Legislature(1995 - 1996)

04/09/1996 03:10 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
          HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                          
                       STANDING COMMITTEE                                      
                         April 9, 1996                                         
                           3:10 p.m.                                           
                                                                               
                                                                               
 MEMBERS PRESENT                                                               
                                                                               
 Representative Cynthia Toohey, Co-Chair                                       
 Representative Con Bunde, Co-Chair                                            
 Representative Gary Davis                                                     
 Representative Norman Rokeberg                                                
 Representative Caren Robinson                                                 
 Representative Tom Brice                                                      
 Representative Al Vezey                                                       
                                                                               
 MEMBERS ABSENT                                                                
                                                                               
 None                                                                          
                                                                               
 COMMITTEE CALENDAR                                                            
                                                                               
 CS FOR SENATE BILL NO. 165(L&C)                                               
                                                                               
 "An Act relating to psychologists and psychological associates."              
                                                                               
      - SUBCOMMITTEE APPOINTED                                                 
                                                                               
 CS FOR SENATE BILL NO. 91(HES)                                                
                                                                               
 "An Act creating the crime of criminal transmission of human                  
 immunodeficiency virus (HIV)."                                                
                                                                               
      - HEARD AND HELD                                                         
                                                                               
 CS FOR SENATE BILL NO. 158(L&C) am                                            
                                                                               
 "An Act relating to pharmacists and pharmacies."                              
                                                                               
      - SCHEDULED BUT NOT HEARD                                                
                                                                               
 CS FOR SENATE BILL NO. 259(FIN)                                               
                                                                               
 "An Act extending the termination date of the Alaska Commission on            
 Aging; and providing for an effective date."                                  
                                                                               
      - SCHEDULED BUT NOT HEARD                                                
                                                                               
 PREVIOUS ACTION                                                               
                                                                              
 BILL:  SB 165                                                                
 SHORT TITLE: PSYCHOLOGISTS & PSYCHOLOGICAL ASSOCIATES                         
 SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES BY REQUEST                    
                                                                               
 JRN-DATE     JRN-PG               ACTION                                      
 04/25/95      1230    (S)   READ THE FIRST TIME - REFERRAL(S)                 
 04/25/95      1230    (S)   HES, L&C                                          
 01/17/96              (S)   HES AT  9:00 AM BUTROVICH ROOM 205                
 01/17/96              (S)   MINUTE(HES)                                       
 01/18/96      2166    (S)   HES RPT  CS  4DP          SAME TITLE              
 01/18/96      2166    (S)   ZERO FISCAL NOTE TO SB & CS (DCED)                
 01/30/96              (S)   L&C AT  1:30 PM FAHRENKAMP RM 203                 
 01/30/96              (S)   MINUTE(L&C)                                       
 01/31/96      2262    (S)   L&C RPT  CS  2DP 2NR   SAME TITLE                 
 01/31/96      2262    (S)   PREVIOUS ZERO FISCAL NOTE (DCED)                  
 02/02/96              (S)   RLS AT 10:15 AM FAHRENKAMP RM 203                 
 02/02/96              (S)   MINUTE(RLS)                                       
 02/07/96      2324    (S)   RULES TO CALENDAR 2/9/96                          
 02/09/96      2359    (S)   READ THE SECOND TIME                              
 02/09/96      2359    (S)   L&C  CS ADOPTED UNAN CONSENT                      
 02/09/96      2359    (S)   ADVANCED TO THIRD READING UNAN                    
                             CONSENT                                           
 02/09/96      2359    (S)   READ THE THIRD TIME  CSSB 165(L&C)                
 02/09/96      2360    (S)   PASSED Y19 N0 E1                                  
 02/09/96      2363    (S)   TRANSMITTED TO (H)                                
 02/12/96      2718    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 02/12/96      2718    (H)   HEALTH,EDUCATION AND SOCIAL SERVICES              
 04/02/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 04/02/96              (H)   MINUTE(HES)                                       
 04/04/96              (H)   HES AT  3:00 PM CAPITOL 106                       
 04/04/96              (H)   MINUTES(HES)                                      
 04/09/96              (H)   HES AT  3:00 PM CAPITOL 106                       
                                                                               
 BILL:  SB  91                                                               
 SHORT TITLE: CRIMINAL TRANSMISSION OF HIV                                     
 SPONSOR(S): SENATOR(S) TAYLOR,Halford                                         
                                                                               
 JRN-DATE     JRN-PG               ACTION                                      
 02/20/95       331    (S)   READ THE FIRST TIME - REFERRAL(S)                 
 02/20/95       331    (S)   HES, JUD                                          
 03/08/95              (S)   HES AT  9:00 AM BUTROVICH RM 205                  
 03/08/95              (S)   MINUTE(HES)                                       
 03/10/95              (S)   MINUTE(HES)                                       
 03/10/95       577    (S)   HES RPT  CS  3DP      SAME TITLE                  
 03/10/95       577    (S)   ZERO FISCAL NOTES (ADM, LAW)                      
 03/20/95              (S)   JUD AT  1:30 PM BELTZ ROOM 211                    
 03/20/95              (S)   MINUTE(JUD)                                       
 03/21/95       720    (S)   JUD RPT  3DP 1DNP (HES)CS                         
 03/21/95       720    (S)   PREVIOUS ZERO FNS (ADM, LAW)                      
 03/22/95              (S)   RLS AT 12:30 PM FAHRENKAMP RM 203                 
 03/22/95              (S)   MINUTE(RLS)                                       
 03/24/95       790    (S)   RLS RPT 3CAL 2DNCAL  CALENDAR 3/27                
 03/27/95       790    (S)   READ THE SECOND TIME                              
 03/27/95       790    (S)   HES  CS ADOPTED UNAN CONSENT                      
 03/27/95       791    (S)   ADVANCE TO 3RD RDG FLD Y11 N7 E2                  
 03/27/95       791    (S)   THIRD READING 3/28 CALENDAR                       
 03/28/95       824    (S)   READ THE THIRD TIME  CSSB 91(HES)                 
 03/28/95       824    (S)   PASSED Y13 N7                                     
 03/28/95       824    (S)   ZHAROFF  NOTICE OF RECONSIDERATION                
 03/30/95       850    (S)   RECONSIDERATION NOT TAKEN UP                      
 03/30/95       851    (S)   TRANSMITTED TO (H)                                
 04/05/95      1015    (H)   READ THE FIRST TIME - REFERRAL(S)                 
 04/05/95      1015    (H)   HES, JUDICIARY                                    
 04/09/96              (H)   HES AT  3:00 PM CAPITOL 106                       
                                                                               
 WITNESS REGISTER                                                              
                                                                               
 DR. ROBB STOKES                                                               
 P.O. Box 20949                                                                
 Juneau, Alaska  99802                                                         
 Telephone:  (907) 586-3580                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 SUSAN BAXTER                                                                  
 1007 West 3rd Street, Suite 301                                               
 Anchorage, Alaska  99501                                                      
 Telephone:  (907) 272-0155                                                    
 POSITION STATEMENT:  Testified in support of CSSB 165(L&C)                    
                                                                               
 SHEILA CLARSON                                                                
 P.O. Box 671634                                                               
 Chugiak, Alaska  99567                                                        
 Telephone:  (907) 688-6404                                                    
 POSITION STATEMENT:  Testified in support of CSSB 165(L&C)                    
                                                                               
 KATHRYN CARSSOW                                                               
 1335 O Street                                                                 
 Anchorage, Alaska 99501                                                       
 Telephone:  (907) 274-7909                                                    
 POSITION STATEMENT:  Testified in support of CSSB 165(L&C)                    
                                                                               
 ALLEN MOMA                                                                    
 P.O. Box 231453                                                               
 Anchorage, Alaska  99523                                                      
 Telephone:  (907) 562-1846                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 KAREN FORREST                                                                 
 408 Gold Street                                                               
 Juneau, Alaska  99801                                                         
 Telephone:  (907) 463-1536                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 KAREN GIBSON                                                                  
 P.O. Box 110623                                                               
 Anchorage, Alaska  99511                                                      
 Telephone:  (907) 346-1986                                                    
 POSITION STATEMENT:  Testified in support of CSSB 165(L&C)                    
                                                                               
 CATHERINE REARDON, Director                                                   
 Division of Occupational Licensing                                            
 Department of Commerce & Economic Development                                 
 P.O. Box 110806                                                               
 Juneau, Alaska  99811-0806                                                    
 Telephone:  (907) 465-2534                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 JERRY REINWAND, Lobbyist                                                      
 Blue Cross of Washington & Alaska                                             
 2 Marine Way, Number 219                                                      
 Juneau, Alaska  99801                                                         
 Telephone:  (907) 586-8966                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 SHARON MACKLIN, Lobbyist                                                      
 Alaska Psychological Association                                              
 315 5th Street, Number 8                                                      
 Juneau, Alaska  99801                                                         
 Telephone:  (907) 586-9518                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 BARBARA GABIER, Program Coordinator                                           
 Division of Occupational Licensing                                            
 Department of Commerce & Economic Development                                 
 P.O. Box 110806                                                               
 Juneau, Alaska  99811-0806                                                    
 Telephone:  (907) 465-2572                                                    
 POSITION STATEMENT:  Answered questions on CSSB 165(L&C)                      
                                                                               
 JENNIFER JONES                                                                
 2453 West 27th Avenue                                                         
 Anchorage, Alaska  99517                                                      
 Telephone:  (907) 243-2868                                                    
 POSITION STATEMENT:  Testified on CSSB 165(L&C)                               
                                                                               
 SENATOR ROBIN TAYLOR                                                          
 Alaska State Legislature                                                      
 Capitol Building, Room 30                                                     
 Juneau, Alaska  99801-1182                                                    
 Telephone:  (907) 465-4906                                                    
 POSITION STATEMENT:  Prime sponsor of SB 91                                   
                                                                               
 BARBARA BRINK, Attorney                                                       
 Alaska Public Defender Agency                                                 
 900 West 5th Avenue, Number 200                                               
 Anchorage, Alaska  99501                                                      
 Telephone:  (907) 264-4400                                                    
 POSITION STATEMENT:  Testified on CSSB 91(HES)                                
                                                                               
 AMY EILERTSEN, Director                                                       
 Stop AIDS Project                                                             
 520 East 4th Avenue                                                           
 Anchorage, Alaska  99501                                                      
 Telephone:  (907) 278-5019                                                    
 POSITION STATEMENT:  Testified on CSSB 91(HES)                                
                                                                               
 JOHN MIDDAUGH, MD., Chief                                                     
 Epidemiology Section                                                          
 Division of Public Health                                                     
 Department of Health & Social Services                                        
 P.O. Box 240249                                                               
 Anchorage, Alaska  99524-0249                                                 
 Telephone:  (907) 561-4406                                                    
 POSITION STATEMENT:  Testified in opposition to CSSB 91(HES)                  
                                                                               
 JAYNE ANDREEN, Executive Director                                             
 Council on Domestic Violence & Sexual Assault                                 
 Department of Public Safety                                                   
 P.O. Box 111200                                                               
 Juneau, Alaska  99811-1200                                                    
 Telephone:  (907) 465-4356                                                    
 POSITION STATEMENT:  Testified in opposition to CSSB 91(HES)                  
                                                                               
 LYNN STIMLER, Executive Director                                              
 American Civil Liberties Union of Alaska                                      
 P.O. Box 201844                                                               
 Anchorage, Alaska  99520                                                      
 Telephone:  (907) 258-0044                                                    
 POSITION STATEMENT:  Testified in opposition to CSSB 91(HES)                  
                                                                               
 RACHEL KING, Board Member                                                     
 Alaskan AIDS Assistance Association                                           
 West Fireweed Lane                                                            
 Anchorage, Alaska  99501                                                      
 Telephone:  (907) 276-3989                                                    
 POSITION STATEMENT:  Testified on CSSB 91(HES)                                
                                                                               
