Legislature(2001 - 2002)

04/17/2001 03:02 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
          HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                                                                         
                       STANDING COMMITTEE                                                                                     
                         April 17, 2001                                                                                         
                           3:02 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Fred Dyson, Chair                                                                                                
Representative Peggy Wilson, Vice Chair                                                                                         
Representative John Coghill                                                                                                     
Representative Gary Stevens                                                                                                     
Representative Vic Kohring                                                                                                      
Representative Sharon Cissna                                                                                                    
Representative Reggie Joule                                                                                                     
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 197                                                                                                              
"An Act relating to directives  for personal health care services                                                               
and for medical treatment."                                                                                                     
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
CS FOR SENATE JOINT RESOLUTION NO. 21(HES)                                                                                      
Urging  the United  States Congress  to extend  the authorization                                                               
date for supplemental  block grants to the State  of Alaska under                                                               
the Federal Temporary Assistance to Needy Families Program.                                                                     
                                                                                                                                
     - MOVED CSSJR 21(HES) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE BILL NO. 173                                                                                                              
"An  Act  relating to  establishing  a  screening, tracking,  and                                                               
intervention program  related to the hearing  ability of newborns                                                               
and  infants;   providing  an  exemption   to  licensure   as  an                                                               
audiologist  for  certain  persons performing  hearing  screening                                                               
tests;  relating to  insurance  coverage for  newborn and  infant                                                               
hearing screening; and providing for an effective date."                                                                      
                                                                                                                              
     - HEARD AND HELD                                                                                                           
                                                                                                                              
HOUSE BILL NO. 174                                                                                                              
"An Act  relating to mental  health information and  records; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - MOVED HB 174 OUT OF COMMITTEE                                                                                            
                                                                                                                                
HOUSE BILL NO. 124                                                                                                              
"An Act prohibiting nursing facilities  and assisted living homes                                                               
from  employing  or  allowing  access  by  persons  with  certain                                                               
criminal backgrounds, with exceptions."                                                                                         
                                                                                                                                
     - MOVED CSHB 124(HES) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE JOINT RESOLUTION NO. 24                                                                                                   
Urging  the United  States Congress  to extend  the authorization                                                               
date for supplemental  block grants to the State  of Alaska under                                                               
the Federal Temporary Assistance to Needy Families Program.                                                                   
                                                                                                                              
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                              
HOUSE BILL NO. 209                                                                                                              
"An Act  directing the Department  of Health and  Social Services                                                               
to establish a  foster care transition program;  relating to that                                                               
program; and providing for an effective date."                                                                                  
                                                                                                                              
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
HOUSE BILL NO. 84                                                                                                               
"An Act relating to civil liability for emergency aid."                                                                         
                                                                                                                                
     - BILL HEARING POSTPONED TO 4/19/01                                                                                        
                                                                                                                                
HOUSE BILL NO. 112                                                                                                              
"An  Act  relating  to  information  and  services  available  to                                                               
pregnant women  and other persons; and  ensuring informed consent                                                               
before an abortion  may be performed, except in  cases of medical                                                               
emergency."                                                                                                                     
                                                                                                                                
     - BILL HEARING POSTPONED TO 4/19/01                                                                                        
                                                                                                                                
PREVIOUS ACTION                                                                                                               
                                                                                                                                
BILL: HB 197                                                                                                                  
SHORT TITLE:HEALTH CARE SERVICES DIRECTIVES                                                                                     
SPONSOR(S): REPRESENTATIVE(S)HUDSON                                                                                             
                                                                                                                                
Jrn-Date   Jrn-Page                     Action                                                                                  
03/19/01     0649       (H)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
03/19/01     0649       (H)        HES, JUD                                                                                     
03/28/01     0762       (H)        COSPONSOR(S): KERTTULA                                                                       
04/10/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
04/10/01                (H)        <Bill Postponed to 4/17>                                                                     
04/17/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
                                                                                                                                
BILL: SJR 21                                                                                                                  
SHORT TITLE:EXTEND FEDERAL TANF GRANTS                                                                                          
SPONSOR(S): HEALTH, EDUCATION & SOCIAL SERVICES                                                                                 
                                                                                                                                
Jrn-Date   Jrn-Page                     Action                                                                                  
03/19/01     0717       (S)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
03/19/01     0717       (S)        HES                                                                                          
03/28/01                (S)        HES AT 1:30 PM BUTROVICH 205                                                                 
03/28/01                (S)        Moved CS(HES) Out of                                                                         
                                   Committee                                                                                    
                                   MINUTE(HES)                                                                                  
03/29/01     0857       (S)        HES RPT CS 4DP SAME TITLE                                                                    
03/29/01     0857       (S)        DP: GREEN, LEMAN, WILKEN,                                                                    
                                   DAVIS                                                                                        
03/29/01     0857       (S)        FN1: ZERO(HSS)                                                                               
04/11/01     1068       (S)        RULES TO CALENDAR 4/11/01                                                                    
04/11/01     1073       (S)        READ THE SECOND TIME                                                                         
04/11/01     1073       (S)        HES CS ADOPTED UNAN CONSENT                                                                  
04/11/01     1073       (S)        ADVANCED TO THIRD READING                                                                    
                                   UNAN CONSENT                                                                                 
04/11/01     1073       (S)        READ THE THIRD TIME CSSJR
                                   21(HES)                                                                                      
04/11/01     1073       (S)        PASSED Y18 N- E1 A1                                                                          
04/11/01     1081       (S)        TRANSMITTED TO (H)                                                                           
04/11/01     1081       (S)        VERSION: CSSJR 21(HES)                                                                       
04/11/01                (S)        RLS AT 10:30 AM FAHRENKAMP                                                                   
                                   203                                                                                          
04/12/01     0977       (H)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
04/12/01     0977       (H)        HES, FIN                                                                                     
04/17/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
                                                                                                                                
BILL: HB 173                                                                                                                  
SHORT TITLE:SCREENING NEWBORNS FOR HEARING ABILITY                                                                              
SPONSOR(S): REPRESENTATIVE(S)JOULE                                                                                              
                                                                                                                                
Jrn-Date   Jrn-Page                     Action                                                                                  
03/12/01     0542       (H)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
03/12/01     0542       (H)        HES, FIN                                                                                     
03/13/01     0579       (H)        COSPONSOR(S): SCALZI                                                                         
03/30/01     0794       (H)        COSPONSOR(S): KERTTULA                                                                       
04/17/01     1021       (H)        COSPONSOR(S): MORGAN                                                                         
04/17/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
                                                                                                                                
BILL: HB 174                                                                                                                  
SHORT TITLE:MENTAL HEALTH INFORMATION AND RECORDS                                                                               
SPONSOR(S): RLS BY REQUEST OF LEG BUDGET & AUDIT                                                                                
                                                                                                                                
Jrn-Date   Jrn-Page                     Action                                                                                  
03/12/01     0543       (H)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
03/12/01     0543       (H)        HES, JUD                                                                                     
04/17/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
                                                                                                                                
BILL: HB 124                                                                                                                  
SHORT TITLE:NURS.HOME/ASSISTED LIV. EMPLOYEES/VISITOR                                                                           
SPONSOR(S): REPRESENTATIVE(S)HALCRO                                                                                             
                                                                                                                                
Jrn-Date   Jrn-Page                     Action                                                                                  
02/09/01     0282       (H)        READ THE FIRST TIME -                                                                        
                                   REFERRALS                                                                                    
02/09/01     0282       (H)        HES, JUD                                                                                     
03/07/01     0501       (H)        COSPONSOR(S): DYSON                                                                          
03/15/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
03/15/01                (H)        Heard & Held                                                                                 
03/15/01                (H)        MINUTE(HES)                                                                                  
03/19/01     0656       (H)        COSPONSOR(S): STEVENS                                                                        
03/20/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
03/20/01                (H)        <Bill Canceled>                                                                              
03/22/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
03/22/01                (H)        Heard & Held                                                                                 
03/22/01                (H)        MINUTE(HES)                                                                                  
04/17/01                (H)        HES AT 3:00 PM CAPITOL 106                                                                   
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
MELANIE LESH, Staff                                                                                                             
to Representative Bill Hudson                                                                                                   
Alaska State Legislature                                                                                                        
Capitol Building, Room 502                                                                                                      
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:  Testified on behalf of the sponsor of HB
197.                                                                                                                            
                                                                                                                                
SIOUX PLUMMER                                                                                                                   
Juneau End of Life Task Force                                                                                                   
2551 Vista Drive                                                                                                                
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:  Testified on behalf of the Juneau End of                                                                   
Life Task Force and herself in favor of HB 197.                                                                                 
                                                                                                                                
JANE DEMMERT, Executive Director                                                                                                
Alaska Commission on Aging                                                                                                      
Department of Administration                                                                                                    
PO Box 110209                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Testified in support of HB 197.                                                                            
                                                                                                                                
MOLLY EIDEM                                                                                                                     
Long Term Care Ombudsman                                                                                                        
3601 C Street                                                                                                                   
Anchorage, Alaska 99503                                                                                                         
POSITION STATEMENT:  Testified on behalf of Suzan Armstrong in                                                                  
support of HB 197.                                                                                                              
                                                                                                                                
JOHN MANLY, Staff                                                                                                               
to Representative John Harris                                                                                                   
Alaska State Legislature                                                                                                        
Capitol Building, Room 513                                                                                                      
Juneau, Alaska 99801                                                                                                            
POSITION  STATEMENT:    Testified  on  behalf  of  Representative                                                               
Harris, sponsor of HJR 24  (the companion bill), presented SJR 21                                                               
and  explained  the  differences  between the  House  and  Senate                                                               
versions.                                                                                                                       
                                                                                                                                
