case from Hawaii.  Representative Rokeberg                  
 summarized that the Hawaiian Supreme Court ruled, based on the                
 amendments to the Hawaii constitution and the civil rights                    
 provision on the word "sex."  They said it was not related to                 
 gender but also allowed sexual orientation.  Therefore, the court             
 ruled that same-sex marriages were allowable under the Hawaiian               
 MR. GAGUINE advised that the court did not go quite that far.                 
 CO-CHAIR TOOHEY told Representative Rokeberg that same sex                    
 marriages were not being discussed.  What was being discussed was             
 marital status at the university for health care benefits.  This              
 can include live-in partnerships or men and women who do not want             
 to get married.  Same-sex relationships are not the only issue, and           
 eventually Representative Rokeberg's bill concerning marriage will            
 be heard.                                                                     
 REPRESENTATIVE ROKEBERG read a footnote on page 15 of Judge                   
 Greene's ruling.  It said, "The University would have to show that            
 same sex marriage is prohibited in Alaska....The University                   
 provided no legal argument that such marriages are prohibited."               
 Representative Rokeberg asked Mr. Gaguine what the effect of this             
 footnote would be on precedent.                                               
 Number 504                                                                    
 MR. GAGUINE felt the footnote says the judge did not want to decide           
 that issue.  She is ducking the issue, basically.                             
 MR. TUMEO asked to reply to a question.  He said that                         
 Representative Rokeberg asked about the decision upon remand, and             
 the request for reconsideration.  It was a very simple, two-                  
 paragraph decision in which the court said two things.  The                   
 university asked for reconsideration claiming the court had missed            
 the very laws that Representative Kelly and Mr. Tumeo have                    
 discussed in terms of protection to the state.                                
 MR. TUMEO explained that the judge said two things.  She said the             
 court cannot miss something that was not presented to it (the                 
 university never brought those issues up in court).  She also said            
 the university had not proven that the law showed the intent of the           
 legislature to discriminate against marital status for the                    
 university.  That is not the exact wording, however, the main point           
 is that Judge Greene ducked the issue of whether it applied to the            
 state or not.  She did not approach that issue.  She basically                
 said, the university did not make this argument before, therefore,            
 it is not appropriate to make it on request for reconsideration.              
 Number 601                                                                    
 REPRESENTATIVE ROBINSON asked Mr. Gaguine if there is any way                 
 anyone could find out how many state employees have filed for                 
 insurance who are actually not married.                                       
 MR. GAGUINE said he would not know that information.                          
 Number 637                                                                    
 MARYLOU BURTON, Director of Statewide Budget, University of Alaska            
 Fairbanks, read in a statement from the university into the record.           
 "The University supports this bill.  As you know, Judge Greene's              
 decision in the Tumeo-Wattum case was that under state law, the               
 University cannot restrict its health care benefits on the basis of           
 marital status.  We are appealing that ruling, but if we fail in              
 our case, we may be faced with the need to limit benefits in some             
 way, which could be not covering spouses or limiting the overall              
 amount of benefits to individuals just to live within our financial           
 "This bill provides the University and other employers the option             
 to limit benefits to employees and their spouses and dependents."             
 MS. BURTON noted that she had just read a basic statement of                  
 support for the bill.                                                         
 Number 714                                                                    
 REPRESENTATIVE ROBINSON asked Ms. Burton how much she thought the             
 loss of Tumeo's case would cost the university.                               
 MS. BURTON said the university does not have that information at              
 this time.  In addition, she did not believe the university has the           
 kind of data that can provide that information at this time.                  
 Number 735                                                                    
 REPRESENTATIVE ROKEBERG asked if it would cost more than $100.                
 MS. BURTON said she could not say if it would, but she would                  
 suspect so.                                                                   
 CO-CHAIR TOOHEY asked who is paying court costs for Tumeo and                 
 Wattum vs. The University of Alaska.                                          
 MR. TUMEO said he paid for his own case, and Ms. Burton said the              
 university is paying for its case.                                            
 CO-CHAIR TOOHEY asked if there is any connection with the                     
 Administration of the state of Alaska, or are the university's                
 court costs strictly out of the budget of the University of Alaska?           