 ANNE CARPENETI, Assistant Attorney General                                    
 Criminal Division                                                             
 Department of Law                                                             
 P.O. Box 110300                                                               
 Juneau, Alaska  99811-0300                                                    
 Telephone:  (907) 465-3428                                                    
 POSITION STATEMENT:  Testified in opposition to CSSB 91(HES)                  
                                                                               
 ACTION NARRATIVE                                                              
                                                                               
 TAPE 96-37, SIDE A                                                            
 Number 001                                                                    
                                                                               
 The House Health, Education and Social Services Standing Committee            
 was called to order by Co-Chair Con Bunde at 3:10 p.m.  Members               
 present at the call to order were Representatives Bunde, Toohey,              
 Rokeberg, Robinson and Vezey.  Members absent were Representatives            
 G. Davis and Representative Brice.  A quorum was present to conduct           
 business.                                                                     
                                                                               
 CO-CHAIR BUNDE announced the calendar for the meeting was CSSB
 165(L&C), "An Act relating to psychologists and psychological                 
 associates"; CSSB 91(HES), "An Act creating the crime of criminal             
 transmission of human immunodeficiency virus (HIV)"; SB 158, "An              
 Act relating to pharmacists and pharmacies;" and SB 259, "An Act              
 extending the termination date of the Alaska Commission on Aging;             
 and providing for an effective date."                                         
                                                                               
 CSSB 165(L&C) - PSYCHOLOGISTS & PSYCHOLOGICAL ASSOCIATES                    
                                                                               
 CO-CHAIR BUNDE said this was the second hearing on CSSB 165(L&C)              
 and asked Dr. Stokes to come forward to testify.                              
                                                                               
 Number 088                                                                    
                                                                               
 DR. ROBB STOKES said the committee had requested he obtain the                
 recommendations of other board members with respect to the length             
 of supervision required.  The licensing examiner, Wanda Fleming,              
 was able to get three responses which constitutes a quorum of the             
 board.  One board member recommends two years of licensed practice            
 which means three years pre-license, licensure, two years and then            
 petition the board.  He noted that current statute requires a                 
 person to petition the board, even with the five years.  The Chair            
 of the board recommends one year; three years pre-license,                    
 supervision for one year post license and then the person would be            
 independent.                                                                  
                                                                               
 CO-CHAIR BUNDE asked if that would be independent without                     
 petitioning the board?                                                        
                                                                               
 DR. STOKES said the individual has to petition the board in all               
 cases.  He stated his recommendation was to leave it at three years           
 pre-license and allow a person to petition the board when they                
 become licensed.  It ranges from two, one to zero post license.               
                                                                               
 CO-CHAIR TOOHEY questioned if he is the only board member who                 
 agrees with that, what chance does a person have petitioning the              
 board?                                                                        
                                                                               
 DR. STOKES replied in his opinion, a very good chance because the             
 board is very flexible.  He added that 99 percent of psychological            
 associates who apply, including psychologists, are rejected because           
 they don't have adequate course work as delineated in statute.                
 Plans are set up for these individuals and they complete those                
 plans.  If an individual lacks certain courses but can demonstrate            
 they have met the criteria for the course work by presenting a                
 syllabus or a letter from their instructor, the board will accept             
 it.  He added that 99 percent of the psychological associates that            
 are rejected because they don't have the course work, do just that.           
                                                                               
 REPRESENTATIVE TOM BRICE arrived at 3:12 p.m.                                 
                                                                               
 CO-CHAIR BUNDE inquired if 99 percent of the people who petition              
 the board are rejected.                                                       
                                                                               
 DR. STOKES said no, the board does everything they can and 99                 
 percent of those rejected will do whatever needs to be done to get            
 their license.  He commented that the committee had not heard                 
 testimony from those individuals, but has heard testimony from the            
 other 1 percent.                                                              
                                                                               
 CO-CHAIR BUNDE asked of the people who petition, how many are                 
 rejected?                                                                     
                                                                               
 DR. STOKES said 50 percent, including psychologists.  He added                
 there was no difference in psychologists or psychological                     
 associates in terms of rejecting applications and it's almost                 
 always because the person doesn't have the course work required by            
 statute.                                                                      
                                                                               
 CO-CHAIR BUNDE clarified that of the 50 percent that get rejected,            
 the majority of those individuals are given a remedial course of              
 action, are able to meet the criteria and are then accepted.                  
                                                                               
 DR. STOKES responded that was correct and the board is very lenient           
 in setting up plans for them and those people do get licensed.                
                                                                               
 CO-CHAIR BUNDE asked if it was correct that of the people who apply           
 for licenses, 90 percent are licensed?                                        
                                                                               
 DR. STOKES reiterated if those individuals choose to go back and              
 meet the requirements.                                                        
                                                                               
 CO-CHAIR TOOHEY asked why a student would go to a school that                 
 wasn't following the criteria of the Board of Psychological                   
 Associates?  Also, why would Postsecondary Education allow a                  
 student to get a student loan and go to a school that does not meet           
 the academic standards for licensure?                                         
                                                                               
 DR. STOKES said that was an excellent question and one that has               
 been raised in the past.  He explained there is no connection                 
 between the university and the board.  One of the big problems is             
 that students do not read the statutes and the requirements before            
 they apply.  Dr. Kappes, Chair of the Board, has been able to get             
 two courses approved and they will now be taught at the University            
 of Alaska, so psychological associates can meet those requirements.           
 The one course that has been in people's way is called Human                  
 Development which Dr. Stokes took as an undergraduate, as do most             
 people.  He said he has tried to get that course out because it has           
 stood in the way of almost every psychological associate who has              
 applied, but he has been voted down.  However, if students are able           
 to show they have met what the board considers adequate                       
 understanding in human development in their course work, the board            
 will grant it.                                                                
                                                                               
 CO-CHAIR TOOHEY said this was appalling to her.  She is a nurse who           
 went to school in Alaska, applied for a nursing degree, took the              
 required courses at school, got her degree, took the state board              
 exams and became a practicing nurse.  She asked why there is such             
 a breakdown in the psychological field?                                       
                                                                               
 DR. STOKES commented that the board gets applications from schools            
 all over the country, but he didn't know why there was a breakdown.           
 He added the board is held to the statutes that were in place                 
 before they became members of the board.                                      
                                                                               
 CO-CHAIR BUNDE suggested that perhaps some of the students in                 
 Alaska's program would be testifying and the committee could find             
 out if they have the same problems.  He said it is kind of                    
 illogical to think that an Alaskan school would not meet the Alaska           
 requirements.                                                                 
                                                                               
 Number 607                                                                    
                                                                               
 DR. STOKES gave the committee some history to point out his                   
 advocacy because it was being alleged that since he had the                   
 intelligence and the motivation to get a Ph.D. and do the eight               
 years somehow that was negative.  When he applied for licensure the           
 requirement was one year, then licensed, and supervised for the               
 rest of your life.  During that time period, it was changed to                
 three years.  He petitioned the board to allow him to do the one              
 year, but he was turned down.  He and another psychological                   
 associate found that untenable and through Senator Fahrenkamp  were           
 able to get legislation passed for the five years in order to get             
 independence.  He commented that he has worked towards getting                
 psychological associates more independent, not the other way                  
 around.                                                                       
                                                                               
 CO-CHAIR BUNDE confirmed Dr. Stokes' testimony was that the current           
 bill says three years before licensure, two years after licensure.            
                                                                               
 DR. STOKES interjected the bill before the committee states two               
 years before licensure, take the exams, and then the person is                
 independent.                                                                  
                                                                               
 CO-CHAIR BUNDE asked if Dr. Stokes was recommending three years,              
 take the exam and then become independent.                                    
                                                                               
 DR. STOKES confirmed that and added another board member is                   
 recommending take the exam, one year and then become independent;             
 another board member recommends three years, take the exam and then           
 two years.  That brings it to an average of one year post getting             
 the degree.  He reiterated his recommendation of three years and to           
 get rid of the five years totally.                                            
                                                                               
 CO-CHAIR TOOHEY asked if three years post was correct?                        
                                                                               
 DR. STOKES replied no, it was three years pre-licensure.                      
                                                                               
 CO-CHAIR TOOHEY remarked it was three years pre- and one year post,           
 for a total of four years.                                                    
                                                                               
 DR. STOKES stated that was correct.                                           
                                                                               
 CO-CHAIR BUNDE explained that was only one board member's                     
 contention.                                                                   
                                                                               
 DR. STOKES pointed out his contention was to get rid of the five              
 years, petition the board and then independence.                              
                                                                               
 CO-CHAIR TOOHEY commented that she had lost faith in the board's              
 ability to go back to what she thinks is reasonable.  It is her               
 belief that eight years supervision for anyone with a master's                
 degree was ludicrous.  Her recommendation was that the board come             
 up with regulations outlining what course work was required and               
 either the schools follow that criteria or they don't get the                 
 students.                                                                     
                                                                               
 DR. STOKES reiterated that the board is held to the existing                  
 statutes and in the four years he has served on the board, to his             
 knowledge the board has never rejected a petition.  He added that             
 at the last board meeting there were two petitions by people who              
 had completed the five years and the board granted them                       
 independence.                                                                 
                                                                               
 CO-CHAIR TOOHEY said she believed there had been testimony at the             
 last meeting that there were 400 people who had graduated and were            
 waiting for their license.                                                    
                                                                               
 DR. STOKES recalled the testimony indicated there were 400 people             
 who had graduated, but only a small amount had applied for                    
 licensure.                                                                    
                                                                               
 CO-CHAIR BUNDE commented there were people on teleconference                  
 waiting to testify.                                                           
                                                                               
 SUSAN BAXTER testified via teleconference from Anchorage that she             
 was licensed in December 1995 after a fairly long process.  When              
 she applied to the board the first time for the examination, she              
 was refused.  In the process she sought specific guidance from the            
 board in terms of what she might be able to do to meet the                    
 requirements.  Specifically, the requirement that she lacked was              
 course work at the graduate level in human development.  There were           
 no classes available in the state of Alaska at that time in human             
 development; however, the university had taken some steps to infuse           
 that (indisc.) in other courses, so the university felt at that               
 time they were meeting that requirement; however, the board did not           
 recognize that course work.  She went through a rather significant            
 process to inform the board of her own qualifications and the                 
 course work she had received.  Because she had worked in the field            
 of early childhood during her three years supervision, the board              
 found her qualified.  She did, however, express concern that the              
 board had requirements which were not possible by their own                   
 interpretations.  She shares the concerns about the interaction               
 between the university program and the board's interpretation of              
 what (indisc.).  There are a number of students caught in the same            
 situation that she was; a change in interpretation of the statute             
 from the previous board to the present board.                                 
                                                                               
 MS. BAXTER said in terms of supervision, she is now licensed but              
 she had an extra year of supervision which gave her a total of four           
 years supervision.  The one year does not count however because the           
 period of time that counts begins at the time the license is                  
 issued, so even though she has four years of supervision now, she             
 still has to do an additional five years.                                     
                                                                               
 Number 1057                                                                   
                                                                               
 CO-CHAIR BUNDE asked if it would be fair to characterize Ms.                  
 Baxter's position as supporting the bill in its current form?                 
                                                                               
 MS. BAXTER replied yes.                                                       
                                                                               