JIM NORDLUND, Director                                                                                                          
Division of Public Assistance                                                                                                   
Department of Health & Social Services                                                                                          
PO Box 110640                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Answered questions on SJR 21.                                                                              
                                                                                                                                
CHRISTINE HESS, Staff                                                                                                           
to Representative Reggie Joule                                                                                                  
Alaska State Legislature                                                                                                        
Capitol Building, Room                                                                                                          
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:  Answered questions on HB 173.                                                                              
                                                                                                                                
KAREN PEARSON, Director                                                                                                         
Division of Public Health                                                                                                       
Department of Health & Social Services                                                                                          
PO Box 110610                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Answered question on HB 173.                                                                               
                                                                                                                                
HEATHER ALLIO, Parent                                                                                                           
3961 Portage Boulevard                                                                                                          
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:  Testified on behalf of herself on HB 173.                                                                  
                                                                                                                                
LISA OWENS, Audiologist and Speech Pathologist                                                                                  
11935 Kristie Circle                                                                                                            
Anchorage, Juneau 99503                                                                                                         
POSITION STATEMENT:  Testified on HB 173.                                                                                       
                                                                                                                                
REPRESENTATIVE HUGH FATE                                                                                                        
Alaska State Legislature                                                                                                        
Capitol Building, Room 416                                                                                                      
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:  Testified as sponsor of HB 174.                                                                            
                                                                                                                                
ELMER LINDSTROM, Special Assistant                                                                                              
Office of the Commissioner                                                                                                      
Department of Health & Social Services                                                                                          
PO Box 110601                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Testified on HB 174 and HB 124.                                                                            
                                                                                                                                
ANNE HENRY, Special Projects Coordinator                                                                                        
Division of Mental Health & Developmental Disabilities                                                                          
Department of Health & Social Services                                                                                          
PO Box 110620                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Answered questions on HB 174.                                                                              
                                                                                                                                
PAT DAVIDSON, Legislative Auditor                                                                                               
Legislative Audit Division                                                                                                      
Alaska State Legislature                                                                                                        
PO Box 113300                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Answered questions on HB 174.                                                                              
                                                                                                                                
KEVIN HAND, Staff                                                                                                               
to Representative Andrew Halcro                                                                                                 
Alaska State Legislature                                                                                                        
Capitol Building, Room 414                                                                                                      
Juneau, Alaska 99801                                                                                                            
POSITION STATEMENT:   Testified  on behalf of  the sponsor  of HB
124.                                                                                                                            
                                                                                                                                
ALISON ELGEE, Deputy Commissioner                                                                                               
Office of the Commissioner                                                                                                      
Department of Administration                                                                                                    
PO Box 110200                                                                                                                   
Juneau, Alaska 99811                                                                                                            
POSITION STATEMENT:  Testified on HB 124.                                                                                       
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 01-44, SIDE A                                                                                                              
Number 0001                                                                                                                     
                                                                                                                                
CHAIR FRED  DYSON called the  House Health, Education  and Social                                                               
Services  Standing  Committee  meeting  to  order  at  3:02  p.m.                                                               
Members present at the call  to order were Representatives Dyson,                                                               
Coghill, Stevens,  and Joule.   Representatives  Wilson, Kohring,                                                               
and Cissna joined the meeting as it was in progress.                                                                            
                                                                                                                                
HB 197-HEALTH CARE SERVICES DIRECTIVES                                                                                        
                                                                                                                                
CHAIR DYSON announced  that the first order of  business would be                                                               
HOUSE BILL NO.  197, "An Act relating to  directives for personal                                                               
health care services and for medical treatment."                                                                                
                                                                                                                                
Number 0019                                                                                                                     
                                                                                                                                
MELANIE LESH,  Staff to Representative Bill  Hudson, Alaska State                                                               
Legislature, came forth on behalf of  the sponsor of HB 197.  She                                                               
read  to  the committee  a  statement  written by  Representative                                                               
Hudson:                                                                                                                         
                                                                                                                                
     I was  asked to  support this  legislation by  people I                                                                    
     respect   and   who   have  long   proved   worthy   of                                                                    
     representing  good causes.   This  cause I  find to  be                                                                    
     very  civilized  and  humanitarian.     You  will  hear                                                                    
     testimony from  several persons  in agencies  that wish                                                                    
     to enable others  to give a voice to others  who can no                                                                    
     longer  offer their  own through  the preparation  of a                                                                    
     list of their  wishes for their final days.   This bill                                                                    
     expands  the options  for people  who  want to  prepare                                                                    
     themselves for when they can  no longer speak or act on                                                                    
     their  own behalf.   These  expanded directives  do not                                                                    
     interfere with  the current statutes  concerning living                                                                    
     wills  and "do  not resuscitate"  orders.   They simply                                                                    
     provide  for a  form to  be circulated  with which  the                                                                    
     patient[s]  can  determine  what   they  will  need  in                                                                    
     respect to  their comforts - emotional,  spiritual, and                                                                    
     physical.   This bill will enable  agencies that assist                                                                    
     terminally  ill   patients  by  providing   a  document                                                                    
     contained in the bill that  spells out choices for them                                                                    
     to  consider with  their family  and their  loved ones.                                                                    
     It is  hope that  this document  will continue  to gain                                                                    
     attention, as it  has in 37 other states,  and broach a                                                                    
     subject  that  is uncomfortable  for  most  of us,  but                                                                    
     necessary for all of us.                                                                                                   
                                                                                                                                
CHAIR DYSON asked what keeps people from doing this now.                                                                        
                                                                                                                                
MS. LESH responded  that she would rather somebody  else spoke to                                                               
that.   She  said there  are limited  allowances in  statutes now                                                               
that  provide for  living wills,  but nothing  sets forth  a form                                                               
providing choices and options.                                                                                                  
                                                                                                                                
Number 0300                                                                                                                     
                                                                                                                                
SIOUX  PLUMMER, Juneau  End of  Life Task  Force, came  forth and                                                               
stated that  [HB 197] is easily  a piece of legislation  that can                                                               
be supported by  a variety of people in [Alaska].   She explained                                                               
that this enables the legislature  to aid Alaskans in having more                                                               
clear  and defined  choices in  how they  want the  end of  their                                                               
lives to  be.   She said 35  other states have  laws that  have a                                                               
similar concept.   This is based  on the Five Wishes,  a document                                                               
of  a few  pages of  statements that  talks about  what a  person                                                               
might want to  think about and want the family  or doctor to know                                                               
when he  or she is terminally  ill.  She stated  that Five Wishes                                                               
was created by  an organization out of Florida  called Aging With                                                               
Dignity.   The gentleman who  formed the Five Wishes  worked with                                                               
Mother Theresa for  several years.  She added that  the intent of                                                               
HB 197 is good public policy.                                                                                                   
                                                                                                                                
CHAIR DYSON asked why this needs to be in law.                                                                                  
                                                                                                                                
MS.  PLUMMER responded  that to  her understanding  this improves                                                               
and expands existing  state statutes so it is clearer  as to what                                                               
the  choices are.   This  aids  someone in  thinking about  these                                                               
things and legally enables him or her to do it.                                                                                 
                                                                                                                                
CHAIR DYSON stated that the value of  law is not to aid people in                                                               
thinking.  He asked who would go  to jail if someone were to fill                                                               
this out and it was not followed through.                                                                                       
                                                                                                                                
MS. PLUMMER  answered that she does  not know of any  language in                                                               
this  law or  the new  proposed  law that  would say  that if  it                                                               
weren't followed, somebody would go to [jail].                                                                                  
                                                                                                                                
CHAIR DYSON asked why this should be put in law, then.                                                                          
                                                                                                                                
MS. PLUMMER  replied that she  thinks the Department of  Health &                                                               
Social Services  or the Department  of Administration  might have                                                               
some suggestions that it merely be in regulation.                                                                               
                                                                                                                                
CHAIR DYSON asked why the state needs to be involved in this.                                                                   
                                                                                                                                
MS. PLUMMER remarked that she  was hoping someone from Aging With                                                               
Dignity  could talk  about what  other states  have done  and why                                                               
this was put it into law.  She  added that she wants to urge [the                                                               
legislature]  to  understand  and  support the  concept  and  the                                                               
intent of [HB 197].                                                                                                             
                                                                                                                                
Number 0573                                                                                                                     
                                                                                                                                
REPRESENTATIVE  STEVENS  stated that  he  thinks  Chair Dyson  is                                                               
getting at a good  point.  He said he had  just received from his                                                               
mother a  power of attorney and  a living will and  would like to                                                               
know what [the  proposed legislation] would do that  the power of                                                               
attorney and the living will do not do.                                                                                         
                                                                                                                                
MS. PLUMMER stated  that she believes this  language just expands                                                               
on what  already exists  and gives  a greater  clarity to  what a                                                               
living will could include.                                                                                                      
                                                                                                                                
REPRESENTATIVE STEVENS  asked if  there is a  contradiction among                                                               
the  living will,  the  power of  attorney,  and this  [proposed]                                                               
form.  He asked what legally would take precedence.                                                                             
                                                                                                                                
Number 0671                                                                                                                     
                                                                                                                                
JANE  DEMMERT, Executive  Director, Alaska  Commission on  Aging,                                                               
Department of Administration, came  forth and stated, in response                                                               
to Representative  Stevens' questions,  that it might  be helpful                                                               
to take a  look at some of  the statements that begin  on page 13                                                               
of the bill.  She said:                                                                                                         
                                                                                                                                
