Legislature(2005 - 2006)CAPITOL 106

02/14/2006 03:00 PM HEALTH, EDUCATION & SOCIAL SERVICES


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03:06:27 PM Start
03:07:13 PM Overview: Office of Children's Services
03:50:53 PM HB393
04:33:15 PM HB414
04:58:01 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation by Dept. of Health & Social TELECONFERENCED
Services on the Office of Children's
Services (OCS)
+= HB 271 LIMIT OVERTIME FOR REGISTERED NURSES TELECONFERENCED
Scheduled But Not Heard
+ HB 393 INSURANCE FOR COLORECTAL CANCER SCREENING TELECONFERENCED
Moved CSHB 393(HES) Out of Committee
*+ HB 414 INTERCEPTION OF MINOR'S COMMUNICATIONS TELECONFERENCED
Moved CSHB 414(HES) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
 HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                               
                       February 14, 2006                                                                                        
                           3:06 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Peggy Wilson, Chair                                                                                              
Representative Paul Seaton, Vice Chair                                                                                          
Representative Tom Anderson                                                                                                     
Representative Carl Gatto                                                                                                       
Representative Vic Kohring                                                                                                      
Representative Sharon Cissna                                                                                                    
Representative Berta Gardner                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
OVERVIEW:  OFFICE OF CHILDREN'S SERVICES                                                                                        
                                                                                                                                
CS FOR HOUSE BILL NO. 393(HES)                                                                                                  
"An  Act  requiring  that certain  health  care  insurance  plans                                                               
provide  coverage for  the costs  of colorectal  cancer screening                                                               
examinations  and   laboratory  tests;   and  providing   for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - MOVED CSHB 393(HES) OUT OF COMMITTEE                                                                                     
                                                                                                                                
CS FOR HOUSE BILL NO. 414(HES)                                                                                                  
"An Act relating  to allowing a parent or guardian  of a minor to                                                               
intercept the private communications of  the minor and to consent                                                               
to an order authorizing law  enforcement to intercept the private                                                               
communications of the minor."                                                                                                   
                                                                                                                                
     - MOVED CSHB 414(HES) OUT OF COMMITTEE                                                                                     
                                                                                                                                
HOUSE BILL NO. 271                                                                                                              
"An  Act  relating  to limitations  on  overtime  for  registered                                                               
nurses in health care facilities;  and providing for an effective                                                               
date."                                                                                                                          
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 393                                                                                                                  
SHORT TITLE: INSURANCE FOR COLORECTAL CANCER SCREENING                                                                          
SPONSOR(s): REPRESENTATIVE(s) ANDERSON                                                                                          
                                                                                                                                
01/25/06       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/25/06       (H)       L&C, HES                                                                                               
02/03/06       (H)       L&C AT 4:15 PM CAPITOL 17                                                                              
02/03/06       (H)       -- Meeting Canceled --                                                                                 
02/06/06       (H)       L&C AT 3:15 PM CAPITOL 17                                                                              
02/06/06       (H)       Moved CSHB 393(L&C) Out of Committee                                                                   
02/06/06       (H)       MINUTE(L&C)                                                                                            
02/08/06       (H)       L&C RPT CS(L&C) 5DP 1NR 1AM                                                                            
02/08/06       (H)       DP: CRAWFORD, LYNN, LEDOUX, GUTTENBERG,                                                                
                         ANDERSON;                                                                                              
02/08/06       (H)       NR: KOTT;                                                                                              
02/08/06       (H)       AM: ROKEBERG                                                                                           
02/14/06       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 414                                                                                                                  
SHORT TITLE: INTERCEPTION OF MINOR'S COMMUNICATIONS                                                                             
SPONSOR(s): REPRESENTATIVE(s) KOTT                                                                                              
                                                                                                                                
02/01/06       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/01/06       (H)       HES, JUD                                                                                               
02/14/06       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
TAMMY SANDOVAL, Deputy Commissioner                                                                                             
Office of Children's Services                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Provided an overview of the Office of                                                                      
Children's Services.                                                                                                            
                                                                                                                                
HEATH HILYARD, Staff                                                                                                            
to Representative Anderson                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented CSHB 393, Version Y, on behalf of                                                                
Representative Tom Anderson, sponsor.                                                                                           
                                                                                                                                