 Number 1072                                                                   
                                                                               
 SHEILA CLARSON testified via teleconference from Anchorage that she           
 is a licensed psychologist at the Ph.D. level, currently in private           
 practice in Anchorage and secretary of the Alaska Psychological               
 Association.  She testified in support of CSHB 165(L&C) and she               
 wished to testify from the perspective of the impact on the rural             
 mental health programs.  From 1988-1994, she was employed as the              
 chief psychologist for the Alaska Area Native Health Service and              
 her job was to provide support, technical assistance and training             
 in the development of mental health programs around the state.  A             
 major issue had to do with the problems created by the fact that              
 mental health programs in the Bush could not hire master's level              
 psychologists as easily as they could hire social workers or nurse            
 practitioners because it was so much more difficult for the people            
 with a masters in psychology to be licensed as psychological                  
 associates.  People who wish to work in the rural region and have             
 a masters in psychology from a program, for example at the                    
 University of Alaska Anchorage, are at a disadvantage if they do              
 wish to be employed in the Bush because social workers and                    
 psychiatric nurse practitioners can be licensed after two years.              
 From the perspective of the mental health programs, in many cases             
 the individual who was thought to be the best person for the job              
 was not licensed and needed to work under supervision because they            
 were a master's level psychologist (indisc.) so a social worker or            
 a nurse practitioner would be hired instead.  Her reason for                  
 supporting this bill is that she believes it brings master's level            
 practitioners in line with other mental health practitioners like             
 social workers and psychiatric nurse practitioners.  She believes             
 that's fair and it provides additional resources to rural mental              
 health programs that want to hire those people.                               
                                                                               
 CO-CHAIR BUNDE asked if Ms. Clarson felt the bill as currently                
 written is adequate with two years of supervised practice?                    
                                                                               
 MS. CLARSON responded yes, she did.                                           
                                                                               
 CO-CHAIR BUNDE asked if there were any questions of the witness.              
 Hearing none, he invited Kathryn Carssow to testify.                          
                                                                               
 Number 1291                                                                   
                                                                               
 KATHRYN CARSSOW testified via teleconference from Anchorage that              
 she has a master's level degree in clinical psychology and wanted             
 to address a couple of points raised by Dr. Stokes.  First, the               
 course work issue regarding psychological associates and the board            
 is a very hot issue presently and is of deep concern to her.                  
 However, she didn't feel that was what this bill was about.  She              
 believes the board will be taken care of.  The Governor's Office              
 has listened to the tapes from the last two board meetings and                
 inasmuch as the board is up for reappointment she is not concerned            
 about that issue because she thinks a reasonable board will take              
 care of it in a fair and just way.  This bill has been in front of            
 individual board members as well as the full group for over six               
 months and she feels the inconsistent input on how to change the              
 years of supervision is a little late and poorly done.  She said it           
 is representative of this board of not being flexible and felt the            
 board is impulsive, arbitrary and hostile towards the master's                
 level psychological associates.  She expressed her disappointment             
 with the board in the way it is reacting.  She concluded that she             
 supports CSHB 165.                                                            
                                                                               
 CO-CHAIR BUNDE asked if it was Ms. Carssow's position that the                
 board of which a member teaches the psychological associate program           
 at UAA is hostile to their own students?                                      
                                                                               
 MS. CARSSOW responded in the affirmative.  She added it was her               
 personal feeling that over the years there has been a difference on           
 the faculty, but when she entered the program she had a written               
 statement that said this University of Alaska clinical psychology             
 program, of all the programs provided in the state, was the only              
 one that had a curriculum which provided that students be eligible            
 to sit for licensing.  She believed the board was aware of that               
 curriculum and was supportive of it.  The university was acting in            
 good faith with a program that in terms of cultural diversity and             
 human development those requirements were infused very purposefully           
 and very thoughtfully in the curriculum.  She has a letter from the           
 Dean's Office supporting that approach.  Suddenly, a year ago last            
 fall, the board re-interpreted its regulations and started                    
 requesting that students go back and get these courses, one of                
 which, human development, was not even provided.  The Chair of the            
 board sits on the graduate study committee.  She sat in his classes           
 as a graduate student.  He also was part of her graduate student              
 orientation and never once did he indicate to her that she may not            
 be eligible for licensure.  Instead, she had a written statement              
 that she would be eligible for licensure.  She added that it had              
 been insinuated that she had asked to sit for licensing, but in               
 fact she cannot ask to sit for the examination until she has three            
 years of supervision.                                                         
                                                                               
 CO-CHAIR TOOHEY asked if the University of Alaska Anchorage program           
 was accredited by the American Psychological Association?                     
                                                                               
 MS. CARSSOW said she would let Mr. Moma answer that question.                 
                                                                               
 Number 1463                                                                   
                                                                               
 ALLEN MOMA, Alaska Psychological Association and Co-Chair of the              
 committee that originated this bill, testified the American                   
 Psychological Association (APA) does not endorse or certify                   
 master's level programs; they only certify doctoral level programs.           
 Currently, the master's level program at UAA is in the process of             
 gaining certification from the North American Association of                  
 Master's Level Programs, which he surmised would be in place in the           
 next year or two.  He added the UAA does have certification at the            
 university and their product is such that it has been certified by            
 the Collegiate Certification Board (indisc.).                                 
                                                                               
 CO-CHAIR BUNDE said he understood that, and asked if that qualifies           
 them to teach psychology.                                                     
                                                                               
 MR. MOMA responded that was correct.                                          
                                                                               
 CO-CHAIR BUNDE asked Karen Forrest to come forward to testify.                
                                                                               
 Number 1540                                                                   
                                                                               
 KAREN FORREST testified that she has a masters degree in clinical             
 and counseling psychology, is working toward licensure as a                   
 psychological associate under Dr. Stokes and has two years                    
 supervision in at the present time.                                           
                                                                               
 CO-CHAIR BUNDE asked where she had gone to school?                            
                                                                               
 MS. FORREST replied Western Washington University in Bellingham.              
 She said it appeared the biggest controversy focused on the number            
 of years for licensing.  She noted a comparison had been made to              
 teachers and how much supervision they might need and urged the               
 committee to look at more similar fields such as clinical social              
 work and marriage and family therapists.  She distributed                     
 information she had received from the Division of Occupational                
 Licensing on the requirements and the scope of practice for                   
 psychological associates, social workers and marriage and family              
 therapists.  It seemed like the main defense against the bill was             
 that the scope of practice for a psychological associate was much             
 more extensive.  She noted that it is different and asked the                 
 committee to review the different scopes of practice and make their           
 own decision in terms of depth of practice.  She encouraged the               
 committee in making the decision to think about the purpose of the            
 license; if it is to protect the public, she wasn't sure that more            
 supervision after the two years is going to protect the public.               
 She said she knew of a tremendous number of people who were not               
 seeking licensure at all, and don't fall under the regulations,               
 because of the overwhelming procedure.                                        
                                                                               
 CO-CHAIR BUNDE asked why it is that people don't realize before               
 they pursue their degree what a seemingly onerous challenge it is             
 to become licensed as a psychological associate.                              
                                                                               
 MS. FORREST thought that people begin graduate studies for                    
 different purposes.  In her particular case, she did not begin                
 graduate studies for the purpose of being a full time therapist in            
 this field, but rather for her own personal reasons, interests and            
 intellectual stimulation.  She realized after going through the               
 program, this is what she would like to do.  She added there is a             
 lack of consistency between programs throughout the country and               
 licensing requirements in different states.  She could have become            
 licensed much more easily in the state of Washington than in                  
 Alaska.                                                                       
                                                                               
 CO-CHAIR BUNDE asked if Washington has reciprocity with other                 
 states?                                                                       
                                                                               
 MS. FORREST said she could have stayed and sought licensure there             
 and there would have been reciprocity, but she was born and raised            
 in Juneau and didn't want to give up her Alaska residency.                    
                                                                               
 CO-CHAIR BUNDE asked if it was fair to say that people who seek the           
 degree and then choose not to work in the field or not to seek                
 licensure are not necessarily seeking licensure because of the                
 onerous requirements, but because they have chosen to study in that           
 field and will apply it somewhere else or for self-fulfillment.               
                                                                               
 MS. FORREST imagined there were other people like that; she started           
 taking the program for those reasons, but she was aware of a                  
 tremendous number of people who had gone through master's level               
 programs and may qualify in another state, but are not seeking                
 licensure in Alaska because of the tremendous procedures involved.            
                                                                               
 Number 1759                                                                   
                                                                               
 REPRESENTATIVE ROBINSON asked Ms. Forrest if she knew what the                
 rules were in Washington State?                                               
                                                                               
 MS. FORREST stated when she went through the program, it was her              
 understanding there was a grandfather clause that would have                  
 allowed her to take the exam when she graduated, but it was being             
 changed to two years of supervision, take the exam and then be                
 independent.                                                                  
                                                                               
 Number 1799                                                                   
                                                                               
 KAREN GIBSON testified in support of the legislation as it is                 
 written.  She noted this bill has received the support of the                 
 professional psychology organization.  Their subcommittee drafted             
 the bill so the body that represents all the psychologists in the             
 state, whether licensed or not, support it and both universities in           
 Anchorage support it.                                                         
                                                                               
 CO-CHAIR BUNDE asked if it was the psychologists or psychological             
 associates who supported the bill?                                            
                                                                               
 MS. GIBSON responded that both can be members of the Alaska                   
 Psychological Association.  She continued that the major thrust of            
 this bill is to seek parity and noted the information before the              
 committee shows the education and supervisory experience required             
 before licensure; however, what it doesn't show is that the                   
 educational requirements are different.  For example, at UAA a                
 person has to have at least 1,000 hours of supervised clinical                
 experience before graduation even though it's not in statute.  The            
 practicum at the university is videotaped for the student and                 
 everyone else to critique.  To become a licensed social worker,               
 their statutes state that a person only needs a masters degree, but           
 to become a psychological associate a person needs a masters                  
 degrees, but it specifies a minimum of 48 semester hours and                  
 certain areas must be covered.  A person only needs 33 hours to be            
 a licensed marital and family therapist.  Even though the bill is             
 seeking some parity in the amount of time after graduation, people            
 who have a masters degree in psychology have received far more                
 training than the other disciplines which are the only comparable             
 disciplines for licensure.  That was the point she wanted to                  
 stress.                                                                       
                                                                               
 Number 1889                                                                   
                                                                               
 REPRESENTATIVE AL VEZEY said he would characterize 33 hours as one            
 academic year.                                                                
                                                                               
 MS. GIBSON responded it would be a tough academic year, but it                
 could be done.                                                                
                                                                               
 REPRESENTATIVE VEZEY commented that he would characterize 48 hours            
 as one and one-half year.                                                     
                                                                               
 MS. GIBSON said it's a two and one-half year program.  A person has           
 to do 20 hours a week for a year in a site and there has to be a              
 certain amount of course work before beginning clinical work.  The            
 48-hour program at UAA, which the degree is a 50-hour minimum,                
 takes at least two and one-half years because of the timing of the            
 courses.                                                                      
                                                                               
 CO-CHAIR BUNDE asked Mike Tibbles to apprise the committee of the             
 insurance issues that were raised at the last hearing.                        
                                                                               
 Catherine Reardon joined Mr. Tibbles at the witness table to                  
 discuss the insurance questions.                                              
                                                                               
 Number 1946                                                                   
                                                                               
 CATHERINE REARDON, Director, Division of Occupational Licensing,              
 Department of Commerce & Economic Development, testified she had              
 requested that a person from the Division of Insurance be available           
 to provide some backup information; however, that person was not              
 prepared to testify.                                                          
                                                                               
 CO-CHAIR BUNDE asked what the resolution was to the question that             
 had been raised at the last hearing on the bill.                              
                                                                               
 MS. REARDON said having not been present at the last hearing, her             
 understanding was the question related to insurance reimbursements            
 for psychological associates versus psychologists; specifically can           
 the psychological associate bill at the same rate even though a               
 psychologist may have more training than the psychological                    
 associate.  She stated that both psychologists and psychological              
 associates already appear in the nondiscrimination section of the             
 insurance statutes which indicates that providers can't be                    
 discriminated among.  She noted that was the same section of                  
 statute that was of concern with the physician assistants                     
 legislation.  It is her understanding that generally insurance                
 companies reimburse for a specific procedure; in this case for                
 mental health care it could be for counseling, and that insurance             
 companies tend to set a standard and customary rate for that                  
 procedure or treatment and not to distinguish between which                   
 licensed health care professional provides it.  When she asked the            
 question if insurance companies could choose to reimburse different           
 amounts depending on which type of licensee provided the service,             
 the answer as she understands it is that it has never been tested             
 in court and perhaps the theory that the treatment is not identical           
 if it is provided by someone with a different background education            
 could be used as an argument for different standard and customary             
 rates.                                                                        
                                                                               