     I'll   just  speak   for  myself   as  an   individual.                                                                    
     Acknowledging that I  will die is a hard  thing to come                                                                    
     to grips with;  it's even harder to think about  how  -                                                                    
     to the  extent that it could  happen - I would  like to                                                                    
     be cared for and treated  when I can no longer, through                                                                    
     a discussion  like this, tell people  what I'm seeking.                                                                    
     One of the  steps that this takes is to  - based on the                                                                    
     experience of  people in many different  settings now -                                                                    
     pose some  statements here  that would  help me  ... to                                                                    
     anticipate  the kinds  of  circumstances  that I  would                                                                    
     experience.   And  then to,  based on  that, say,  "And                                                                    
     here's  how I'd  like you  to support  me as  I'm going                                                                    
     through these last stages of my life."                                                                                     
                                                                                                                                
CHAIR DYSON asked what would take  precedence and if this has any                                                               
legal standing.                                                                                                                 
                                                                                                                                
MS. DEMMERT explained that there is  a reference on page 17 about                                                               
how this would phase in.  It states:                                                                                            
                                                                                                                                
     ...  a  person  who,  by  a  statutory  form  power  of                                                                    
     attorney  executed   under  AS  13.26.332   before  the                                                                    
     effective date  of this Act,  has been given  powers to                                                                    
     make health  care decisions  under and  consistent with                                                                    
     authority  set  out  in the  repealed  provisions,  may                                                                    
     continue to exercise those  powers under and consistent                                                                    
     with the  authority set out in  the repealed provisions                                                                    
     until the appointment made by  the statutory form power                                                                    
     of  attorney  with  respect  to  health  care  services                                                                    
     terminates or is revoked.                                                                                                  
                                                                                                                                
MS. DEMMERT  stated that  she thinks  this speaks  to one  of the                                                               
considerations  in  terms  of  how  this  would  articulate  with                                                               
current statutes.                                                                                                               
                                                                                                                                
Number 0880                                                                                                                     
                                                                                                                                
CHAIR DYSON  remarked that there  is no "or  else."  He  asked if                                                               
there is  anything that binds  the caregiver to obey  it, besides                                                               
helping people  think this  through.  He  asked what  the penalty                                                               
would be for disobedience.                                                                                                      
                                                                                                                                
MS.  DEMMERT  responded that  she  does  not  know.   She  asked,                                                               
"Philosophically, do you think there should be, if there's not?"                                                                
                                                                                                                                
CHAIR DYSON  answered absolutely, if it  is going to be  put into                                                               
law.                                                                                                                            
                                                                                                                                
MS. DEMMERT  remarked that  this is  very interesting  because it                                                               
brings together  a number  of provisions as  well as  charts some                                                               
new ground.   She  said she believes  everyone is  thinking about                                                               
this in a more comprehensive fashion.                                                                                           
                                                                                                                                
Number 0981                                                                                                                     
                                                                                                                                
REPRESENTATIVE  CISSNA  asked  if  this is  a  general  power  of                                                               
attorney.   She  said that  would mean  the person  who has  been                                                               
designated  as having  the power  of attorney  can do  the things                                                               
that are  listed here; therefore,  there would be  some statutory                                                               
strength.  She also asked if  there are additional things in [the                                                               
proposed form] beyond a normal power of attorney                                                                                
                                                                                                                                
MS. DEMMERT answered yes.                                                                                                       
                                                                                                                                
REPRESENTATIVE CISSNA  remarked that  she personally  thinks this                                                               
is  useful.   She shared  that her  late husband  had a  power of                                                               
attorney and a living will, and  one of the horrendous things she                                                               
went through  was trying to figure  out what he meant.   She said                                                               
she  can  see a  real  need  for trying  to  make  that very  end                                                               
decision a clear one.                                                                                                           
                                                                                                                                
CHAIR DYSON stated  that it certainly is a power  of attorney and                                                               
covers  a  lot  of  things.    He  said  that  he  suspects  [the                                                               
committee]  will  pass the  bill  and  let [the  House  Judiciary                                                               
Standing Committee] wrestle  with whether or not  there should be                                                               
a form in state law.                                                                                                            
                                                                                                                                
MS. LESH  commented that  Representative Hudson  has acknowledged                                                               
that the directive  could be maintained in the bill  and that the                                                               
form  could  be  brought  about through  a  regulatory  direction                                                               
through  the legislature.   She  said  Representative Hudson  was                                                               
willing  to  work with  the  national  Dying with  Dignity  group                                                               
because there  is some legislation  in other states  that enables                                                               
the state  agency to create  the form  with the direction  of the                                                               
legislature.    She added  that  Representative  Hudson has  also                                                               
wrestled with the  idea that the form's being in  the statute may                                                               
not be the best method.                                                                                                         
                                                                                                                                
Number 1245                                                                                                                     
                                                                                                                                
CHAIR DYSON  stated that he  appreciates that.  He  remarked that                                                               
he  is  particularly interested  in  how  the [medical]  industry                                                               
feels when  somebody says, "I  don't want pain killers,"  and yet                                                               
the whole  tradition has  been to  make the  patient comfortable.                                                               
He asked if [the industry] will be afraid of liabilities.                                                                       
                                                                                                                                
MS. PLUMMER  stated that the Juneau  End of Life Task  Force is a                                                               
group  of people  that began  talking with  Representative Hudson                                                               
about this legislation.  She said  she also serves on the Hospice                                                               
Foundation Board  for Juneau,  which endorses HB  197.   She read                                                               
from a document from the Hospice Foundation Board:                                                                              
                                                                                                                                
     The meaning of HB 197 is  really a gift to one's family                                                                    
     members and  friends so they  won't have to  guess what                                                                    
     you want.   The Hospice and Homecare  of Juneau's board                                                                    
     of directors urges approval of HB 197.                                                                                     
                                                                                                                                
CHAIR DYSON remarked  that the two times he has  been involved in                                                               
cases  like this,  there  weren't elderly  people  involved.   He                                                               
noted that  nothing has  been put  in [the  bill] that  refers to                                                               
children.                                                                                                                       
                                                                                                                                
MS. PLUMMER  responded that  those are the  kinds of  things that                                                               
people  often include  in  their durable  powers  of attorney  or                                                               
their wills.  She said this  is only addressing the very intimate                                                               
end of life decisions a person makes.                                                                                           
                                                                                                                                
CHAIR DYSON  stated that he  is confused  because page 2  [of the                                                               
bill]  lists   a  lot  of   important  things  such   as  banking                                                               
transactions, real estate, claims, and litigation.                                                                              
                                                                                                                                
MS. LESH responded that those  provisions stay in statute just as                                                               
they are.   [House  Bill 197]  creates a  new section  that deals                                                               
with health care directives.                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA stated  that she is assuming  the line here                                                               
is between  the [the  person the]  power of  attorney that  is in                                                               
place while the  person in question is alive and  the executor of                                                               
the will who is there after that transition.                                                                                    
                                                                                                                                
MS. PLUMMER responded  that sometimes it is the  same person [who                                                               
is named  in the durable  power of attorney],  but that is  up to                                                               
each individual.                                                                                                                
                                                                                                                                
Number 1444                                                                                                                     
                                                                                                                                
MOLLY   EIDEM,   Long   Term  Care   Ombudsman,   testified   via                                                               
teleconference on  behalf of  Suzan Armstrong.   She read  to the                                                               
committee:                                                                                                                      
                                                                                                                                
     The  Office of  the  Long Term  Care Ombudsman  (OLTCO)                                                                    
     supports  HB 197,  "An Act  relating to  directives for                                                                    
     personal   health  care   services   and  for   medical                                                                    
     treatment."   Long Term Care Ombudsmen  from around the                                                                    
     country  have  been  extolling  the  benefits  of  Five                                                                    
     Wishes for some time now.   Our clients, the elderly of                                                                    
     Alaska,   need  clear   tools,   written  in   specific                                                                    
     language, that  [direct] our health care  providers and                                                                    
     others  on  how to  administer  to  our clients'  final                                                                    
     needs.   Too  often, the  OLTCO has  attempted to  help                                                                    
     family and  friends struggling to determine  what their                                                                    
     loved one would  want and not want,  and having little,                                                                    
     if any, input from the  elder.  Sadly, acute conditions                                                                    
     that  inhibit   worthwhile  communication   or  chronic                                                                    
     conditions such  as dementia  prevent our  clients from                                                                    
     expressing their wishes and  desires during their final                                                                    
     days  and hours.   The  Five Wishes  format would  be a                                                                    
     priceless gift to all of  our Alaska families and would                                                                    
     greatly enhance  our capabilities to administer  to our                                                                    
     dying Alaskans' final wishes and to plan for our own.                                                                      
                                                                                                                                
Number 1529                                                                                                                     
                                                                                                                                
CHAIR DYSON called  for an at-ease at 3:28 p.m.   The meeting was                                                               
called back to order at 3:40 p.m.                                                                                               
                                                                                                                                
[HB 197 was held over.]                                                                                                         
                                                                                                                                
SJR 21-EXTEND FEDERAL TANF GRANTS                                                                                             
                                                                                                                                
[Contains discussion of HJR 24, the companion bill.]                                                                            
                                                                                                                                
CHAIR DYSON  announced that the  next order of business  would be                                                               
CS FOR  SENATE JOINT  RESOLUTION NO.  21(HES), Urging  the United                                                               
States   Congress   to   extend  the   authorization   date   for                                                               
supplemental  block  grants to  the  State  of Alaska  under  the                                                               
Federal Temporary Assistance to Needy Families Program.                                                                         
                                                                                                                                