 MS. BURTON answered that to the best of her knowledge, the court              
 costs were coming strictly out of the university's budget.                    
 Number 722                                                                    
 REPRESENTATIVE ROBINSON asked how much the case has cost so far.              
 MS. BURTON answered that she does not have that information,                  
 however, someone at the university probably knows, and she could              
 get that information for the committee.                                       
 MR. TUMEO spoke to the plaintiff costs.  He has individually                  
 accumulated $10,000 in legal fees, and his attorney is charging him           
 half price.  He also noted he has a legal defense fund, if anyone             
 in the room wanted to contribute.                                             
 REPRESENTATIVE ROBINSON would assume the university has personal              
 policies that can be amended that would probably correct this                 
 MS. BURTON replied that the university does have personnel policies           
 that could presumably could be corrected in such a way that would             
 address the problem--if that is the way the case is decided.                  
 Number 852                                                                    
 REPRESENTATIVE BRICE asked if currently the university pays for               
 spousal benefits.                                                             
 MS. BURTON said she has been back with the university for about one           
 and one half months, and she was sent to the HESS Committee to read           
 a statement in lieu of someone who could not be present. She wanted           
 to attach that disclaimer to her comments.  However, she said under           
 the university's policy, you have to pay an extra amount of money             
 if you want your spouse or dependents covered.  The coverage is not           
 just automatic.                                                               
 REPRESENTATIVE BRICE said therefore, the employee pays for the                
 increase, and Ms. Burton said yes.  Representative Brice then                 
 suggested that in the instances of Tumeo and Wattum, the university           
 would not even allow them to pay for the increase.                            
 MR. TUMEO said that was correct.                                              
 CO-CHAIR TOOHEY asked the cost.                                               
 MS. BURTON believed the cost was about $6.50 every pay period.                
 Number 892                                                                    
 MR. TUMEO said the university charges depending on which package is           
 chosen for you and your partner.  The charge is somewhere between             
 $4 to $7 a pay period.  The university also provides a small                  
 amount, so there is some minimal charge to the university.  When,             
 in the law case, the university was asked what that amount was, the           
 university was unable to produce statistics to show how much that             
 was because the amount is not big enough for them to keep track of            
 in their system.                                                              
 MR. TUMEO continued that the university would not even allow him to           
 pay the university's portion to get the benefit, because it did not           
 know how much that portion was.                                               
 REPRESENTATIVE BRICE said that is what this bill is trying to                 
 restrict.  It is not being requested that the university or any               
 employers give benefits away.  Just the opposite, people are                  
 willing to pay for the benefits.                                              
 MS. BURTON said she could not speak on this issues.                           
 CO-CHAIR TOOHEY told her that these are the kinds of questions that           
 HESS Committee members need answers to.  She then asked Mr. Gaguine           
 if it was the place of the legislature to intervene in a decision             
 in the courts before that decision is finalized.                              
 MR. GAGUINE said that is obviously a policy decision for the                  
 legislature.  He thinks, however, at this point there is a final              
 Superior Court decision.  The legislature is not intervening in the           
 beginning of a lawsuit before there has been any decision rendered.           
 There has been a decision rendered by the superior court.                     
 Number 996                                                                    
 CO-CHAIR TOOHEY summarized Mr. Gaguine's comments as the decision             
 has already been made.                                                        
 MR. GAGUINE said the final word has not been handed down yet, as              
 the case is in appeal.                                                        
 CO-CHAIR TOOHEY asked if, in fact legislation is passed that says             
 no non-employees will be accepted on benefits unless they are duly            
 married with a license, can the court's decision be made                      
 MR. GAGUINE said there might be problems making the decision                  
 retroactive.  There is a rule that states if the existing law has             
 been relied upon, a change in that cannot be retroactive.                     
 Generally, some statutes can be made retroactive, however, Mr.                
 Gaguine felt there would be problems making any decisions here                
 CO-CHAIR TOOHEY asked HESS Committee members what other information           
 they would like to request from those testifying so the bill can be           
 heard again promptly.  She also asked to hear the amendment at the            
 next hearing of the bill.                                                     
 REPRESENTATIVE BRICE said he still would like someone from the DHSS           
 to address some questions.  Co-Chair Toohey agreed that would be              
 REPRESENTATIVE ROKEBERG said there has been a brand new case that             
 has come down, and he would like some clarification on the existing           
 benefit statute for the state of Alaska.  He suggested that Mr.               