 CO-CHAIR TOOHEY believed the committee was given a totally                    
 different answer at the last hearing.  She felt it was dishonest to           
 be treated by a psychological associate and billed at the rate for            
 a psychologist.  She believed it was important that the issue be              
 addressed, particularly at a time when attempts are being made to             
 lower the cost of medical care.  The other issue is why should a              
 person become a psychologist when you can get the same fee for                
 being a psychological associate.                                              
                                                                               
 REPRESENTATIVE GARY DAVIS arrived at 3:50 p.m.                                
                                                                               
 Number 2117                                                                   
                                                                               
 REPRESENTATIVE VEZEY said this all points to Title 21 dealing with            
 the insurance discrimination statutes.  He noted that two years ago           
 the statute was changed so direct entry mid-wives couldn't be                 
 discriminated against and four years ago psychologists,                       
 psychological associates and licensed clinical workers were added             
 to that statute.  It appeared to him the problem some people were             
 having with the bill was not whether these people could be licensed           
 in two, four or five years, but rather what kind of financial                 
 burden would it be compelling the group insurance providers to pay            
 for this service by granting them this license privilege in                   
 connection with an anti-discrimination statute.                               
                                                                               
 MS. REARDON said she didn't believe this bill would change the                
 situation concerning billing.  She explained the state doesn't set            
 the rates health care providers can charge and she assumed the                
 legislature didn't want to get into how much different                        
 professionals could charge for their services.  In terms of the               
 reimbursement, a professional can charge whatever he/she wants and            
 then the amount that would be reimbursed is up to the insurance               
 policy.  Even if the psychologists and psychological associates               
 were removed from the non-discrimination statute, all that would              
 happen is their patients would have to pay for the service out of             
 their pockets.  She wasn't sure it would necessarily result in the            
 type of distinguishing between the different professionals in terms           
 of their billings that was being discussed.                                   
                                                                               
 CO-CHAIR BUNDE commented that an individual had called him earlier            
 and expressed some serious concerns that the insurance companies              
 were really practicing medicine because they were deciding, in                
 essence de facto, by what service they would cover and how much               
 they would pay.  The individual offered that perhaps if the non-              
 discrimination clause was deleted, the insurance companies may quit           
 practicing medicine.                                                          
                                                                               
 Number 2234                                                                   
                                                                               
 CO-CHAIR TOOHEY asked what the point was of having the non-                   
 discrimination list if the insurance companies were not taking                
 advantage of it?  If the insurance companies are paying a fee for             
 a particular service, regardless of who provides the service, she             
 questioned whose responsibility it was to cut the cost of medicine?           
 She maintained it is each persons's responsibility to oversee it              
 and when a particular service is being provided, a person should              
 demand that it be provided by a nurse or physician assistant for              
 example, because it will be cheaper.  She believed the Division of            
 Insurance should be looking at those things.                                  
                                                                               
 Number 2275                                                                   
                                                                               
 JERRY REINWAND, Lobbyist for Blue Cross of Washington & Alaska,               
 said he really hadn't intended to create a problem by raising the             
 question at the last hearing, but he did think there was an                   
 underlying issue that gets to the unfair discrimination issue and             
 that's why he had asked the question, "Can, for example, if we get            
 a bill for the same scope of service from somebody who charges $500           
 an hour or the same person arguably is providing the same scope of            
 service for $50 an hour and under the unfair discrimination                   
 statute, which -- can we say we don't pay the $50 and we can pay              
 the $500 one?"  In all fairness to the Division of Insurance, he              
 said it was a huge gray area and the division is looking at this              
 very question.  His specific question last week was, "Does this               
 bill in any way open the flood gate a little bit more so that                 
 because of the unfair discrimination statute that psychologists,              
 psychological associates and clinical social workers are now on the           
 books for, does that somehow increase costs to either the state               
 and/or insurance companies and ultimately policy holders?"  He does           
 believe there is a link there.  He didn't really want to cause a              
 problem with this bill particularly, but he thinks there is a                 
 bigger policy question involved.  He added this probably isn't the            
 vehicle to attack the issue, however.                                         
                                                                               
 CO-CHAIR TOOHEY asked if it would be in the best interest of the              
 insurance company to handle the issue of setting different degrees            
 of pay for different degrees of education, not service.                       
                                                                               
 MR. REINWAND replied he really hadn't thought about it in that                
 context.                                                                      
                                                                               
 TAPE 96-37, SIDE B                                                            
 Number 001                                                                    
                                                                               
 MR. REINWAND continued he would like to leave the unfair                      
 discrimination statute for the committee to consider as he felt it            
 could have some interesting interpretations.  He added there have             
 been conflicting interpretations from the division and he would               
 probably be asking the committee to revisit this issue at some                
 point.                                                                        
                                                                               
 CO-CHAIR TOOHEY asked if there were three levels of mental health             
 providers - psychological associates, psychologist or a                       
 psychiatrist - which one would Mr Reinwand want to pay?                       
                                                                               
 MR. REINWAND said probably from the insurance company's point of              
 view and hopefully from the patient's as well, a person would want            
 to go to the health care provider that provided the best service              
 for the least cost; that's ultimately what everyone is after.                 
 Whether this bill does that and whether the unfair discrimination             
 statute ultimately results in that is another question.                       
                                                                               
 Number 051                                                                    
                                                                               
 REPRESENTATIVE ROKEBERG asked if Blue Cross makes a differentiation           
 between a temporary licensed psychological associate and a licensed           
 psychological associate in terms of paying a fee?                             
                                                                               
 MR. REINWAND said he didn't know.  He added that he has asked his             
 client, Blue Cross, a series of questions and he hasn't yet gotten            
 any answers back, but he would check on it.                                   
                                                                               
 REPRESENTATIVE ROKEBERG said he felt that was really the question.            
 There certainly is a differential between the experience level and            
 as far as he could tell, this bill as well as the existing statute            
 does not draw a differentiation between those people that are                 
 temporarily licensed and those who are not.                                   
                                                                               
 CO-CHAIR BUNDE asked if there was any further testimony on CSSB
 165(L&C).                                                                     
                                                                               
 Number 094                                                                    
                                                                               
 SHARON MACKLIN, Lobbyist for the Alaska Psychological Association             
 said she would try to answer a couple of questions that had been              
 raised.  Regarding the scope of practice, she referred to page 3,             
 Section 5, and said that could be coordinated with the last page of           
 the document that had been distributed to the committee on the                
 scope of practice for a psychological associate.  She said that is            
 the only section that includes the scope of practice and this bill            
 does not expand the scope of practice that psychological associates           
 would be providing.  Another question that was raised had to do               
 with whether insurance companies pay different rates for the cost             
 of services by psychological associates, psychologists, masters of            
 social workers and marriage and family therapists.  She said when             
 the issue of unfair discrimination was raised several years at the            
 time when psychologists, psychological associates and masters of              
 social workers were added, part of the testimony brought forward              
 was that these people provided services at a lesser rate and they             
 are more available in rural Alaska and in less urban areas.  She              
 added that psychiatrists who are Mds probably charge the most, but            
 are not located all over the state so not everyone has access to              
 mental health services through a psychiatrist.  Therefore, more               
 services can be provided by adding other levels of mental health              
 providers and their rates are different.  She noted that SB 165 was           
 introduced last year but didn't have any hearings.  It's had two              
 hearings in the Senate this year and passed the Senate by a big               
 majority vote.  Some of the other insurance companies have had a              
 chance to review this and no questions were raised until now.  She            
 invited questions from committee members.                                     
                                                                               
 CO-CHAIR TOOHEY asked if continuing education was required for                
 psychological associates and psychologists?                                   
                                                                               
 DR. STOKES responded 20 hours annually was required for both.                 
                                                                               
 REPRESENTATIVE ROKEBERG asked Ms. Macklin if she was saying this              
 bill didn't expand the scope of service of a psychological                    
 associate?  He said, "Correct me if I'm wrong, Ms. Macklin, but it            
 seems it deletes specificity and the specified areas on the license           
 which could be provided or work done by an associate, and expands             
 it to almost anything.  I'm not sure that's the intention, but that           
 certainly looks like an expansion of services to me."                         
                                                                               
 MS. REARDON responded that under current law the division does                
 license psychological associates as counseling or clinical and that           
 is printed on the license.  However, it was her understanding there           
 have not been any distinctions made in terms of what is legal for             
 someone who has clinical written on their license and what is legal           
 for someone else who has counseling written on their license to do.           
 She understood that both types are able to do the whole range of              
 psychological services as long as the person stays within their               
 area of knowledge and competence.  It was her impression that                 
 although the division is printing a certain thing on the license,             
 it does not come in any way with a list of things that a person               
 should or shouldn't do under that license that really distinguishes           
 one from the other.  She said that perhaps Dr. Stokes had a                   
 different understanding and deferred the question to him.                     
                                                                               
 DR. STOKES said the only difference is under Title 47 which                   
 involved civil commitment.  Only a psychological associate with a             
 specialty in clinical psychology is considered a mental health                
 professional.  Whereas, a psychological associate with a counseling           
 specialty is not considered a mental health professional (indisc.).           
                                                                               
 Number 342                                                                    
                                                                               
 MS. FORREST mentioned that she would like to address Representative           
 Rokeberg's question.  She referred to page 3, line 7 of CSSB
 165(L&C) which states "A psychological associate shall be licensed            
 to provide psychological services..." and said the statute defines            
 psychological services.  Thus, it is spelled out (indisc.-paper               
 shuffling).                                                                   
                                                                               
 REPRESENTATIVE ROKEBERG asked Ms. Reardon if the word "temporary"             
 appears on the license?                                                       
                                                                               
 MS. REARDON replied yes.                                                      
                                                                               
 REPRESENTATIVE ROKEBERG asked for verification that it would read             
 "Temporary psychological associate."                                          
                                                                               
 MS. REARDON clarified that she had been referring to the temporary            
 psychologists license; there are no temporary psychological                   
 associate licenses at this time.                                              
                                                                               
 REPRESENTATIVE ROKEBERG asked if a person under the three year                
 supervision plan is licensed as a psychological associate or is the           
 person not granted a license for those three years?                           
                                                                               
 MS. REARDON deferred the question to her Program Coordinator,                 
 Barbara Gabier.                                                               
                                                                               
 Number 417                                                                    
                                                                               
 BARBARA GABIER, Program Coordinator, Division of Occupational                 
 Licensing, Department of Commerce & Economic Development, said                
 currently there is no temporary license or licensure required while           
 an associate level graduate is getting the three years of                     
 experience.                                                                   
                                                                               
 CO-CHAIR BUNDE asked if that was because they work under the direct           
 supervision of a psychologist?                                                
                                                                               
 MS. GABIER confirmed that.                                                    
                                                                               
 CO-CHAIR TOOHEY asked if the person would receive a temporary                 
 license for five years after graduation?                                      
                                                                               
 MS. GABIER replied no.  She explained that currently when a person            
 graduates, he/she has to get the three years of supervised                    
 experience before applying for the exam.  Then after licensure, the           
 person would have to practice for five years before applying for              
 independent practice.                                                         
                                                                               
 CO-CHAIR BUNDE announced there were two additional people in                  
 Anchorage who would like to testify.                                          
                                                                               