EMILY NENON, Director                                                                                                           
Alaska Government Relations                                                                                                     
American Cancer Society (ACS)                                                                                                   
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:   Testified in support for  CSHB 393, Version                                                               
Y.                                                                                                                              
                                                                                                                                
MARIANNE BURKE                                                                                                                  
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in strong support of HB 393.                                                                     
                                                                                                                                
REED STOOPS, Lobbyist                                                                                                           
Aetna and American Health Insurance Plans (AHIP)                                                                                
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Proposed amendments  to CSHB 393, Version Y,                                                               
on behalf of Aetna and AHIP.                                                                                                    
                                                                                                                                
REPRESENTATIVE PETE KOTT                                                                                                        
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as prime sponsor of HB 414.                                                                      
                                                                                                                                
JOSH FINK, Director                                                                                                             
Office of Public Advocacy                                                                                                       
Department of Administration (DOA)                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified on HB 414.                                                                                       
                                                                                                                                
DEAN GUANELI, Chief Assistant Attorney General                                                                                  
Legal Services Section                                                                                                          
Criminal Division                                                                                                               
Department of Law (DOL)                                                                                                         
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified on HB 414.                                                                                       
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
                                                                                                                                
CHAIR PEGGY WILSON called the  House Health, Education and Social                                                             
Services  Standing  Committee meeting  to  order  at 3:06:27  PM.                                                             
Representatives  Wilson, Anderson,  Kohring, Gardner,  and Cissna                                                               
were present  at the call  to order.  Representatives  Seaton and                                                               
Gatto arrived as the meeting was in progress.                                                                                   
                                                                                                                                
^OVERVIEW:  Office of Children's Services                                                                                     
                                                                                                                                
3:07:13 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON announced that the  first order of business would be                                                               
the overview by the Office of Children's Services (OCS).                                                                        
                                                                                                                                
3:07:56 PM                                                                                                                    
                                                                                                                                
TAMMY  SANDOVAL,   Deputy  Commissioner,  Office   of  Children's                                                               
Services, Department of Health and  Social Services (DHSS), began                                                               
by providing  an update on  the agency's  performance improvement                                                               
plan, which the agency has  worked on with the federal government                                                               
since  2003.   August  31, 2005,  completed  the two-year  period                                                               
during which OCS was measured.   She related that OCS was able to                                                               
complete 100 percent  of its action steps and 100  percent of its                                                               
benchmarks.   However, OCS  was only  able to  complete 18  of 23                                                               
outcomes  set by  the federal  government.   One of  the outcomes                                                               
that wasn't  met was  the timeliness  of investigation,  which is                                                               
the time  period after  which a report  is received  and assigned                                                               
for investigation.   The  agency has  one more  year to  meet the                                                               
timeliness  outcome   before  penalties  are  instituted.     Ms.                                                               
Sandoval  explained  that  the  agency must  meet  the  goal  two                                                               
consecutive quarters and  at the end of the week  she expected to                                                               
receive news  that the  goal was  met.   Two other  outcomes that                                                               
weren't  met were  the worker  visits with  the child  and worker                                                               
visits with  the parents.   Again, she  expected that  the agency                                                               
will meet  those two goals.   Ms. Sandoval noted that  OCS wasn't                                                               
able to achieve two national  indicators, which are reunification                                                               
in less than 12 months and adoption  in less than 24 months.  The                                                               
aforementioned  are  data measures  that  come  out of  the  data                                                               
management  information  system, ORCA.    She  expected that  OCS                                                               
would meet  those goals by the  end of August.   She related that                                                               
the  federal government  wrote a  very complimentary  letter with                                                               
regard to  how OCS  has shored up  its quality  assurance system,                                                               
which OCS  believes to be  the foundation for how  the department                                                               
will  continue   to  measure  itself   long  after   the  federal                                                               
government relaxes its oversight.                                                                                               
                                                                                                                                
MS. SANDOVAL then  related that in July 1,  2003, some prevention                                                               
programs came  under the  purview of OCS,  which has  resulted in                                                               
review  as  to  how  best   to  integrate  prevention  and  child                                                               
protection  services.   Therefore,  the agency  has  a number  of                                                               
initiatives and projects to better connect the two processes.                                                                   
                                                                                                                                