Number 1650                                                                                                                     
                                                                                                                                
JOHN  MANLY, Staff  to Representative  John Harris,  Alaska State                                                               
Legislature,  came  forth  on behalf  of  Representative  Harris,                                                               
sponsor of HJR  21, to explain SJR  21.  He stated  that [SJR 21]                                                               
asks the federal government to  continue the supplemental funding                                                               
for the  TANF (Temporary Assistance  to Needy  Families) program,                                                               
which is  about $6.9  million or about  30 percent  of [Alaska's]                                                               
block  grant.   He remarked  that a  number of  states that  were                                                               
either  poor  or  growing  faster than  the  national  rate  were                                                               
allowed this.   He  noted that according  to the  census figures,                                                               
[Alaska] has grown  by 14 percent since 1990.   [The supplemental                                                               
funding] is  scheduled to  expire the  next federal  fiscal year,                                                               
and the  whole TANF  authorization program  expires a  year after                                                               
that.   He  explained that  this resolution  asks for  a one-year                                                               
extension  so that  when the  program  is reconsidered,  [Alaska]                                                               
will be funded up to that point.                                                                                                
                                                                                                                                
MR. MANLY  explained that there are  a few changes in  the Senate                                                               
version  from the  House version  of the  resolution.   The House                                                               
version  had included  the  Head  Start program  in  the list  of                                                               
programs and  services that  TANF funds cover.   However,  in the                                                               
Senate version,  on page  2, line  10, that  has been  taken out.                                                               
The  Senate  version  also  added  the  President  and  the  U.S.                                                               
Secretary to be the designated recipients of the resolution.                                                                    
                                                                                                                                
CHAIR DYSON asked  why the legislature needs to  be involved with                                                               
this.                                                                                                                           
                                                                                                                                
Number 1753                                                                                                                     
                                                                                                                                
JIM   NORDLUND,   Director,   Division  of   Public   Assistance,                                                               
Department of  Health &  Social Services  (DHSS), came  forth and                                                               
stated that this is a  resolution to Congress encouraging them to                                                               
continue  the funding.    This  is using  the  "finesse" and  the                                                               
authority of the legislature to deliver that message.                                                                           
                                                                                                                                
REPRESENTATIVE JOULE  asked, if  the legislature  did not  pass a                                                               
resolution, whether congress would [continue the funding].                                                                      
                                                                                                                                
MR.  NORDLUND answered  that this  is  a formal  way of  bringing                                                               
attention to the  issue.  He noted that [the  resolution] will be                                                               
fairly well  received by  Congress.  There  have already  been 14                                                               
[U.S.] Senators who have written  letters to the President asking                                                               
for this  extended funding,  including Alaska's  Senator Stevens.                                                               
It  is  supported by  resolutions  from  the National  Governor's                                                               
Association,  and   from  the  American  Public   Human  Services                                                               
Association.   He stated  that there is  broad support  for this,                                                               
but  lending  the  voice  of   [Alaska's]  legislature  would  be                                                               
helpful.                                                                                                                        
                                                                                                                                
Number 1816                                                                                                                     
                                                                                                                                
CHAIR  DYSON  stated  that he  thinks  Representative  Joule  was                                                               
asking if this is  the only way to make this  happen and that Mr.                                                               
Nordlund's response was, "No, but it  would be useful."  He asked                                                               
if the Knowles Administration has  any other way of notifying the                                                               
U.S. government of the desire to have this funding continue.                                                                    
                                                                                                                                
MR. NORDLUND responded that [DHSS]  has been  working through the                                                               
Governor's office  and the congressional  delegation to  get this                                                               
[resolution] through.   He said it certainly would  be helpful if                                                               
the legislature  would lend  its voice  as well.   He  added that                                                               
this could happen without the passage [of the resolution].                                                                      
                                                                                                                                
MR. NORDLUND, in reply to  a further question, explained that the                                                               
resolution  states  that "we"  have  committed  this funding  for                                                               
various programs.   If [Alaska]  receives that $7 million  cut to                                                               
the block  grant, then  "we" will  have to reach  out to  some of                                                               
those agencies  and figure out who  can no longer be  funded.  He                                                               
added that  [Alaska] is  facing a $14  million deficit  with TANF                                                               
funds  for FY  2003.   He said  getting the  supplemental funding                                                               
continued would plug a big hole in that deficit.                                                                                
                                                                                                                                
CHAIR DYSON asked Mr. Nordlund  what the Senate's thinking was in                                                               
taking out Head Start.                                                                                                          
                                                                                                                                
MR. NORDLUND  answered that it  was [DHSS's] request.   He stated                                                               
that [DHSS] is funding Head  Start right now; however, it doesn't                                                               
seem  proper.   [DHSS]  is  presently  under  an audit,  and  the                                                               
legislature should  not have  extended TANF  funding to  the Head                                                               
Start  program because  it  is  not an  allowable  use under  the                                                               
federal rights.                                                                                                                 
                                                                                                                                
Number 1959                                                                                                                     
                                                                                                                                
REPRESENTATIVE CISSNA  stated that it  would seem to her  that as                                                               
money policy  makers [legislators]  should be weighing  the costs                                                               
of all of these things,  making resolutions on federal funds, and                                                               
knowing what they are.                                                                                                          
                                                                                                                                
REPRESENTATIVE COGHILL  remarked that  block grants are  based on                                                               
the rolls of  the temporary assistance [programs].   He asked Mr.                                                               
Nordlund  if, since  [Alaska] has  gone  down in  the [number  of                                                               
people on  temporary assistance,  [this resolution] is  asking to                                                               
be held harmless for the amount [Alaska] has gone down.                                                                         
                                                                                                                                
MR.  NORDLUND responded  that with  the way  the block  grant was                                                               
structured when welfare  reform passed, the deal  in Congress was                                                               
that the  entitlement status  for welfare  would end,  and states                                                               
would be given a  set amount of money.  The  states would have to                                                               
live with  that amount of money  if the welfare caseloads  go up;                                                               
if  the caseloads  go down,  the states  get to  keep the  money,                                                               
regardless of  the size of  the caseload.   He stated  that there                                                               
was one  provision whereby states  with high populations  and the                                                               
poorer states would get a 2.5  percent bump every year.  [Alaska]                                                               
has been getting  that "bump" every year, regardless  of what has                                                               
been happening  with the caseload.   Since the caseload  has been                                                               
going down, the  state has been able to keep  that difference and                                                               
use  that funding  for  other  purposes.   He  explained that  in                                                               
[Alaska] the  child care program  used to have about  $10 million                                                               
in general fund  (GF) money.  The federal TANF  dollars that have                                                               
been saved  have supplemented  the GF,  thereby helping  to close                                                               
the fiscal gap.                                                                                                                 
                                                                                                                                
Number 2078                                                                                                                     
                                                                                                                                
REPRESENTATIVE COGHILL  asked if the  grant itself will  be based                                                               
on the reauthorization of what [Alaska's] caseload is.                                                                          
                                                                                                                                
MR. NORDLUND answered  that "we" don't know that yet.   He stated                                                               
that this  is a huge  debate in Congress right  now.  There  is a                                                               
lot  of  pressure  within  Congress  to  say,  "Well,  since  the                                                               
caseload has  dropped in half,  you obviously don't need  as much                                                               
money  as we  guaranteed you  in '94."   But  states are  saying,                                                               
"Well, but  we are  using those funds  for very  legitimate other                                                               
purposes and are  actually running programs with  it. ... Pulling                                                               
back that funding level would mean defunding certain programs."                                                                 
                                                                                                                                
REPRESENTATIVE  COGHILL remarked  that  this is  probably why  he                                                               
won't  support  the  resolution,  because he  thinks  it  is  the                                                               
state's responsibility and not the  federal government's [to fund                                                               
these other programs].                                                                                                          
                                                                                                                                
Number 2152                                                                                                                     
                                                                                                                                
REPRESENTATIVE  JOULE  made  a  motion  to  move  SJR  21  [CSSJR
21(HES)] from  committee with individual recommendations  and the                                                               
attached zero fiscal note.                                                                                                      
                                                                                                                                
REPRESENTATIVE COGHILL objected.                                                                                                
                                                                                                                                
A  roll call  vote was  taken.   Representative Stevens,  Cissna,                                                               
Joule,  Wilson,   and  Dyson  voted   in  favor  of   moving  the                                                               
resolution.      Representative   Coghill   voted   against   it.                                                               
[Representative Kohring  was absent.]   Therefore,  CSSJR 21(HES)                                                               
moved  from  the  House Health,  Education  and  Social  Services                                                               
Standing Committee by a vote of 5-1.                                                                                            
                                                                                                                                
HB 173-SCREENING NEWBORNS FOR HEARING ABILITY                                                                                 
                                                                                                                                
CHAIR DYSON  announced that the  next order of business  would be                                                               
HOUSE  BILL  NO.   173,  "An  Act  relating   to  establishing  a                                                               
screening,  tracking, and  intervention  program  related to  the                                                               
hearing ability  of newborns and infants;  providing an exemption                                                               
to  licensure as  an audiologist  for certain  persons performing                                                               
hearing  screening  tests;  relating to  insurance  coverage  for                                                               
newborn  and  infant  hearing screening;  and  providing  for  an                                                               
effective date."   [Before the  committee was the  original bill;                                                               
although there  was a proposed  committee substitute (CS)  in the                                                               
packets; version  22-LS0003\B, Lauterbach, 4/11/01, it  was never                                                               
adopted.                                                                                                                        
                                                                                                                                