 Number 454                                                                    
                                                                               
 MR. MOMA testified that he was with the Alaska Psychological                  
 Association.  He said with regard to the issue of scope of                    
 practice, the underlying theme is based on the American                       
 Psychologist Association's ethics guidelines which specify that a             
 person cannot perform a procedure in which they have no training              
 and expertise in performing.  He referenced the examples of                   
 biofeedback and hypnosis that were given at the last hearing and              
 said he had checked with a variety of people, both master's level             
 individuals and Ph.D. level individuals to try to find out if                 
 biofeedback or hypnosis was part of a typical Ph.D. program; both             
 of the areas are not part of a typical Ph.D. program.  Both a                 
 master's level person or a Ph.D. level person would be required to            
 get additional training in order to perform those types of                    
 services.  The point is that (indisc.) tried to tie to the national           
 standard for acceptability of practice as opposed to specifying a             
 laundry list of things that a person can or can't do.  He said the            
 issue had been raised about why psychological associates or                   
 individuals receiving a masters degree were suddenly interested in            
 having a license.  He explained that over the last few years,                 
 managed care has come into play as insurance companies have become            
 more cost conscious and are starting to require a license of                  
 individuals before they will reimburse.  That is not just for                 
 individuals in private practice, but also for individuals working             
 for agencies.  What is happening is that agencies will not hire a             
 psychological associate because they can't get reimbursement from             
 the insurance companies.  The (indisc.) is starting to dry up which           
 has made the need for a license more critical now than it has been            
 in the past.                                                                  
                                                                               
 MR. MOMA said that insurance companies usually reimburse based on             
 a standard they set internally and usually reimburse at the usual             
 and customary charge for a given service as it is provided.  There            
 are mechanisms in place for insurance companies to determine what             
 an acceptable fee is to be charged.  Another point that comes into            
 play relating to insurance companies is typically individuals,                
 particularly children in smaller communities in Alaska, are being             
 transported into Anchorage to spend time at North Star, Charter               
 North or some type of facility when that child might be able to               
 receive services in their home community if there were individuals            
 available with the training and the ability to provide services.              
 Presently, a number of smaller communities don't have anyone to               
 provide those services because there is no reimbursement mechanism            
 in place.                                                                     
                                                                               
 MR. MOMA conveyed a story relating to the board where an individual           
 in Anchorage had completed her three years of training, had sat for           
 her exam, passed her exam and was at the end of her five year                 
 period of supervision.  The board at its last meeting decided she             
 didn't have the human development and multi-cultural (indisc.)                
 classes that are part of the board's determination, so the board              
 denied her the ability to practice independently based on not                 
 having those two classes.  Part of the reason they have implemented           
 the temporary license idea has to do with being able to meet with             
 the board and have a contractual relationship to agree on a                   
 proposal for an acceptable standard and an acceptable course of               
 training so at the end of that training a person could get a                  
 license.  What's happening now, especially with this board, is that           
 the rules have been changed and individuals who have been on a time           
 line for eight years are not being notified and accommodations are            
 not being made for the individual to get the course.  In                      
 conclusion, he believes this bill provides psychological associates           
 and mental health services in rural communities.  Also it improves            
 the oversight of the board on mental health providers who are                 
 practicing in the community currently.                                        
                                                                               
 Number 735                                                                    
                                                                               
 JENNIFER JONES from Anchorage said she had nothing more to add to             
 the discussion on CSSB 165(L&C).                                              
                                                                               
 Number 745                                                                    
                                                                               
 DR. STOKES said the board is being painted as negative.  He pointed           
 out the board did not write the statutes and the individuals who              
 are upset with the statutes should be angry at whoever wrote the              
 statutes.  The board is held by law to follow the statutes.  His              
 recommendation for the additional year is because of psychological            
 testing.  Several years ago, the primary reason for complaints and            
 litigation against psychologists and psychological associates was             
 sexual activity between the therapist and the patient.  In the last           
 year that has changed.  The primary reason for litigation and                 
 complaints filed with the Division of Occupational Licensing has to           
 do with child custody evaluations involving psychological testing.            
 It is his opinion that without the additional year of supervision             
 specific to psychological testing, psychological associates under             
 this bill are setting themselves up for malpractice suits and                 
 litigation.  His concern is to protect psychological associates by            
 ensuring they are prepared and to protect the public at the same              
 time.                                                                         
                                                                               
 Number 804                                                                    
                                                                               
 CO-CHAIR BUNDE closed public testimony on CSSB 165(L&C).                      
                                                                               
 REPRESENTATIVE ROKEBERG expressed concern about the definition of             
 psychological services and how it fits into the statute.  Also, he            
 was concerned about the length of time, the lack of differential              
 between a temporary license and another license, and also the                 
 questions regarding the insurance issue.  He felt that additional             
 work was needed and he wasn't prepared to vote on the bill at this            
 time.                                                                         
                                                                               
 CO-CHAIR BUNDE announced he would place CSSB 165(L&C) in a                    
 subcommittee to be chaired by Representative Rokeberg and                     
 Representatives Vezey and Robinson as members.                                
                                                                               
 CO-CHAIR BUNDE turned the gavel over to Co-Chair Toohey.                      
                                                                               
 CSSB 91(HES) - CRIMINAL TRANSMISSION OF HIV                                  
                                                                              
 Number 881                                                                    
                                                                               
 CO-CHAIR TOOHEY said the committee would be taking testimony only             
 and would not be moving CSSB 91(HES) out of committee at this                 
 meeting.                                                                      
                                                                               
 Number 929                                                                    
                                                                               
 SENATOR ROBIN TAYLOR, Sponsor, said Senate Bill 91 was introduced             
 because of an article, which he had provided committee members with           
 a copy, relating to one of the more winning race car drivers on the           
 Nascar circuit named Richmond.  He earned $2.3 million and won 13             
 Winston Cup races.  He also was infected with AIDS, never bothered            
 to notify his sexual partners and it is estimated he's probably               
 going to kill 30 women.  He already died.  The picture in the                 
 article is that of a beautiful woman who has graced the covers of             
 Glamour, Seventeen and Cosmopolitan magazines.  Her doctor is           
 quoted as saying, "She suffers today from temporal wasting"; in               
 other words her skull is caving in as a complication of the AIDS.             
 He referred to another article about a heterosexual woman infected            
 with AIDS who said, "I feel if I have to die of a horrible disease,           
 I won't be going alone."  This woman lives in the Dallas area where           
 she frequents bars and attempts to infect as many man as she can.             
 He added that Dallas is rated number 12 nationally for AIDS; they             
 have over 3,200 recorded cases in their community.  Another reason            
 he introduced this legislation is because of an individual named              
 Governor Jim Edgar, current Governor of Illinois, who wanted to be            
 kind and considerate.  He explained that a woman had been convicted           
 and sentenced to three years in prison because after being                    
 diagnosed with AIDS, she intentionally attempted to infect other              
 people with the disease by having unprotected sex.  Governor Edgar,           
 who wanted to be a nice person, commuted her sentence.  Three weeks           
 after her sentence was commuted, "Tracy Eichman, 34, was arrested             
 by Rockford police on Tuesday after offering to perform sexual acts           
 for a police officer for $20, authorities said.  She was being held           
 in the Winnebago County Jail on $25,000 bond.  She faces one to               
 three years in prison if convicted on the new charges.  In February           
 1991, Eichman was sentenced to 3 years in prison after being                  
 convicted."  Governor Edgar commuted her sentence so she could get            
 back out on the street and infect more people.  Senator Taylor                
 referred to an article about a heterosexual male, William Barker,             
 who had tested positive for the AIDS virus and threatened to take             
 all the women with him that he could before he dies.  He quoted               
 from the article, "Barker was arrested April 9 after a parole                 
 officer received a tip that Barker was deliberately trying to                 
 infect women with AIDS, Stewart said.  Police found Barker and the            
 women in a motel room.  She became hysterical when officers told              
 her Barker had AIDS."  Senator Taylor added that any one of us                
 would probably become hysterical to find out such information after           
 the fact.                                                                     
                                                                               
 SENATOR TAYLOR directed the committee's attention to the article              
 about a homosexual who knowing that he was diagnosed with AIDS had            
 a sexual relationship with a 17-year-old boy.  He noted that the              
 United States military doesn't handle it quite the same way as                
 Governor Edgar, and instead dishonorably court martialed him and he           
 is serving 10 years.  His crime is, "He was likely to transmit HIV.           
 The crime of transmitting HIV or being likely to transmit and                 
 engaging in such acts that would transmit it in Texas is a felony."           
                                                                               
 SENATOR TAYLOR said this issue was brought to his attention by a              
 friend, John Walsh, of America's Most Wanted television show.                 
 Before Mr. Walsh started his television program, he came to Alaska            
 and worked with many individuals to bring about changes concerning            
 lost and sexually abused children and background checks for people            
 who deal with children.  On one of Mr. Walsh's programs, he asked             
 the public to call in if they knew of a heterosexual man from                 
 Georgia who was estimated to have infected at least 30 women.  They           
 believed he could be hiding out in any one of the states that did             
 not have a law against this type of conduct.  A map was displayed             
 on the television screen and to Senator Taylor's chagrin, Alaska              
 was one of those states which attracts people like that.  The most            
 risk an individual would run is being prosecuted for reckless                 
 endangerment, which is a misdemeanor and carries a maximum of one             
 year in jail.  He informed the committee that CSSB 91(HES) passed             
 overwhelming in the Senate.                                                   
                                                                               
 SENATOR TAYLOR said that Illinois' law was taken to the state                 
 Supreme Court to find out if it was constitutional.  He noted the             
 legislation before the committee was taken directly off the                   
 Illinois legislation.  The case was upheld by the Illinois Supreme            
 Court and at the time it was upheld, there were two cases pending.            
 In one case a woman was charged with knowingly spreading the virus            
 when she had sex without telling her partner.  In the second case             
 a man was charged with raping a woman when he knew he was infected            
 with the virus.  Senator Taylor said he couldn't understand why               
 anyone would want to protect and make life more comfortable for a             
 person that fails to inform their sexual partners they are infected           
 with this virus and knowing full well they could be transmitting              
 not a disease, but a death sentence.  He said he didn't understand            
 it and would like to be informed of what the reasons are because he           
 certainly hopes they are sufficient that if in fact there are                 
 people in Alaska currently (latest indications are there are over             
 500 who are currently infected) if there is only one or two                   
 individuals who are being so cavalier or who are so filled with               
 anger and rage over contracting this disease, do we really want to            
 risk that?   Will it have a "chilling" effect on people coming                
 forward to being examined?  The response is no.  Illinois                     
 prosecuted only three people, but at least those three were                   
 prosecuted and he would be willing to bet that Governor Edgar was             
 not going to turn any more of them loose.  In fact, Governor Edgar            
 is quoted as saying, "In the future, if he has a clemency request             
 from a person like that, he wants to do a much more careful                   
 examination of whether or not they are going to survive if the are            
 turned loose."                                                                
                                                                               
 SENATOR TAYLOR commented that Miami had the very same problem                 
 several years ago and Florida passed similar legislation.  A trial            
 judge in Miami had a lady who was a prostitute before him for the             
 third time and was in the final stages of AIDS.  The judge knew she           
 was in that condition when she was released the two previous times,           
 but the third time the judge locked her up because she was trying             
 to kill people.  He commented the social libertarians however                 
 thought she was being denied her freedom and added for some reason            
 there seems to be a bizarre schizophrenic twist in American society           
 today.                                                                        
                                                                               
 SENATOR TAYLOR informed the committee of an incident involving a              
 local sandwich shop who had an employee with hepatitis.  The shop             
 was closed down and every employee was tested to find out who had             
 the disease, who was spreading it and why.  That's not even being             
 done with the AIDS virus.  He remarked that hepatitis kills; his              
 brother-in-law died because of hepatitis.  He asked what was being            
 done in the world today about typhus, and where is "Typhoid Mary"?            
 Do we allow her to work in the school kitchens?  No, she is charged           
 with a crime if she does that.  Does it prevent people from being             
 tested for typhus?  No, in fact barriers have been established to             
 ensure that people who work in those facilities are tested for that           
 disease.  He asked how comfortable do you feel getting on an                  
 airplane knowing what is happening with tuberculosis today?  Does             
 it keep people from getting tested for TB?  The answer is no.  Do             
 we as responsible citizens take actions that will hopefully prevent           
 that from ever being transmitted to another person?  He thought               
 people did.                                                                   
                                                                               