3:14:05 PM                                                                                                                    
                                                                                                                                
MS. SANDOVAL  then informed the  committee that in the  past year                                                               
there  was  review  of  a   three-year  strategic  plan  of  2004                                                               
performed under  the former deputy commissioner.   The three-year                                                               
strategic plan, the federal outcomes  and goals, and the agency's                                                               
own goals were  broken down into one-year increments.   She noted                                                               
that before the  committee is a draft of this  year's "road map."                                                               
She  highlighted   the  following  critical   success  benchmark:                                                               
moving  from investigation  to initial  assessment such  that the                                                               
OCS staff review  who the family is and determine  what it needs.                                                               
This  initiative  will train  workers  to  be initial  assessment                                                               
workers   rather  than   investigators.     She  mentioned   that                                                               
supervisors will also be [trained]  to be more involved with what                                                               
is  happening with  workers, which  she  predicted will  increase                                                               
worker morale and  decrease turnover.  The  other main initiative                                                               
is continued  work on  resource family  assessment, which  is the                                                               
new  term  for recruiting  foster  and  adoptive families.    She                                                               
related  her  expectation  that  putting  more  time  in  at  the                                                               
beginning  will  save  time  and   problems  in  the  end.    The                                                               
aforementioned  are two  of the  main initiatives  for which  the                                                               
one-time training money from the legislature is being utilized.                                                                 
                                                                                                                                
3:22:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA  explained   her  experience  with  foster                                                               
family  work  since 1988,  which  she  characterized as  families                                                               
being ground  up and spit  out.   Therefore, she opined  that the                                                               
training money  would need to be  ongoing to help sustain  a pool                                                               
of trained  foster parents,  and thus  she asked  if OCS  needs a                                                               
legislative commitment for funds.                                                                                               
                                                                                                                                
MS.  SANDOVAL  related   that  part  of  OCS's   success  can  be                                                               
attributed to the  new positions that it has  acquired, which has                                                               
allowed caseloads  to be lowered.   Furthermore, the  training of                                                               
the   resource  family   assessment  process   and  the   initial                                                               
assessment process  is occurring  statewide and being  built into                                                               
the training academy  at the University of Alaska  - Anchorage to                                                               
train  future   new  staff.     The  aforementioned   provides  a                                                               
sustainable foundation through the  training academy, she opined.                                                               
Moreover,  this  philosophy  maintains the  [goal]  of,  whenever                                                               
possible, serving children  and their families in  their homes as                                                               
that is the  best way.  Therefore, front-line  social workers are                                                               
equipped to  make better  assessments in  the beginning  and thus                                                               
will sustain the progress and continue improvement.                                                                             
                                                                                                                                
3:26:55 PM                                                                                                                    
                                                                                                                                
MS.  SANDOVAL related  that in  the past  three years  there have                                                               
been   many   changes   with   OCS   in   the   following   ways:                                                               
reorganization of the office, the  federal review, and initiative                                                               
work.   She  expressed  the need  for  OCS to  now  have time  to                                                               
implement  and experience  the benefits  that are  to come.   She                                                               
highlighted that the new positions,  which were mainly front-line                                                               
social  workers, have  been crucial  to the  success of  OCS this                                                               
last year.   The next  biggest increase in  staff at OCS  was the                                                               
licensing  positions.   Other  positions  that  were filled  were                                                               
independent  living positions,  of  which there  is  one in  each                                                               
region for  a total  of four  were filled.    She  explained that                                                               
these  independent   living  specialists   help  those   who  are                                                               
graduating or moving out of the  system due to age to prepare for                                                               
adulthood.    Two  positions were  quality  assurance  positions,                                                               
which she suggested  is the area in which  the federal government                                                               
has  probably noticed  the  most improvement.    Having a  strong                                                               
quality  assurance   unit  within   OCS  allows  the   agency  to                                                               
constantly review  and evaluate the  agency.  New  positions were                                                               
also included  in support  of ORCA, the  new automated  system to                                                               
track case monitoring.                                                                                                          
                                                                                                                                