Number 2199                                                                                                                     
                                                                                                                                
CHAIR DYSON called  for an at-ease at 3:55 p.m.   The meeting was                                                               
called back to order at 3:56 p.m.                                                                                               
                                                                                                                                
REPRESENTATIVE JOULE  stated, as sponsor  of the bill,  that each                                                               
year in Alaska  approximately 10,000 babies are born.   Around 30                                                               
to  40  of these  children  will  have  some sort  of  congenital                                                               
hearing loss.  Hearing loss, he  said, is more prevalent than any                                                               
other  congenital abnormality  for which  newborns are  routinely                                                               
screened.   Without newborn screening,  the average age  at which                                                               
children in  the United States  are identified with  hearing loss                                                               
is 12  to 25  months -  after critical  windows of  learning have                                                               
passed.  If left undetected,  hearing loss can result in lifelong                                                               
delays  in  language,  cognitive, socio-emotional,  and  academic                                                               
development.                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOULE  explained that [HB 173]  does three things.                                                               
It requires testing of infants  before release from a hospital or                                                               
within 30  days, except if hospitals  have less than 50  births a                                                               
year or birthing centers refer  for screening within 30 days; the                                                               
development of  a reporting and  tracking system for  newborn and                                                               
infants; and  intervention by providing parents  with information                                                               
through  which they  could  get  services if  their  child has  a                                                               
hearing  loss, as  well as  providing  general information  about                                                               
hearing testing of infants.                                                                                                     
                                                                                                                                
REPRESENTATIVE JOULE explained that in  the last several years 32                                                               
states   have  passed   legislation  requiring   newborn  hearing                                                               
screening.  Three  or more states test on a  voluntary basis, and                                                               
four  states are  considering legislation  this year.   He  added                                                               
that there is a new fiscal  note for [the bill], which is $90,000                                                               
a year, whereas the old fiscal note, was over $500,000.                                                                         
                                                                                                                                
REPRESENTATIVE JOULE offered Amendment 1, which read:                                                                           
                                                                                                                                
          Page 5, subsection (g), lines 14-18                                                                                   
          DELETE                                                                                                              
                                                                                                                                
TAPE 01-44, SIDE B                                                                                                              
                                                                                                                                
CHAIR   DYSON  asked,   if  [the   committee]   were  to   accept                                                               
Representative Joule's  amendment, whether the fiscal  note would                                                               
go away.                                                                                                                        
                                                                                                                                
REPRESENTATIVE  JOULE responded  that  the change  in the  fiscal                                                               
note is  the result of deleting  the one section [referred  to in                                                               
the amendment].                                                                                                                 
                                                                                                                                
CHAIR DYSON asked how much the old fiscal note was.                                                                             
                                                                                                                                
Number 2275                                                                                                                     
                                                                                                                                
CHRISTINE  HESS, Staff  to  Representative  Reggie Joule,  Alaska                                                               
State Legislature, answered that it was almost $600,000.                                                                        
                                                                                                                                
REPRESENTATIVE  JOULE   explained  that   if  newborns   who  are                                                               
otherwise covered by some form  of insurance, such as IHS (Indian                                                               
Health Service) or  Denali KidCare, are born in  a hospital where                                                               
there  are 50  or more  births, they  automatically get  screened                                                               
within the first 30  days.  The cost that goes  away is for those                                                               
children  who  were  not  covered  by  one  form  or  another  of                                                               
insurance, which is about four to six children yearly.                                                                          
                                                                                                                                
CHAIR  DYSON asked  if Denali  KidCare covers  hearing screenings                                                               
for newborns.                                                                                                                   
                                                                                                                                
MS. HESS answered yes.                                                                                                          
                                                                                                                                
CHAIR  DYSON asked  if  most  of the  health  care policies  that                                                               
families have in Alaska cover it.                                                                                               
                                                                                                                                
MS.  HESS responded  that several  hospitals are  screening right                                                               
now and  have reported  that they haven't  had any  problems with                                                               
the  insurance covering  it.    It has  been  part  of a  newborn                                                               
hearing-screening  package.   The hearing  screening is  included                                                               
with everything that  is done now with the  newborn.  Eventually,                                                               
she said,  it will get its  own medical code.   However, the bill                                                               
provides that in certain circumstances  the insurance is going to                                                               
have to provide that as part of the insurance coverage.                                                                         
                                                                                                                                
CHAIR DYSON asked what those circumstances would be.                                                                            
                                                                                                                                
MS. HESS responded that on page  3, lines 9 through 14, it states                                                               
that  if  the  plan  covers services  provided  to  women  during                                                               
pregnancy  and  childbirth  and   the  dependents  of  a  covered                                                               
individual,  it  should  include  the  hearing  screening  and  a                                                               
follow-up if  required.   She added that  the test  is relatively                                                               
inexpensive,  ranging from  $45  to $100,  and  takes about  five                                                               
minutes.                                                                                                                        
                                                                                                                                
CHAIR DYSON  asked about the deletion  Representative Joule wants                                                               
to make on page 5.                                                                                                              
                                                                                                                                
REPRESENTATIVE JOULE  stated that the deletion  of subsection (g)                                                               
eliminates  a large  part of  the  fiscal note  for a  relatively                                                               
small group of  children.  He said he felt  it was more important                                                               
at this point to get the larger  number of kids taken care of and                                                               
to get the bill moving.   In discussing the bill with [committee]                                                               
members, he  said, there is a  huge concern about a  large fiscal                                                               
note.                                                                                                                           
                                                                                                                                
CHAIR DYSON asked if most hospitals are already doing this.                                                                     
                                                                                                                                
REPRESENTATIVE JOULE answered no.                                                                                               
                                                                                                                                
CHAIR DYSON asked  if by deleting [subsection]  (g), coverage for                                                               
the people who fall through that crack would be eliminated.                                                                     
                                                                                                                                
REPRESENTATIVE JOULE said he was correct.                                                                                       
                                                                                                                                
MS. HESS stated that from  discussions the Department of Health &                                                               
Social Services  (DHSS), a  couple of things  would happen.   She                                                               
said    [DHSS] is  not  actually  sure  of the  statistical  data                                                               
regarding how many  kids are uninsured with Denali  KidCare.  She                                                               
said "we're"  hoping it's  only two  to four  kids and  that some                                                               
nonprofit groups  such as the  Lion's Club and Rotary  will help.                                                               
The hospitals will  help with the hearing screenings.   The other                                                               
good news,  she said,  is that ILP  (Infant Learning  Program) is                                                               
currently funded for $700,000; therefore,  those kids would go on                                                               
to the ILP waitlist and hopefully get services through that.                                                                    
                                                                                                                                
Number 2028                                                                                                                     
                                                                                                                                
REPRESENTATIVE  WILSON  said  she  is thinking  about  her  area,                                                               
Wrangell,  and asked  how much  the  machines that  do the  tests                                                               
cost; she noted that right  now Wrangell's hospital does not have                                                               
anything like  that.  She also  said she is concerned  that since                                                               
the hospital doesn't  [have the machine] but has 30  days to make                                                               
sure the patient  gets referred, the patient would  have to spend                                                               
money to fly someplace else.                                                                                                    
                                                                                                                                
MS.  HESS responded  that the  testing  equipment costs  anywhere                                                               
from $9,000  to $15,000.   There is  a program with  the National                                                               
Hearing Association  whereby hospitals can [lease]  the equipment                                                               
while they  get started, for  free.  There  is also, she  said, a                                                               
portable device, which  can be easily transported.   Therefore, a                                                               
couple  of hospitals  could  get together  and  share a  hearing-                                                               
screening device.   Some  rural states  are actually  doing this,                                                               
and other states use volunteers  to do the testing, which reduces                                                               
the cost.  She  added that there is a lot  of federal grant money                                                               
available now.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  STEVENS  asked, since  the  old  fiscal plan  was                                                               
$600,000 and this fiscal plan  is $95,000 and the only difference                                                               
is two  to four  children who  will not  be tested,  whether that                                                               
means it costs $500,000 for two to four children.                                                                               
                                                                                                                                
MS. HESS  responded yes, but it  is not only for  the testing; it                                                               
is  for  the  intervention,  all  follow  ups,  and  any  hearing                                                               
devices.                                                                                                                        
                                                                                                                                
Number 1931                                                                                                                     
                                                                                                                                
KAREN PEARSON, Director of Public  Health, Department of Health &                                                               
Social Services, came  forth and explained that the  title of the                                                               
initial  bill states  that it  provides for  screening tests  and                                                               
intervention.   The three  to four children  would have  been the                                                               
ones without  insurance who  needed the  full-blown intervention.                                                               
There  is  an  unknown  number  of  kids,  represented  by  about                                                               
$200,000 in  the original fiscal  note, who don't have  a payment                                                               
source for  their screening.   The remainder for the  fiscal note                                                               
was for the  intervention as well as travel for  kids who live in                                                               
a place  where screening or  intervention is not available.   She                                                               
stated that the current fiscal note  is what is needed to put the                                                               
data system  together to do  the tracking.  Then,  she explained,                                                               
in 2005 the grant  for the staff goes away so  there is a request                                                               
for half a staff person to keep the project going.                                                                              
                                                                                                                                
REPRESENTATIVE  COGHILL  asked  how   many  screenings  would  be                                                               
mandated to Alaska right now under this bill.                                                                                   
                                                                                                                                