 SENATOR TAYLOR said criminal activity is just another form of                 
 irresponsible activity.  He questioned if that was any more                   
 irresponsible than Mr. Richmond, the wealthy, playboy, race car               
 driver who wants to infect women all over the country and decides             
 he's not going to tell anyone.   Four of the infected women have              
 already died, and there are estimates of another 30 waiting.  He              
 wondered how anyone would explain to any of the family members that           
 he was a super hero and shouldn't have been charged with any                  
 criminal activity.  On the other hand if he had been charged, it              
 probably would have been on national news and had a deterring                 
 effect on other individuals from trying the same irresponsible,               
 deadly act.  He encouraged committee members to pass CSSB 91(HES)             
 from committee.                                                               
                                                                               
 CO-CHAIR TOOHEY asked if there were any questions of Senator                  
 Taylor.                                                                       
                                                                               
 Number 1583                                                                   
                                                                               
 REPRESENTATIVE ROKEBERG asked Senator Taylor to explain the concept           
 of intent in criminal law.                                                    
                                                                               
 SENATOR TAYLOR said there was a legal opinion from the Attorney               
 General's Office in the packet, stating that intent would be                  
 required.  In this instance, the intent that is required is within            
 the bill.  It's a general intent crime, that a person merely                  
 intends to do this act.  It has to be done knowingly, and the only            
 way to get to knowingly is the person has to be knowingly diagnosed           
 as having AIDS.  Once that diagnosis has been made, if a person               
 participates in a sexual act with another consenting adult, they              
 must inform the other adult of the AIDS diagnosis and give that               
 other person the opportunity to know and to take additional                   
 precautions or not participate in that act.                                   
                                                                               
 REPRESENTATIVE ROKEBERG asked about the defense of wearing a                  
 prophylactic in that case?                                                    
                                                                               
 SENATOR TAYLOR replied this has nothing to do with wearing a                  
 prophylactic, but merely notifying the sexual partner.  That is the           
 only act that is required by this legislation.                                
                                                                               
 REPRESENTATIVE ROKEBERG asked what would happen if the individual             
 with HIV took a preventive measure, but did not inform the sexual             
 partner?                                                                      
                                                                               
 SENATOR TAYLOR responded the person would be guilty if he/she did             
 not inform the partner.  He emphasized that if an individual knew             
 they had AIDS, did not inform their sexual partner and went forward           
 with an act likely to transmit would be guilty.                               
                                                                               
 REPRESENTATIVE ROKEBERG thought there would be a problem with                 
 criminal intent under criminal construction if there was no intent            
 to transmit by wearing a prophylactic.                                        
                                                                               
 SENATOR TAYLOR remarked that an individual cannot avoid it by doing           
 that.  He added that if an individual with HIV has informed their             
 sexual partner of the virus, it doesn't matter if the individual is           
 wearing a prophylactic or not because the knowledge has been                  
 communicated to the person who may be the victim, and that person             
 then has the consensual right to risk that activity if they wish to           
 do so.  He emphasized the important thing is that the potential               
 victim know and have the opportunity to make a rational decision.             
                                                                               
 CO-CHAIR TOOHEY asked if there were other questions of Senator                
 Taylor?  Hearing none, she invited testimony from individuals via             
 teleconference.                                                               
                                                                               
 Number 1784                                                                   
                                                                               
 BARBARA BRINK, Attorney, Alaska Public Defender Agency, testified             
 from Anchorage that unlike Senator Taylor, she believes that Alaska           
 law already covers this type of behavior.  She said Senator Taylor            
 had questioned why the state would want to protect a person who is            
 engaging in this risky behavior to which she responded, Alaska does           
 not protect this person; Alaska punishes this person and punishes             
 the person severely.  She did not understand at the beginning the             
 impetus for this legislation, because if the legislature wants to             
 prosecute someone who is deliberately and recklessly setting about            
 to infect someone with the virus, Alaska laws already exist that              
 provide a range of prosecutorial charges and punishment to cover              
 every set of conduct mentioned by Senator Taylor.  She disagreed              
 with the analysis that the only thing a person could be charged               
 with is reckless endangerment.  The assault statutes in the state             
 of Alaska were constructed as a whole to deal with any situation              
 where violence is perpetrated upon a person, and as a whole they              
 cover every situation where an act or acts intentionally,                     
 recklessly or even just carelessly in causing harm to another                 
 person.  The assault statutes also prosecute differently, depending           
 on the actual seriousness of the harm caused.  She said the                   
 behavior described by Senator Taylor could be prosecuted as                   
 attempted murder, assault in the first degree, assault in the                 
 second degree and all the way down to reckless endangerment                   
 depending upon the actual harm caused.  Alaskans are protected from           
 this type of behavior and this legislation is unnecessary in order            
 to prosecute someone who infects the virus deliberately, recklessly           
 or knowingly.                                                                 
                                                                               
 MS. BRINK further stated in contrast, drafting a piece of                     
 legislation to cover a particular crime has raised a host of                  
 problems.   She said, "it makes this a Class B felony offense for             
 a person who has tested positive for the HIV virus, and I want to             
 distinguish that from someone who is diagnosed with AIDS - those              
 are two different things.  A person who is (indisc.) positive for             
 the HIV virus may engage in sexual activity with someone and be               
 prosecuted and charged with this crime, even though they never                
 develop the AIDS virus and the person they've engaged in conduct              
 with never actually develops the virus."  To have this thrown in              
 the middle of the assault statutes is out of whack proportionally             
 with the danger and with the harm.  She pointed out there is                  
 epidemiological evidence that the risk of transmission of the HIV             
 from a single incident is only 1 in 1,000.  She said that                     
 Representative Rokeberg had raised a good question about when a               
 person wears a prophylactic or a condom and under those                       
 circumstances, the chance of transmission is about 1 in 10,000.               
 This legislation would make this a Class B felony with a 10-year              
 sentence when there is little danger and little harm.  By creating            
 a special class of people she was concerned that this bill, if                
 enacted, would violate the equal protection.  She said we have                
 taken a single class of people, those persons infected with HIV,              
 and set about criminalizing their conduct.  What about people who             
 knowingly infect others with syphilis, gonorrhea, herpes or as                
 Senator Taylor mentioned, tuberculosis or hepatitis - why isn't               
 that behavior being criminalized?  To single out this class of                
 persons is not rationally related to protection to the health of              
 the public.  Additionally, it is over broad and interferes with               
 Alaskans' right to privacy.  The sexual behavior of an entire class           
 of people is being damned when it is not necessary and not                    
 productive.                                                                   
                                                                               
 MS. BRINK remarked she has real and demonstrable concerns that this           
 will accomplish just the opposite of what Senator Taylor wants to             
 accomplish.  Everyone wants to slow down the spread of HIV and                
 protect people.  Public education regarding transmission of the HIV           
 virus to enable people to voluntarily modify their behavior is far            
 more cost effective than punishing it after the fact.  If people              
 are told we want them to get tested but they cannot engage in                 
 intimate sexual conduct if they test positive, will have a negative           
 effect on the number of people getting tested.  This legislation              
 would have a definite impact of deterring people.  Therefore,                 
 rather than reducing the risk of the spread of HIV, she believes              
 this legislation will increase it.  Increasing public education and           
 removing restrictions on the availability of sterilized, disposable           
 hypodermic needles and encouraging hygienic HIV practices would be            
 far more cost effective in stopping the spread of HIV than this               
 bill.                                                                         
                                                                               
 TAPE 96-38, SIDE A                                                            
 Number 001                                                                    
                                                                               
 REPRESENTATIVE ROKEBERG asked if Ms. Brink was suggesting that                
 incarceration is not a deterrent to criminal activity?                        
                                                                               
 MS. BRINK replied no, she never suggested that.                               
                                                                               
 REPRESENTATIVE ROKEBERG said he asked the question because he                 
 thought that's what she had said.                                             
                                                                               
 MS. BRINK said when she had spoken of deterrents, she believed that           
 criminalizing the conduct of whether or not a person knows they are           
 HIV positive would deter people from getting tested.                          
                                                                               
 CO-CHAIR TOOHEY asked if there were further questions of Ms. Brink.           
 Hearing none, she asked Amy Eilertsen to present her testimony.               
                                                                               
 Number 064                                                                    
                                                                               
 AMY EILERTSEN, Director, Stop AIDS Project, testified from                    
 Anchorage.  As a former student of Representative Bunde's at UAA,             
 she urged him to pay special attention to the repercussions of CSSB
 91(HES).  She commented that as a registered nurse directing the              
 safer techniques of a prevention project, her goal is to reduce the           
 spread of HIV in the injectable drug users in Anchorage.  She said            
 in a high risk population such as this, denial and fear of knowing            
 one's HIV status is a big barrier to HIV testing.  The important              
 and indispensable part of HIV testing protocol is the risk                    
 reduction counseling that people receive.  This counseling informs            
 people on how not to get (indisc.) spread HIV and other sexually              
 transmitted diseases.  She believed this bill would reduce the                
 number of people being tested for HIV.  People would not only be              
 afraid to know their status because of the shock and social stigma            
 surrounding HIV, but people would be terrified of the legal                   
 repercussions regarding being tested and perhaps finding out they             
 have HIV.  Not being tested would mean not receiving this life-               
 saving personalized risk reduction counseling.  Without this                  
 counseling, those who do not have HIV would probably be at greater            
 risk for getting HIV.  In the state of Alaska, there have been                
 approximately 87,000 tests going through the state laboratory of              
 which 560 have come up positive as of December 31, 1995.                      
                                                                               
 MS. EILERTSEN said according to the Center for Disease Control and            
 prevention statistics, 9 out of 10 people who have HIV are not                
 being tested for HIV.  She commented, "So Senator Taylor, we can              
 say that between 3,000 and 5,000 residents of the state of Alaska             
 have HIV; 560 of these have been counseled on how not to give HIV             
 to people, the other 1,000 have not."  She believes the solution is           
 further education.  She reiterated her belief that this legislation           
 would reduce the number of people being HIV tested and would                  
 probably increase the spread of HIV.  She called the committee's              
 attention to page 1, line 12, which indicates that a woman who                
 knowingly passes HIV to her fetus purposefully will not be                    
 prosecuted, and yet a person who has HIV can have sex with someone            
 who does not have HIV transmitted to them and be prosecuted under             
 this bill.  She thanked the committee for giving her the                      
 opportunity to testify.                                                       
                                                                               
 Number 320                                                                    
                                                                               
 SENATOR TAYLOR asked Ms. Eilertsen if all the people she counsels             
 follow her directions and to the best of her knowledge have all               
 those people informed their sexual partners?  Or does she have                
 people she is counseling who continue to have an active sex life              
 without informing any of their sexual partners?                               
                                                                               
 MS. EILERTSEN asked what would they be informed their sexual                  
 partners of?                                                                  
                                                                               
 SENATOR TAYLOR responded informing them of the fact they have been            
 diagnosed.                                                                    
                                                                               
 MS. EILERTSEN interjected the people she has been counseling have             
 not necessarily been diagnosed or tested positive for HIV.  She               
 maintained that was her point - if people come in to be tested,               
 they may come up negative and this is an opportunity to coach                 
 people on how to stay negative.  If people don't come in to be                
 tested because they are afraid of being criminally prosecuted, the            
 opportunity for individualized education does not exist.                      
                                                                               
 SENATOR TAYLOR reiterated his question that of those people Ms.               
 Eilertsen knows to have tested positive and infected with AIDS that           
 she is counseling, are they restricting their sexual activity or              
 does she in fact have people who are sexually active and not                  
 telling their sexual partners they have been diagnosed?                       
                                                                               
 MS. EILERTSEN apologized for not quite understanding the question             
 in that people who have tested positive for HIV don't necessarily             
 (indisc.), so she doesn't know about people with AIDS.                        
                                                                               
 SENATOR TAYLOR thought she was in charge of a center that had                 
 something to do with AIDS.                                                    
                                                                               