3:30:44 PM                                                                                                                    
                                                                                                                                
MS. SANDOVAL concluded by pointing  out that the OCS brochure she                                                               
provided the committee  includes the five goals  the agency views                                                               
as   its   most   important  goals,   which   are   as   follows:                                                               
strengthening  families;   keeping  children   safer;  decreasing                                                               
disproportionality; having  a quality and stable  work force; and                                                               
improving   community  partnerships.     If   OCS  achieves   the                                                               
aforementioned goals,  the other smaller pieces  will come along,                                                               
she opined.                                                                                                                     
                                                                                                                                
3:31:39 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER  requested that  Ms. Sandoval  discuss the                                                               
ways in which OCS is addressing the disproportionality issue.                                                                   
                                                                                                                                
MS. SANDOVAL informed  the committee that OCS  has partnered with                                                               
the tribal leaders statewide as  well as Casey Family Programs to                                                               
take on the issue of  the disproportional amount of Alaska Native                                                               
children in the system.  Since  November 2004 when OCS learned of                                                               
this  disproportionality, OCS  was committed  to determining  why                                                               
with the help and funding of  Casey Family Programs.  Three times                                                               
a   year  this   partnership   group   gathers  for   "courageous                                                               
conversations"  during  which   tribal  leaders  challenge  state                                                               
employees to  review their  policies, procedures,  and practices.                                                               
These  conversations also  further the  partnerships between  the                                                               
groups as  well as recognize  that [the  disproportional] problem                                                               
isn't all about  OCS.  She related that 15  local teams have been                                                               
assembled  to develop  plans and  strategies.   There  is also  a                                                               
Breakthrough Series  Collaborative that  utilizes experts  on the                                                               
issue of  disproportionality to  create a  structure that  can be                                                               
utilized  to test  ideas on  a local  scale.   This is  about the                                                               
ground up rather  than the top down; the people  in the field are                                                               
empowered  to  inform leadership  what  needs  to happen  on  the                                                               
ground, she explained.                                                                                                          
                                                                                                                                
3:36:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   GARDNER   asked   if  the   aforementioned   has                                                               
eliminated  the situation  in which  after there  is a  permanent                                                               
placement  outside the  home the  tribe would  disagree with  the                                                               
placement and everything would halt and start over again.                                                                       
                                                                                                                                
MS.  SANDOVAL said  that remains  part of  the work  ahead.   She                                                               
emphasized  the  importance  of  OCS  ensuring  that  the  tribal                                                               
partners have  been engaged early.   She reiterated that  doing a                                                               
better job  during the  initial assessment  phase will  result in                                                               
the identification of  deficiencies and work to  remedy them will                                                               
occur.    Therefore,  better  decisions  will  be  made  for  the                                                               
children all through the process.                                                                                               
                                                                                                                                
3:37:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARDNER asked  if  a better  job of  establishing                                                               
paternity and tracking relatives is occurring early on.                                                                         
                                                                                                                                
MS. SANDOVAL  opined that OCS  is doing better,  although finding                                                               
absent parents remains one of the agency's goals.                                                                               
                                                                                                                                
3:38:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO  turned attention to the  information in the                                                               
brochure that  specifies that 60  percent of the children  in OCS                                                               
are Native, but the  exit rates are lower.  He  asked if there is                                                               
a  corrective factor  that  specifies  that OCS  is  on task  and                                                               
identifies the problem as the crowding or exit rates.                                                                           
                                                                                                                                
MS.  SANDOVAL  related  her  belief   that  Alaska  does  have  a                                                               
disproportionality problem.   For instance,  at the  beginning of                                                               
this work  in Juneau 80  percent of  the children in  foster care                                                               
were  Alaska  Native, although  that  isn't  proportional to  the                                                               
Alaska  Native population  in  the area.   The  same  is true  of                                                               
Anchorage.   Until more data is  available on disproportionality,                                                               
OCS will continue  the work on the  disproportionality problem as                                                               
if it's as large as reported in November 2004.                                                                                  
                                                                                                                                
3:41:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO  inquired as  to what  would be  the correct                                                               
proportion.                                                                                                                     
                                                                                                                                