MS. Pearson responded that she does not have that information.                                                                  
                                                                                                                                
REPRESENTATIVE COGHILL  stated that  he is concerned  that places                                                               
like Wrangell, Kotzebue,  or Barrow, where they  have health care                                                               
facilities, will be  mandated a $9,000 to  $12,000 machine, which                                                               
seems like a pretty heavy load.   He added that this is not going                                                               
to have a small impact on health care facilities.                                                                               
                                                                                                                                
MS. PEARSON stated that the  technology is changing quite rapidly                                                               
and she  thinks the costs  will be coming  down.  She  added that                                                               
there is  a lot  of interest  in this area  at the  federal level                                                               
because they  understand the impact  on the education  system and                                                               
justice system of children not being able to hear.                                                                              
                                                                                                                                
REPRESENTATIVE  STEVENS asked  what  would  be accomplished  with                                                               
this equipment  that a good  family doctor  would not be  able to                                                               
tell when examining a baby.                                                                                                     
                                                                                                                                
Number 1787                                                                                                                     
                                                                                                                                
HEATHER ALLIO,  Parent, came  forth and stated  that to  test for                                                               
[hearing loss, doctors] originally put  a sound into a baby's ear                                                               
and then measured  the amount of sound that came  back out.  That                                                               
can tell whether or not a child  has a hearing loss, but it can't                                                               
tell the degree of  the hearing loss.  A second  test can then be                                                               
performed, which  is called an ABR  (auditory brainstem response)                                                               
test or a BAER (brainstem  auditory evoked response) test, during                                                               
which electrodes  are put on  the head.   Sound is  admitted into                                                               
the ear and the brain's response to the sound is tested.                                                                        
                                                                                                                                
CHAIR DYSON asked how that has gone for her family.                                                                             
                                                                                                                                
MS. ALLIO shared her story with the committee:                                                                                  
                                                                                                                                
     My first  son was  diagnosed at six  months.   In fact,                                                                    
     [apart from]  a family dog  that barked and  barked and                                                                    
     barked and  my son never  responded, he was  not tested                                                                    
     at birth.   He was  then fitted with the  hearing aids.                                                                    
     Since then  - he's three  - he [knows] well  over 1,500                                                                    
     signs [of sign  language]; he's got sounds  that he can                                                                    
     make  that  represent words.    Had  he not  had  those                                                                    
     hearing aids  at six  months, he  would have  missed an                                                                    
     awful  lot of  that.   My  second son,  Brady (ph)  was                                                                    
     tested at  one week old,  here at the  audiologist, and                                                                    
     found that he had a loss of  some sorts.  So we went to                                                                    
     Seattle and had the second test done.                                                                                      
                                                                                                                                
CHAIR DYSON asked if this is hereditary in her family.                                                                          
                                                                                                                                
MS. ALLIO answered no.  She  continued stating that most kids are                                                               
not caught at six  months like her son was.   Most are not caught                                                               
until age two;  therefore, they have missed out  on that two-year                                                               
window  of the  ability to  hear and  the ability  to learn  sign                                                               
language.                                                                                                                       
                                                                                                                                
Number 1675                                                                                                                     
                                                                                                                                
CHAIR DYSON asked Ms. Pearson  what [Alaska's] situation would be                                                               
if parents were  unwilling to have their kids tested  and if that                                                               
would be considered a child-in-need-of-aid case.                                                                                
                                                                                                                                
MS. PEARSON responded that there  is the potential of being asked                                                               
what the  impact on the child  is if there is  no religious basis                                                               
for the choice of medical care.                                                                                                 
                                                                                                                                
CHAIR DYSON  asked if it would  be the same situation  if it were                                                               
diagnosed and [the parents] refused to do anything remedial.                                                                    
                                                                                                                                
MS. PEARSON stated that she thinks so.                                                                                          
                                                                                                                                
MS. HESS  responded that  the bill provides  for an  exemption if                                                               
the  parent objects,  for example,  due  to religious  practices.                                                               
She  added that  DFYS  (Division of  Family  and Youth  Services)                                                               
could step  in if  a parent refuses  to take  appropriate medical                                                               
procedures.                                                                                                                     
                                                                                                                                
Number 1574                                                                                                                     
                                                                                                                                
LISA  OWENS, Audiologist  and Speech  Pathologist, testified  via                                                               
teleconference.   She explained that there  is audiology coverage                                                               
for almost  every area of the  state right now, and  almost every                                                               
audiologist has one of the types  of systems being used, that can                                                               
travel.   She said  she thinks  there are  three areas  right now                                                               
that have the  equipment available; however, they  are working on                                                               
getting  grants to  cover the  costs through  state task  forces.                                                               
The second point  is that for 50 percent of  children there is no                                                               
known cause for hearing loss.   The average age of identification                                                               
right now, in states that  do not have newborn hearing screening,                                                               
is  18 months  to 2  years.   In states  such as  Colorado, Rhode                                                               
Island,  and   Hawaii  that  have  been   doing  newborn  hearing                                                               
screenings for  the past six or  seven years, the average  age of                                                               
identification is  lowered to 3  months of  age.  She  said there                                                               
are many  studies showing that  children who are identified  by 3                                                               
months of age  and given hearing aids and  early intervention are                                                               
developing language  and communication skills  at age-appropriate                                                               
levels,  versus children  who are  identified at  18 months  to 2                                                               
years who end up having a reading level of third grade.                                                                         
                                                                                                                                
MS. OWENS  explained that a  child being identified at  18 months                                                               
to 2 years  hears virtually nothing for those first  18 months or                                                               
2 years of life.  Information  on brain research shows that there                                                               
is a  critical time for  brain development, and if  children miss                                                               
that  window it  is hard  for them  to ever  fully develop  those                                                               
skills.  In states that have  been doing these programs, kids are                                                               
going on to preschool and  kindergarten and are not requiring the                                                               
special assistance that  they would need if  they were identified                                                               
later in life, which is a huge cost savings.                                                                                    
                                                                                                                                
CHAIR DYSON  asked, if this  passes, whether Ms. Owens  would get                                                               
more business.                                                                                                                  
                                                                                                                                
MS.  OWENS answered  probably  not; she  said  [her practice]  is                                                               
pretty full  as it is.   She stated that this  would protect kids                                                               
who are missing out on hearing.                                                                                                 
                                                                                                                                
CHAIR DYSON  asked what  percentage of  the newborns  in [Alaska]                                                               
are not getting screened now.                                                                                                   
                                                                                                                                
MS. OWENS  responded that  right now  Providence Hospital  is the                                                               
primary  birthing center  and  is screening  all  babies, as  are                                                               
Columbia National  Regional and the  Native hospitals.   She said                                                               
Nome is  now screening and  Kotzebue is going to  start screening                                                               
within  the next  month.   She said  the problem  in some  of the                                                               
rural areas is not necessarily  the equipment but the training of                                                               
the  hospital staff.   Therefore,  most of  the audiologists  are                                                               
trying to get to those  areas to provide appropriate training and                                                               
help them to get the funding for equipment.                                                                                     
                                                                                                                                
CHAIR DYSON asked who pays [the audiologists] to do that.                                                                       
                                                                                                                                
MS.  OWENS  stated  that  nobody  does; she  is  doing  it  on  a                                                               
volunteer basis.                                                                                                                
                                                                                                                                
Number 1320                                                                                                                     
                                                                                                                                
REPRESENTATIVE COGHILL asked how the follow-up works now.                                                                       
                                                                                                                                
MS.  OWENS explained  that typically  babies are  screened during                                                               
their  first  day of  life  in  a hospital.    If  they fail  the                                                               
screening,  the hospital  will try  to rescreen  before they  are                                                               
discharged or  they are  screened within the  first week  of life                                                               
when the parents  bring them back to the hospital.   Children who                                                               
fail both screenings,  are referred to an audiologist  for a full                                                               
diagnostic  test,   who  would  then  confirm   the  [hospital's]                                                               
diagnostic testing.   From that point, they would  be referred to                                                               
the ILP  and to  the Alaska  Early Intervention  Hearing Resource                                                               
Program,   which  provides   parents  with   sign  language   and                                                               
educational support.                                                                                                            
                                                                                                                                
[HB 173 was held over.]                                                                                                         
                                                                                                                                
HB 174-MENTAL HEALTH INFORMATION AND RECORDS                                                                                  
                                                                                                                                
CHAIR DYSON  announced that the  next order of business  would be                                                               
HOUSE  BILL   NO.  174,  "An   Act  relating  to   mental  health                                                               
information and records; and providing for an effective date."                                                                  
                                                                                                                                
CHAIR DYSON called  for an at-ease at 4:29 p.m.   The meeting was                                                               
called back to order at 4:31 p.m.                                                                                               
                                                                                                                                
Number 1070                                                                                                                     
                                                                                                                                
REPRESENTATIVE HUGH  FATE, Alaska  State Legislature,  came forth                                                               
as sponsor on  HB 174.  He  stated that this bill is  a result of                                                               
the Legislative Budget & Audit  Committee's recommendation to the                                                               
state auditor  and the  Department of  Health &  Social Services.                                                               
House  Bill 174  allows the  state to  better track  direct grant                                                               
money given  to a  community mental health  provider.   He stated                                                               
that the  bill does two things:   it complies with  the auditor's                                                               
report for reporting actual consumer  data, and it holds agencies                                                               
harmless  for   being  sued  by   the  consumer  for   breach  of                                                               
confidentiality if  that should ever  occur.  He added  that this                                                               
is about accountability for state grant funds.                                                                                  
                                                                                                                                