 Gaguine provide that information.  He asked Mr. Gaguine to look up            
 the case Lilly vs. The City of Minneapolis, and then to study the             
 Minnesota statute as it relates to the Alaska statute.  The                   
 relation will be evident.                                                     
 CO-CHAIR TOOHEY said she would also like a position paper from the            
 Number 1134                                                                   
 REPRESENTATIVE ROBINSON asked to speak to Representative Kelly's              
 comments on her amendment.  Representative Kelly had commented that           
 her amendment was discriminatory toward low income people.  She               
 asked HESS Committee members to take the time to read her                     
 amendment.  It clearly states that it refers to a domestic partners           
 who reside together.  There is a whole series of criteria that must           
 be met, such as having a joint banking account.                               
 REPRESENTATIVE ROBINSON stressed it was important to remember that            
 only employed people are being addressed in her amendment and in              
 the bill, not unemployed people.  There is a whole series of                  
 criteria, and the couple must meet five of those criteria.  One of            
 them is having entered into a legally binding domestic partnership            
 agreement.  That does not cost anything to the partners.                      
 REPRESENTATIVE ROBINSON wanted to make it clear that those who are            
 "the working poor" could definitely enter into a domestic                     
 partnership act.  This amendment does not discriminate against                
 people who are poor.  Representative Robinson wanted to get that on           
 the record.                                                                   
 Number 1205                                                                   
 MARY GRAHAM, Interested Citizen, said she is opposed to HB 226                
 which appears to now say, "We, the State of Alaska, don't want to             
 discriminate based on marital status in general, but we will allow            
 extra compensation by public employers for persons who are legally            
 married to be considered a non-discriminatory practice."  In short,           
 it says the state is not going to allow discrimination but anyone             
 can discriminate.  That is how it reads to Ms. Graham.                        
 MS. GRAHAM said, as has been pointed out in previous hearings on              
 this bill, persons can enter into civil contracts of many sorts to            
 become financially obligated to each other.  Therefore, Ms. Graham            
 feels HB 226 is a detriment to equal protection for all Alaskans,             
 no an enhancement.  Ultimately, it provides not equal rights but              
 special rights for married persons.                                           
 MS. GRAHAM urged HESS Committee members to dismiss this bill in               
 light of Judge Greene's ruling, and get on with the other important           
 business of this legislature.  As noted in Judge Greene's decision,           
 in the two Supreme Court cases that have challenged discrimination            
 under the Human Rights Act, the courts conclude that protection               
 against discrimination based on marital status protects the rights            
 of unmarried couples.  Although these were housing cases, Ms.                 
 Graham believes the same principles apply.                                    
 Number 1285                                                                   
 MS. GRAHAM asked if the state should tell landlords they cannot               
 discriminate, but public employers may.  Ms. Graham did not think             
 so, and it seems illogical to pass legislation that has already               
 been determined to discriminate.  If HESS Committee members choose            
 to move forward with this bill, Ms. Graham asked that the bill be             
 amended to include domestic partnership language to continue to               
 hold to the intent of the Human Rights Act and not encourage                  
 Number 1306                                                                   
 CO-CHAIR TOOHEY thanked Ms. Graham and asked a question to Mr.                
 Tumeo.  She asked if he would be allowed to pay $500 a month for              
 the insurance if he wanted to.                                                
 MR. TUMEO answered there is some level at which, of course, an                
 individual can buy insurance.  The standard is because the                    
 university is a large pool, it is less expensive to buy there.  The           
 standard cost, as he understands it, is somewhere between $150 and            
 $190.  Mr. Tumeo and his partner offered to pay that to the                   
 university and the university would not allow him to enroll his               
 CO-CHAIR TOOHEY asked when HESS Committee members would be able to            
 hear testimony again, and it was tentatively decided that the bill            
 would be heard again in nine days, on Thursday, April 6.                      
 CO-CHAIR TOOHEY adjourned the meeting at 4:54 p.m.                            

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