 MS. EILERTSEN said the center counsels people on how not to get               
 HIV.                                                                          
                                                                               
 Number 447                                                                    
                                                                               
 JOHN MIDDAUGH, MD., Chief, Epidemiology Section, Division of Public           
 Health, Department of Health & Social Services, testified that he             
 has been responsible for overseeing the development of the AIDS               
 policies and enhancing the prevention efforts since 1982, when the            
 first person was diagnosed in Alaska with AIDS.  He appreciated the           
 very grave concerns that have been reflected in the submission of             
 Senator Taylor's bill and he believed that everyone shared the goal           
 in an abhorrence of the idea that a person would knowingly and                
 intentionally attempt to infect other individuals with a disease,             
 regardless of what that disease is.  He believed that current                 
 statutes and policies exist in the state to take care of the                  
 instances when it is able to be shown that that intention exists.             
 He said the department, division, AIDS program and AIDS task force            
 oppose this legislation and it's difficult to sort out some of the            
 issues in this very powerful and important area about why that is.            
                                                                               
 DR. MIDDAUGH said this legislation adds two major new components to           
 the existing statutes and procedures.  One is it removes the issue            
 of intention and it does not take into account whether transmission           
 of HIV does or does not occur.  It also fails to include any                  
 scientific information about the likelihood or infectiousness of an           
 individual attempting to infect another.  Now, that's not the                 
 (indisc.-paper shuffling) support anything, it's simply to say that           
 we know that during the period of infectivity with HIV, that at               
 some times individuals are not infectious at all.  Late in the                
 course of illness when AIDS occurs, then it's been able to be shown           
 that the virus is more present and the person is presumably more              
 infectious.  However, none of this information is reflected in the            
 proposed legislation.  He said what we are doing then is                      
 criminalizing an infectious agent in the absence of disease or                
 potentially in the absence of a degree of infectiousness to another           
 person.  As the committee had heard, that analogy then occurs in              
 that we have a registry of 1400 Alaskans who are hepatitis B                  
 surface antigen carriers.  The risk of transmission of hepatitis B            
 through sexual contact is far greater than HIV, perhaps as much as            
 10,000 to 100,000 times greater.  Dr. Middaugh said we have an                
 ability today to diagnose and fingerprint many kinds of viruses and           
 infectious agents.  Would we propose that we would criminalize the            
 behavior of a mother who dropped her child at a daycare center with           
 a fever, conjunctivitis, or a little rash and then learned the                
 child had measles and had infected another child at the daycare               
 center.  The history of public health is that the ability to                  
 prevent infections generally requires the enrollment of individuals           
 in a manner to prevent disease transmission and that often attempts           
 to prevent or criminalize diseases has in fact had the opposite               
 effect and led to the lack of early detection, the lack of                    
 effective prevention, and has led to greater problems of disease              
 transmission.  Dr. Middaugh said because of these reasons, he feels           
 it is very important that this type of legislation not be                     
 supported.  It would have very little benefit to either attempting            
 to punish individuals who have an intention to attempt to harm                
 another through transmission.  Frankly, if a person was attempting            
 to do a person in, the infection of HIV is a very inefficient way             
 to do it because of its low risk of transmission during an                    
 individual or several encounters.                                             
                                                                               
 DR. MIDDAUGH pointed out there were additional housekeeping type              
 problems with this legislation.  One is that the legislation                  
 discusses an affirmative defense that the defendant knew he/she was           
 infected and informed the other individual, and that consent was              
 given.  He said,  "Well, we know that many individuals who are                
 engaged in different activities, occasionally use drugs or alcohol            
 and that later recall of what was or wasn't transmitted and what              
 consent or level of knowledge was given, can be quite problematic."           
 He mentioned another problem is the definition of any contact                 
 between one or another that might or could result in the                      
 transmission of HIV.  He said, "Does that mean theoretically could            
 or is likely to; in other words, we know that for hospital workers            
 taking care of persons with AIDS, who have been stuck with a needle           
 after the needle has been first in the person with AIDS, that the             
 risk of the hospital person becoming infected from being stuck is             
 1 or 2 in 1,000 needle sticks.  It's not a highly infectious agent,           
 but circumstances and risk factors are able to be weighed and are             
 being increasingly understood about the likelihood of                         
 transmission."                                                                
                                                                               
 DR. MIDDAUGH stated another housekeeping problem with the bill is             
 that under the provision related to "dispenses, delivers,                     
 exchanges, sells, or in any manner transfers to another person any            
 nonsterile intravenous or intramuscular drug paraphernalia."  He              
 said that a person with diabetes who is HIV infected would have no            
 legal mechanism of disposing of their diabetes syringe and in fact            
 would be committing a criminal act if they turned it over to                  
 another person under this legislation.  He knew that wasn't                   
 intended by the sponsor, but the problem with trying to legislate             
 specifically against one single disease in order to accomplish a              
 different goal he thinks is very counter-productive to the combined           
 efforts of 1) to make sure there are mechanisms to avoid an                   
 intentional transmission of any lethal or potentially lethal                  
 infection and 2) more importantly, to try to prevent the disease.             
 The final point he wished to make is that we have an effort that's            
 in place to work with individuals who are infected with HIV and               
 enlist their cooperation in identifying all of their contacts.  He            
 remarked that what ensued when Magic Johnson announced his HIV                
 status was that thousands of people went and got tested because               
 they were concerned they may have HIV and almost none were                    
 infected.  In other words, huge numbers of tests of low risk, but             
 worried persons.  Alaska is a low prevalence HIV state and our                
 greatest efforts to prevent transmission are to work with all                 
 infected persons, identify  their contacts who are the most likely            
 themselves to be infected and to enlist and work with them to                 
 change their behaviors in order to prevent opportunities for the              
 virus to be transmitted in the future.  For the multiplicity of               
 these reasons, he urged the committee to make a difficult decision,           
 but not to pass this bill.                                                    
                                                                               
 Number 923                                                                    
                                                                               
 REPRESENTATIVE ROKEBERG referenced Dr. Middaugh's concerns about              
 intimate contact and asked if kissing would be a method of                    
 transmitted the HIV virus?                                                    
                                                                               
 DR. MIDDAUGH responded that it is not thought to be a likely                  
 transmission, but it potentially, theoretically could be considered           
 to result if, for instance, there was a cut in one person's mouth             
 and the other person had blood in their mouth from dental work,               
 vigorous brushing of teeth or braces abrading the mouth.  He added            
 this is one of the difficulties of attempting to achieve a goal by            
 legislating against the disease that has a complicated scientific             
 epidemiology and mode of transmission.                                        
                                                                               
 REPRESENTATIVE ROKEBERG asked about the known cases of the disease            
 being transmitted by dental practitioners.                                    
                                                                               
 DR. MIDDAUGH said no one knows for certain, but in the Kimberly               
 Burgelis tragedy, there is suspicion that that particular dentist             
 may have wilfully infected others to call attention to the plight             
 of the absence of funding and support to deal with the disease, but           
 it is also clear there was inadequate sterilization of the dental             
 instruments in that instance.  He commented there was also quite a            
 bit of IV drug abuse in that practice and among many of the                   
 individuals who were found to have been infected.                             
                                                                               
 Number 1022                                                                   
                                                                               
 REPRESENTATIVE ROBINSON asked Dr. Middaugh if he was aware of any             
 case in Alaska where someone knowingly transmitted HIV?                       
                                                                               
 DR. MIDDAUGH replied no.                                                      
                                                                               
 CO-CHAIR TOOHEY said there had been testimony on Representative               
 Ogan's bill, which is basically the same as Senator Taylor's, from            
 a woman who had prosecuted an individual who knowingly had infected           
 others in Juneau.                                                             
                                                                               
 DR. MIDDAUGH said he was unaware of the case.                                 
                                                                               
 CO-CHAIR TOOHEY offered to provide him with the tape of the                   
 committee hearing.                                                            
                                                                               
 Number 1069                                                                   
                                                                               
 REPRESENTATIVE VEZEY said there had been previous testimony to the            
 effect that this legislation was unnecessary because it is already            
 a crime to do the things mentioned in this bill.  There has also              
 been testimony in opposition because it may discourage people from            
 being tested for HIV.  He felt this was putting into statute what             
 constitutes a convictable offense; however, he did feel this                  
 legislation was ahead of the curve in terms of perpetrators and               
 victims.  He viewed this bill as simply saying that a person has              
 committed a crime if he/she knowingly infects another person,                 
 whether or not you kill the victim and that we as a society can               
 recognize that that form of behavior is not acceptable and can                
 remove such a person from society where innocent victims are                  
 exposed.  He commented that's what most of the laws do - they                 
 remove people from society.  He noted there had been discussions              
 about people with tuberculosis and we have tried to address them              
 with great compassion, but we have allowed people with tuberculosis           
 to be arrested and removed from society until the disease can be              
 brought under control.                                                        
                                                                               
 DR. MIDDAUGH said Representative Vezey's points were important                
 ones, but in the case of tuberculosis, that is only done when a               
 person is highly infectious with pulmonary tuberculosis.  He added            
 there is an effective drug which totally eliminates the                       
 infectiousness and there's an accurate test to both detect the                
 infectiousness as well as detect when the infectiousness goes away.           
 He added it is their hope to soon have some drugs and weapons that            
 will be able to eliminate infectiousness.  He said, "The state of             
 being HIV positive is one where not only is it not infectious                 
 during the whole period of many years, but unlike tuberculosis                
 where if I had tuberculosis I could give it to you in just our                
 discussion regardless of your behavior.  With HIV, just my own                
 behavior in the absence of another criminal offense, such as forced           
 criminal sexual penetration or rape or some form of assault, you              
 would not be at risk of getting HIV regardless of my HIV status and           
 infectiousness because it is not transmitted to you by the air or             
 easily like tuberculosis."  He didn't totally disagree with the               
 concepts, but the different behaviors, medically and biologically,            
 of the risk factors and likelihood of transmission make a big                 
 difference in this disease versus others and he felt there were               
 (indisc.) consequences of criminalizing a diagnosis in the absence            
 of disease or potential infectiousness or in fact, potential harm.            
 This bill does also not require that a person be infected in order            
 to have the defendant found guilty of a criminal act.                         
                                                                               
 Number 1248                                                                   
                                                                               
 REPRESENTATIVE VEZEY said he appreciated Dr. Middaugh's comments,             
 but this bill does not make a crime out of social intercourse.  It            
 does establish that it is a crime to engage in sexual intercourse             
 or other form of bodily fluid transmission if a person knows their            
 body fluids may carry a contagion.  He said he related this more to           
 rabies than to tuberculosis or a lot of other diseases.  He added             
 we would not allow a rabid person to wander in society and the                
 public would insist this person be removed from society.  He viewed           
 this as a tool which would allow us to remove from society this               
 infinitesimal small number of persons who are infected because                
 their social behavior is totally unacceptable.                                
                                                                               
 DR. MIDDAUGH said he agreed with that intent when the behavior is             
 unacceptable and removal is necessary.  He said, "I think the                 
 problem that I would view is that the consequences of this                    
 legislation could be very negative in terms of being able to both             
 identify and elicit partners from individuals infected and to work            
 with them to identify their contacts and that the likelihood that             
 we would be able to then effectively use the legislation to achieve           
 a goal, which is to try to remove individuals who may be wilfully             
 attempting to infect others, would be a very small benefit compared           
 to the existing legislation that we have which does still provide             
 in our existing legislation for weighing, as you heard before, the            
 likelihood of risk and consequences."  The concern with this bill             
 is that it does not do that.                                                  
                                                                               
 CO-CHAIR TOOHEY asked if there were further questions for Dr.                 
 Middaugh.  Hearing none, she called on Jayne Andreen to testify.              
                                                                               