CHAIR   DYSON   asked   whether    somebody   who   breaks   that                                                               
confidentiality would not be liable for it.                                                                                     
                                                                                                                                
REPRESENTATIVE FATE  responded yes,  that this holds  harmless an                                                               
agency  if a  suit should  occur by  a consumer  for a  breach of                                                               
confidentiality.                                                                                                                
                                                                                                                                
Number 0974                                                                                                                     
                                                                                                                                
ELMER LINDSTROM,  Special Assistant, Office of  the Commissioner,                                                               
Department of  Health &  Social Services  [DHSS], came  forth and                                                               
stated  that there  has been  a requirement  in regulation  for a                                                               
number  of  years  for  providers  and  community  mental  health                                                               
centers to provide client information.   Generally, they have not                                                               
complied.   He explained that  one of  the reasons they  have not                                                               
done  so  is because  of  a  fear  that without  clear,  explicit                                                               
authority for  them to  share this  information with  the [DHSS],                                                               
they would  be subject to  suit by a  consumer.  This  bill gives                                                               
immunity  to the  community mental  health center  that would  be                                                               
required to provide [DHSS] the data under this bill.                                                                            
                                                                                                                                
CHAIR DYSON  asked if there is  very limited scope in  this bill,                                                               
which  gives [the  community mental  health centers]  immunity if                                                               
they are providing this confidential information.                                                                               
                                                                                                                                
MR.  LINDSTROM replied  that this  is specifically  for providing                                                               
the information to [DHSS].                                                                                                      
                                                                                                                                
CHAIR DYSON asked if [DHSS] will treat [the information] well.                                                                  
                                                                                                                                
MR.  LINDSTROM  answered that  there  is  a lot  of  confidential                                                               
information in his  department.  He stated that in  his ten years                                                               
working for  the department he  doesn't recall ever  being called                                                               
"on the  carpet" by the  legislature for  disclosing confidential                                                               
information.   On  the other  hand,  he said,  he gets  questions                                                               
about   why   [the   department]   won't   release   confidential                                                               
information.    He  added  that  this is  a  normal  bit  of  his                                                               
business.                                                                                                                       
                                                                                                                                
CHAIR DYSON  asked if the  information are held in  electronic or                                                               
paper files.                                                                                                                    
                                                                                                                                
MR. LINDSTROM  responded that files  exist in both formats.   The                                                               
goal in this  program ultimately would be  an electronic exchange                                                               
of information that is encrypted.                                                                                               
                                                                                                                                
CHAIR DYSON asked if anyone has every "hacked" into [the files].                                                                
                                                                                                                                
MR. LINDSTROM answered not to his knowledge.                                                                                    
                                                                                                                                
Number 0808                                                                                                                     
                                                                                                                                
REPRESENTATIVE  STEVENS  asked   whether  the  information  being                                                               
collected about people with mental  health problems is by name or                                                               
just includes data.                                                                                                             
                                                                                                                                
MR.  LINDSTROM answered  that  it would  be  client-specific.   A                                                               
unique identifier would  be used for an individual,  but it would                                                               
be encrypted so  [the person] would not  be readily identifiable.                                                               
He  clarified  for  the committee  that  [DHSS]  funds  community                                                               
mental  health  centers in  two  ways.    One  is the  grant  aid                                                               
process,  whereby  general  fund   grant  dollars  are  given  to                                                               
community  mental   health  centers  to  provide   mental  health                                                               
services to  clients.   He stated  that this  was the  only thing                                                               
that existed  as recently as  eight or nine  years ago.   In 1992                                                               
[DHSS]  began allowing  them to  bill through  Medicaid, and  the                                                               
costs  of mental  health services  billed  through Medicaid  went                                                               
from $0 to $5  million to $10 million to $20  million and are now                                                               
in excess  of $50 million.   The Finance Committee  requested the                                                               
original  audit,  and  in  noting this  growth  in  the  Medicaid                                                               
budget, wondered how the funding  through Medicaid related to the                                                               
funding  of the  general  fund  grants.   The  conclusion of  the                                                               
audit,  he  stated,  is  that  they  really  cannot  [relate  the                                                               
funding],  because while  [DHSS] gets  that client-specific  data                                                               
very well  in the Medicaid  system, it has not  been historically                                                               
captured for persons  served through those grant  dollars that go                                                               
to  the community  mental health  centers.   He  added that  this                                                               
would  give [DHSS]  that same  level  of detail  for those  grant                                                               
dollars that have been customarily  received through the Medicaid                                                               
program.                                                                                                                        
                                                                                                                                
Number 0684                                                                                                                     
                                                                                                                                
REPRESENTATIVE STEVENS asked why [DHSS] would need the name.                                                                    
                                                                                                                                
MR. LINDSTROM answered  that he believes it gets to  the issue of                                                               
outcomes of individual clients' treatment.   He stated that it is                                                               
not unusual  and that it  is the  same data received  on Medicaid                                                               
clients as a matter of course.                                                                                                  
                                                                                                                                
REPRESENTATIVE CISSNA  asked if  it is  possible to  have numbers                                                               
rather than names [in the data].                                                                                                
                                                                                                                                
MR.  LINDSTROM   responded  that   that  is   the  goal.     [The                                                               
information] would be electronically transmitted and encrypted.                                                                 
                                                                                                                                
Number 0578                                                                                                                     
                                                                                                                                
ANNE  HENRY, Special  Projects  Coordinator,  Division of  Mental                                                               
Health  &  Developmental  Disabilities, Department  of  Health  &                                                               
Social  Services,   came  forth   and  stated  that   the  unique                                                               
identifier used  on the  data that  are collected  from providers                                                               
include the person's  initials, date of birth, and  the last four                                                               
digits of  the social security  number.   She added that  for the                                                               
grant  work, [DHSS]  does not  collect  any names.   When  [DHSS]                                                               
receives  the  information from  providers,  it  is in  encrypted                                                               
form, which  is then decrypted  [by DHSS]  and stored back  in an                                                               
encrypted form.                                                                                                                 
                                                                                                                                
CHAIR DYSON  asked if [DHSS]  has been  unable to figure  out how                                                               
the public  money was  being spent or  the desired  outcomes that                                                               
were happening because they couldn't track individual clients.                                                                  
                                                                                                                                
PAT  DAVIDSON, Legislative  Auditor, Legislative  Audit Division,                                                               
Alaska  State Legislature,  answered that  he was  correct.   She                                                               
stated  that the  auditors could  show  what the  trends were  in                                                               
Medicaid, what services were being  provided, and what clients in                                                               
terms  of  age or  location  services  were being  provided  for.                                                               
After discussing it  with [DHSS] they could see  where the growth                                                               
was.  As a result of the audit,  she said, one of the things that                                                               
changed was  the rate.   There  was a leveling  off and,  in some                                                               
cases,  decreased  costs in  certain  activities.   However,  she                                                               
said, the  auditors hit a  blank wall when  it came to  the state                                                               
grants  because they  did not  know  who was  being served,  what                                                               
services  were being  provided, or  if some  of the  clients were                                                               
also being  billed under  Medicaid or  private insurance.   This,                                                               
she  explained, comes  down to  the unique  identifier.   From an                                                               
accountability standpoint it  is necessary to know  that the same                                                               
person isn't  billing insurance,  Medicaid, and the  state grant.                                                               
She remarked that  [the auditors'] conclusion was that  a fee for                                                               
service  and a  grant  program are  inherently incompatible,  and                                                               
that  one way  around that  is to  get the  same data  for state-                                                               
funded clients as for Medicaid clients.                                                                                         
                                                                                                                                
CHAIR  DYSON asked  Representative Fate  if he  or anyone  in his                                                               
office has talked with any of  the mental health consumers to see                                                               
if they would take exception to this bill.                                                                                      
                                                                                                                                
Number 0300                                                                                                                     
                                                                                                                                
REPRESENTATIVE FATE  answered that they  haven't.  He  noted that                                                               
there is an  ongoing lawsuit that involves  a Fairbanks community                                                               
mental health  center.  That  lawsuit was brought because  of the                                                               
mere fact that  [the mental health center] was  liable because of                                                               
its requirement  for submissions  of certain  confidential client                                                               
information.   He stated  that if  this bill  were to  pass, this                                                               
lawsuit would be dropped.                                                                                                       
                                                                                                                                
CHAIR DYSON remarked that it is his  sense that this is more of a                                                               
legal issue than a health issue  and perhaps it should be sent on                                                               
to the  consideration of the House  Judiciary Standing Committee.                                                               
He added  that if that  occurs then he will  write a note  to the                                                               
chairman of  the House Judiciary  Standing Committee  that [DHSS]                                                               
should  give  notice  to  and  an  opportunity  for  any  of  the                                                               
representatives of the mental health  consumer community to weigh                                                               
in on it.                                                                                                                       
                                                                                                                                
Number 0223                                                                                                                     
                                                                                                                                
REPRESENTATIVE  CISSNA  made  a  motion   to  move  HB  174  from                                                               
committee with  individual recommendations and the  attached zero                                                               
fiscal note.   There being  no objection,  HB 174 moved  from the                                                               
House Health, Education and Social Services Standing Committee.                                                                 
                                                                                                                                
HB 124-NURS.HOME/ASSISTED LIV. EMPLOYEES/VISITOR                                                                              
                                                                                                                                
CHAIR DYSON  announced that  the last item  of business  would be                                                               
HOUSE BILL  NO. 124, "An  Act prohibiting nursing  facilities and                                                               
assisted  living  homes  from employing  or  allowing  access  by                                                               
persons with certain criminal backgrounds, with exceptions."                                                                    
                                                                                                                                
KEVIN HAND,  Staff to Representative Andrew  Halcro, Alaska State                                                               
Legislature, came forth  on behalf of the sponsor of  HB 124.  He                                                               
noted that  the most current  committee substitute (CS)  draft is                                                               
Version P.  He explained that  HB 124 is a barrier-crime piece of                                                               
legislation  that  was  brought  about   in  part  because  of  a                                                               
legislative  audit,  which  mentioned  that  the  Pioneers'  Home                                                               
employs several  sex offenders.   Version P  removes a  number of                                                               
contentious  points that  were raised  by various  parties.   For                                                               
example,  contract workers,  non-employees, and  volunteers would                                                               
be removed  from being subject  to a  background check.   It also                                                               
removes crimes in  which the victim was a resident  [of a nursing                                                               
home] from the background check requirement                                                                                     
                                                                                                                                
TAPE 01-45, SIDE A                                                                                                              
                                                                                                                                
MR. HAND  continued, stating that  [Version P] adds Section  2 on                                                               
page  3,   line  11,  which   reads,  "(d)  A   nursing  facility                                                               
administrator   shall   provide   safeguards   to   ensure   that                                                               
contractors, volunteers,  and other persons entering  the nursing                                                               
facility  do not  abuse, neglect,  or exploit  a resident  of the                                                               
facility."  He added that this  has a mirror section for assisted                                                               
living facilities later in the bill.                                                                                            
                                                                                                                                
Number 0101                                                                                                                     
                                                                                                                                
REPRESENTATIVE  WILSON  asked  if the  concern  about  facilities                                                               
where the owner lives in the same household was taken care of.                                                                  
                                                                                                                                
MR. HAND answered that it has  been addressed by a slight change;                                                               
however, there  is not a  total agreement on it.   Part of  it is                                                               
because it is  under a receivership clause in the  latter part of                                                               
the  bill.    From  the  standpoint  of  the  administration,  it                                                               
wouldn't be  people taking  physical possession  of the  home; it                                                               
would just be administration of  the services of those residents.                                                               
The other option  would be that those people are  just kicked out                                                               
in the  street because the  government would be forced  to either                                                               
shut it down or take it  over, the alternative being that someone                                                               
would come in on a daily basis and run the home.                                                                                
                                                                                                                                
CHAIR DYSON stated  that in the last hearing of  this bill he had                                                               
a question  concerning what should be  done with a new  hire that                                                               
just "got  off the boat,"  since there would be  no instantaneous                                                               
criminal check.   He asked if  this was addressed in  the current                                                               
revisions.                                                                                                                      
                                                                                                                                
MR.  HAND responded  that  it  was point  that  was discussed  at                                                               
length regarding how in-state workers  would have some background                                                               
information  available   with  nursing  home   administrators  in                                                               
assisted living  home facilities.  [The  administrators] were all                                                               
in   agreement  that   that  point   would  make   it  completely                                                               
unworkable, and they  would all voice opposition  if that portion                                                               
were included.                                                                                                                  
                                                                                                                                
Number 0317                                                                                                                     
                                                                                                                                
REPRESENTATIVE  CISSNA remarked  that  she  has recently  learned                                                               
that  personnel  in a  few  of  the  nursing  homes in  her  area                                                               
[Anchorage]  make  trips  to  foreign  countries  to  get  staff,                                                               
because there  is such  a shortage.   She asked  what is  done in                                                               
situations  like that  and if  there  is any  kind of  reciprocal                                                               
information exchange with foreign countries.                                                                                    
                                                                                                                                
MR.  HAND  replied  that  as  for  the  person's  background  and                                                               
criminal  history,  that  question   may  be  better  suited  for                                                               
licensing.   He added that these  people are subject to  the same                                                               
background checks; however, the  availability of that information                                                               
would seemingly be difficult, although it is ascertainable.                                                                     
                                                                                                                                
CHAIR DYSON asked where the bill is going next.                                                                                 
                                                                                                                                
MR.HAND  stated   that  it  is   going  to  [the   House  Finance                                                               
Committee].   He explained that  it is actually referred  to [the                                                               
House Judiciary  Standing Committee] next; however,  the chairman                                                               
has waived it in lieu of a new House finance Committee referral.                                                                
                                                                                                                                
CHAIR DYSON  asked Mr.  Hand how  he would  feel about  adding on                                                               
page  3, line  13, after  "volunteers,"  "new hires  from out  of                                                               
state or out  of country,".  He stated that  this establishes the                                                               
duty of the administrator to take care of it.                                                                                   
                                                                                                                                
MR.  HAND responded  that he  sees no  [problem with  adding that                                                               
language].                                                                                                                      
                                                                                                                                
REPRESENTATIVE  CISSNA remarked  that  she thinks  this is  worth                                                               
investigating.   She  stated that  she has  heard some  folks who                                                               
have relatives  in nursing  homes say that  when they  looked for                                                               
nursing homes they discovered that  the people who appeared to be                                                               
most  concerned  about  the  elderly  were  in  fact  from  other                                                               
countries.                                                                                                                      
                                                                                                                                
ELMER LINDSTROM,  Special Assistant, Office of  the Commissioner,                                                               
Department of  Health & Social  Services, remarked that  there is                                                               
parallel language  relative to assisted living  [homes] beginning                                                               
on page 5, line  31.  He stated that he does  not think that this                                                               
would be a meaningless amendment.   The licensing agency would go                                                               
into a nursing  home or an assisted living home  and will want to                                                               
see concrete evidence of policy  procedures that have been put in                                                               
place to implement that section.                                                                                                
                                                                                                                                
Number 0740                                                                                                                     
                                                                                                                                
REPRESENTATIVE  CISSNA   made  a   motion  to   adopt  Conceptual                                                               
Amendment 1, adding, after "volunteers,"  on page 3, line 13, and                                                               
on  page 6,  line 1,  "new hires  from out  of state  and out  of                                                               
country,".                                                                                                                      
                                                                                                                                
REPRESENTATIVE COGHILL  made a  motion to  adopt the  proposed CS                                                               
for HB 124, version 22-LS008\P,  Lauterbach, 4/5/01.  There being                                                               
no objection, Version P was before the committee.                                                                               
                                                                                                                                
REPRESENTATIVE  CISSNA repeated  her motion  to adopt  Conceptual                                                               
Amendment 1.   There being  no objection, Conceptual  Amendment 1                                                               
was adopted.                                                                                                                    
                                                                                                                                
Number 0890                                                                                                                     
                                                                                                                                
REPRESENTATIVE  COGHILL  referred  to the  emergency  involuntary                                                               
termination of contract on page  8, which states, "with less than                                                               
30 days' notice".   He asked if the less than  30 days could mean                                                               
immediately, for example, if somebody becomes violent.                                                                          
                                                                                                                                
MR.  HAND responded  that it  is not  necessarily immediate.   He                                                               
stated that  this deals with the  termination of a contract.   If                                                               
someone  were to  grow violent  in  a home,  he or  she could  be                                                               
removed  immediately.   The  home could  then  move forward  with                                                               
terminating the  person's contract,  which could take  [as little                                                               
as] 72 hours.                                                                                                                   
                                                                                                                                
REPRESENTATIVE COGHILL asked if  the receivership of the assisted                                                               
living home, referenced  on page 12, Section 15, has  been run by                                                               
the assisted living home organization.                                                                                          
                                                                                                                                
MR.  HAND  answered  that  it  has  been  a  point  of  extensive                                                               
discussion; however,  not everyone  agrees with  how it  has been                                                               
written.                                                                                                                        
                                                                                                                                
Number 1049                                                                                                                     
                                                                                                                                
ALISON ELGEE,  Deputy Commissioner,  Office of  the Commissioner,                                                               
Department  of Administration,  came  forth and  stated that  the                                                               
receivership provision is a very  last recourse and would only be                                                               
used if  there were  no other  alternatives.   One of  the things                                                               
heard from  some of  the assisted  living administrators  is that                                                               
maybe it could be limited from  a size standpoint.  However, this                                                               
is a  situation in which there  is not any other  capacity in the                                                               
community to  deal with a  long-term care situation.   She stated                                                               
that  the first  choice, if  there were  problems with  the home,                                                               
would be  to relocate  the residents from  the home  into another                                                               
environment  and not  to  take  over the  operation  of the  home                                                               
itself.  She added  that if there is a small  home in a community                                                               
where that is  the only home, this may take  a little longer than                                                               
if it were a home in  a community with a variety of alternatives.                                                               
She  remarked   that  this  provides   some  protection   to  the                                                               
administrators of these assisted  living homes, because it brings                                                               
a neutral third  party into it.  The licensing  agency would have                                                               
to go to  court to demonstrate that it has  exhausted every other                                                               
possibility in  terms of remedying  the problems of  the assisted                                                               
living home operations.                                                                                                         
                                                                                                                                
 Number 1138                                                                                                                    
                                                                                                                                
REPRESENTATIVE COGHILL made  a motion to move the CS  for HB 124,                                                               
22-LS0087\P, Lauterbach, 4/5/01, as  amended, from committee with                                                               
individual  recommendations and  the attached  zero fiscal  note.                                                               
There  being no  objection, CSHB  124(HES) moved  from the  House                                                               
Health, Education and Social Services Standing Committee.                                                                       
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health, Education and Social Services Standing Committee meeting                                                                
was adjourned at 5:09 p.m.                                                                                                      

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