 Number 1398                                                                   
                                                                               
 JAYNE ANDREEN, Executive Director, Council on Domestic Violence &             
 Sexual Assault, Department of Public Safety, expressed the                    
 council's concern with CSSB 91(HES).  She said last year one of the           
 strongest concerns the council had related to the potential                   
 transmission of the mother to an unborn fetus whether or not she              
 knows that she is an HIV carrier.  She pointed out that issue has             
 been dealt with on page 1, line 12.  She stated this is a difficult           
 bill and it's difficult to listen to the testimony, but basically             
 the council feels that current offenses covered under this bill can           
 already be charged under state law.  She echoed the concern                   
 expressed that this legislation would decrease the amount of                  
 voluntary testing that would take place for people throughout                 
 Alaska.  She said it was interesting to note how conversations have           
 a tendency to "mushroom off" when discussing bills, and as the                
 council was discussing this bill, one of the issues that came up              
 was sexual assault victims and the potential risk they face being             
 exposed to HIV.  She said that issue had been discussed before the            
 legislature previously and currently there is legislation which               
 gives the victim the opportunity to have the alleged offender                 
 tested.  The council proposed, for future reference, having some              
 type of aggravator added for sexual offenses when the offender                
 knows he/she is an HIV carrier.                                               
                                                                               
 Number 1475                                                                   
                                                                               
 REPRESENTATIVE VEZEY said he finally understood that the assumption           
 exists that fewer people will get tested for HIV if they think it             
 might be associated with a crime.  According to the legal experts             
 however, it's already a crime to recklessly expose another person             
 to HIV, so he didn't think anything would change in that regard.              
 He added that it kind of defies logic that we know for a medical              
 fact that drugs are available currently that will extend the life             
 of AIDS patients and will reduce symptoms and side effects of the             
 disease.  He questioned if people would knowingly forego the                  
 possibility of meaningful medical treatment to avoid the                      
 possibility of criminal prosecution for something they can already            
 be prosecuted for?  It just didn't make any sense to him.                     
                                                                               
 MS. ANDREEN said that is one of the council's concerns and there is           
 no way to gauge what the outcome would be.  She said, "The concern            
 I think primarily is the way it currently exists, there isn't                 
 anything in the statutes that says if you are HIV positive and you            
 have unprotected sex with someone and don't tell them about it, you           
 would be charged with these offenses.  It's when it actually is put           
 -- you know, it's under existing assault and attempted murder and             
 murder offenses that a person could be charged at this time.  When            
 you have a bill that actually lists out that if you are HIV, this             
 is what can happen to you if you do X, Y, Z is what the concern is,           
 is that it will really focus the attention in for people."                    
                                                                               
 Number 1589                                                                   
                                                                               
 SENATOR TAYLOR remarked that of all the people who testified on the           
 Senate side who testified that they feared a reduction in the                 
 number of people coming forward to be tested, not one of the people           
 who so testified called one state where this has been criminalized            
 and asked them what happened; Senator Taylor had and no one single            
 state has seen any decline in testing after passing and                       
 criminalizing conduct where a person fails to notify their partner.           
 He affirmed that is all that is required - just notify your partner           
 before engaging in sex with them.   For those people who testify              
 there will be a "chilling effect" he would like to see their                  
 statistics, because he was not able to find any such statistics               
 from the 22 different states he contacted.                                    
                                                                               
 Number 1643                                                                   
                                                                               
 REPRESENTATIVE ROKEBERG was curious and disturbed by Ms. Andreen's            
 comment regarding an aggravator provision in terms of developing              
 statutes relating to domestic violence victims.  He inquired if Ms.           
 Andreen was implying that victims of domestic violence should                 
 receive special statutory treatment as opposed to something like              
 this.                                                                         
                                                                               
 MS. ANDREEN hoped that wasn't what she had said and thanked                   
 Representative Rokeberg for allowing her to clarify.  What she had            
 been talking about in cases of sexual assault, sex offenses, was              
 that if the offender knows that he/she is HIV positive, that an               
 aggravator be written into the statute that could be reviewed at              
 the time of sentencing to increase the sentence.                              
                                                                               
 REPRESENTATIVE ROKEBERG thought that was what this bill was all               
 about.                                                                        
                                                                               
 CO-CHAIR TOOHEY said no, she thought it was Representative Kott's             
 bill last year that addressed the person who knowing had HIV and              
 was convicted of sexual assault.                                              
                                                                               
 REPRESENTATIVE ROKEBERG asked if that had been enacted?                       
                                                                               
 CO-CHAIR TOOHEY responded it was passed.                                      
                                                                               
 Number 1710                                                                   
                                                                               
 LYNN STIMLER, Executive Director, American Civil Liberties Union of           
 Alaska, said the ACLU opposes CSSB 91(HES).  She wanted to point              
 out why the ACLU thinks this legislation is particularly vague and            
 over broad, so that people with common intelligence can't really              
 guess at the meaning of it.  She noted that in the statute,                   
 intimate contact can mean any contact, because it's sexual                    
 penetration or contact in which the body of one person and the body           
 fluid of another in a manner that could result.  She said,                    
 "Potentially that raises the issue because HIV has been detected in           
 minute amounts in saliva, perspiration and tears -- it raises the             
 issue of whether an athlete - a young high school student whose               
 gotten HIV and was participating in sports and got a bloody nose,             
 would he be theoretically possible and under this statute, I think            
 it would be grounds for prosecution, that the intimate contact                
 provision if an HIV positive high school athletic was playing in a            
 field."  She questioned if all HIV people should be quarantined               
 from all athletic activity under this statute?  The New England             
 Journal of Medicine in 1987 said it is unrealistic to require proof         
 with absolute certainty that HIV is not transmitted in certain                
 ways, which means because we don't know, this statute is on its               
 face vague.  The other issue the ACLU wished to address was that              
 the National Academy of Sciences in 1986 said any admonition to               
 avoid intimate bodily contact and the exchange of bodily fluid can            
 convey at best a vague message; it is not specific enough.  The               
 ACLU believes that because the point of testing is for people who             
 don't know about their status, to come in and get information and             
 counseling which can keep them from transmitting this virus, it's             
 very important that testing be as open as possible.  The ACLU does            
 not agree with Senator Taylor in that they feel Hepatitis B and               
 tuberculosis are being tested for the very purposes that they are             
 not criminalized.  Additionally, this bill shifts the burden of               
 proof.  Normally the state of Alaska has to prove every element of            
 a crime which is part of the due process guarantee.  In this bill,            
 instead of the state having to prove the defendant did not inform             
 their partner, the defendant has to somehow prove that he did.  She           
 further commented she believes CSSB 91(HES) violates privacy and              
 equal protection.                                                             
                                                                               
 Number 1898                                                                   
                                                                               
 RACHEL KING, Board Member, Alaskan AIDS Assistance Association,               
 testified from Anchorage that she had been involved with AIDS                 
 education for the past 10 years.  She has seen a tremendous amount            
 of fear and loathing around the whole issue of AIDS and HIV.  She             
 believes that two big fears - the fear of homosexuality and the               
 fear of IV drug use has kept education from going forward as it               
 should.  She stated that education is the best weapon against AIDS            
 and the board's biggest concern with CSSB 91(HES) is that the                 
 provision that requires people to know they are infected with HIV             
 will in fact prevent people from wanting to find out their HIV                
 status.  Senator Taylor had pointed out that in doing surveys from            
 other states the rate of testing did not decline due to the                   
 criminalization of HIV; however, she said that didn't mean that               
 more people wouldn't have gotten tested had those laws not gone               
 into effect.  Testing is on the rise everywhere and perhaps it                
 would have continued to go up in those states.                                
                                                                               
 CO-CHAIR TOOHEY asked Anne Carpeneti from the Department of Law to            
 present her testimony.                                                        
                                                                               
 Number 1981                                                                   
                                                                               
 ANNE CARPENETI, Assistant Attorney General, Criminal Division,                
 Department of Law, testified there are two reasons the Department             
 of Law opposes CSSB 91(HES).  First, the department agrees with               
 Barbara Brink in that this behavior is already covered by other               
 criminal statutes, beginning with attempted murder in the first               
 degree which is an unclassified felony.  Secondly, the people who             
 are in risk groups who fear the diagnosis, wouldn't be tested and             
 this would not encourage testing by criminalizing a person who                
 knows that he/she is infected by their behavior, but not                      
 criminalizing the behavior of people who don't know.                          
                                                                               
 Number 2024                                                                   
                                                                               
 REPRESENTATIVE ROKEBERG commented that Ms. Brink had spoke to the             
 litany of assault statutes and asked if there was anything                    
 specifically defined in the assault statutes which addresses the              
 transmission of the HIV virus.                                                
                                                                               
 MS. CARPENETI responded the statutes do not specify HIV                       
 transmission.                                                                 
                                                                               
 REPRESENTATIVE ROKEBERG asked how those statues would have any                
 deterring effect on this type of activity if they are not specific?           
                                                                               
 MS. CARPENETI said they are specific in terms in outlawing the                
 egregious behavior that Senator Taylor has described; that being a            
 person intentionally going around having sex with people and                  
 transmitting the virus.  She added that Alaska's statutes don't               
 specify generally a particular activity, but rather prohibit                  
 general activity.                                                             
                                                                               
 Number 2057                                                                   
                                                                               
 REPRESENTATIVE ROKEBERG commented he was not familiar with the                
 state's criminal statutes, but he wondered if Alaska has a felony             
 aggravated assault statute.                                                   
                                                                               
 MS. CARPENETI responded the state has felony assault statutes.                
 Assault in the first, second and third degree are felonies and                
 assault in the fourth degree is a misdemeanor.                                
                                                                               
 REPRESENTATIVE ROKEBERG inquired about assault as opposed to                  
 battery.                                                                      
                                                                               
 MS. CARPENETI said the criminal code revision committee did away              
 with the distinction between battery and assault.                             
                                                                               
 REPRESENTATIVE ROKEBERG asked if assault in the state of Alaska is            
 physical contact?                                                             
                                                                               
 MS. CARPENETI said it includes battery.                                       
                                                                               
 Number 2090                                                                   
                                                                               
 REPRESENTATIVE DAVIS asked if any of the other 20+ states had                 
 existing statutes they believed would have covered this type of               
 behavior?                                                                     
                                                                               
 MS. CARPENETI said she didn't know, but she would be happy to work            
 with the sponsor to obtain that information.                                  
                                                                               
 SENATOR TAYLOR commented that every state had the same generic type           
 assault, intentional murder - everything that Alaska has, and every           
 state decided they couldn't keep a prostitute off the street or               
 couldn't convict under those statutes.                                        
                                                                               
 CO-CHAIR TOOHEY asked if the committee had any further questions.             
                                                                               
 Number 2132                                                                   
                                                                               
 SENATOR TAYLOR asked if we still intend to require consent for                
 sexual acts in the state.  Also, could he give his consent to a               
 sexual act with someone if he does not know what they may bring               
 with them?                                                                    
                                                                               
 CO-CHAIR TOOHEY speaking as a nurse said any woman or any man in              
 this state or any state that has sex without being protected                  
 deserves to get sick.  Anyone that has sex in this day and age with           
 an unknown partner, will get some type of disease.                            
                                                                               
 SENATOR TAYLOR commented that Co-Chair Toohey had used the word               
 "unknown."  He questioned if a wife was consenting to have sex with           
 a husband who finds out that he has HIV but fails to notify her?              
 He didn't think so, because the wife didn't know the full facts.              
 When that husband lies and misleads and does it intentionally,                
 knowing he has the illness, yet chooses to go forward with the act,           
 the wife then becomes a nonconsensual victim.  In Senator Taylor's            
 opinion it is very close to rape, but our laws don't cover it.                
 That is why this bill is before the committee.                                
                                                                               
 CO-CHAIR TOOHEY asked if there were any further questions.  Hearing           
 none, she closed public testimony.                                            
                                                                               
 ADJOURNMENT                                                                   
                                                                               
 CO-CHAIR TOOHEY adjourned the meeting of the House Health,                    
 Education and Social Services Committee at 5:28 p.m.                          
                                                                               

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