MS. SANDOVAL  indicated that  what has  to be  reviewed is  why a                                                               
disproportionate number  of Alaska Native children  are placed in                                                               
foster care when  there isn't a disproportionate  number of calls                                                               
made about Alaska Native children.                                                                                              
                                                                                                                                
CHAIR WILSON asked  if part of the problem could  be that perhaps                                                               
not   enough  services   are  being   provided   to  the   Native                                                               
communities, and  thus there are  more problems.   She questioned                                                               
whether there could  also be cultural differences  that should be                                                               
considered.  Chair Wilson then  suggested that perhaps some early                                                               
childhood development tools could bring about change.                                                                           
                                                                                                                                
MS. SANDOVAL noted her agreement  with Chair Wilson and specified                                                               
that  OCS  is  merely  questioning  why  the  [disproportionality                                                               
exists] and trying  to determine what can be done  to address the                                                               
situation.                                                                                                                      
                                                                                                                                
3:43:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON pointed  out that  there is  a significant                                                               
amount  more  children  in  the Native  population  than  in  the                                                               
general population and thus he  presumed that's being considered.                                                               
He  then recalled  a recent  presentation from  Petersburg Mental                                                               
Health during  which the organization  expressed the need  to cut                                                               
its  clients  by  half  due to  reporting  requirements  and  the                                                               
reporting system problems.  Therefore,  he inquired as to how the                                                               
ORCA   system  is working  for OCS.   He  further inquired  as to                                                               
whether in remote locations,  the automated reporting requirement                                                               
is  causing less  services  to  be provided  as  is  the case  in                                                               
Petersburg.                                                                                                                     
                                                                                                                                
MS.  SANDOVAL  acknowledged that  there  are  problems [with  the                                                               
automated  reporting  system],  but emphasized  that  it  doesn't                                                               
impact OCS's  level of service because  the work has to  be done.                                                               
However, she  did agree that  there is a connectivity  problem in                                                               
remote locations and the  department's technology staff continues                                                               
to work on improving the situation.   In the meantime, a regional                                                               
input system is being utilized for new reports.                                                                                 
                                                                                                                                
3:46:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  suggested  that OCS's  level  of  service                                                               
would be  impacted because if it  takes longer than it  should to                                                               
do a report  and those reports have to be  done, then staff isn't                                                               
available  to perform  other work.   He  then related  his recent                                                               
understanding that  the notes and  personal information  that was                                                               
thought to  have been  required to be  entered in  the electronic                                                               
database   due   to   the  Health   Insurance   Portability   and                                                               
Accountability  Act (HIPPA)  requirements  isn't  necessary.   He                                                               
explained that the  electric database merely has  to specify that                                                               
the notes are in the file.   He suggested that the aforementioned                                                               
may simplify  the process  and allow the  agency to  provide more                                                               
service.                                                                                                                        
                                                                                                                                
3:49:10 PM                                                                                                                    
                                                                                                                                
MS.  SANDOVAL, in  response  to  Representative Gatto,  specified                                                               
that  everything  in  the  brochure is  part  of  the  three-year                                                               
strategic  plan  under  the  former  deputy  commissioner.    The                                                               
brochure the committee has specifies  what OCS believes to be the                                                               
most critical to  the agency's success for this  year's road map.                                                               
In further response to Representative  Gatto, Ms. Sandoval opined                                                               
that  by working  on  the  five goals  in  the  brochure and  the                                                               
[federal] goals, OCS will come  closer to accomplishing the goals                                                               
of the three-year strategic plan.                                                                                               
                                                                                                                                
HB 393-INSURANCE FOR COLORECTAL CANCER SCREENING                                                                              
                                                                                                                                
3:50:53 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON announced  that the next order of  business would be                                                               
HOUSE BILL  NO. 393, "An  Act requiring that certain  health care                                                               
insurance  plans provide  coverage  for the  costs of  colorectal                                                               
cancer   screening  examinations   and   laboratory  tests;   and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
3:51:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   ANDERSON,  speaking   as   the  prime   sponsor,                                                               
introduced  HB 393  and paraphrased  from  his sponsor  statement                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     Colon cancer  (technically known as  colorectal cancer)                                                                    
     is the second leading cause  of cancer deaths in Alaska                                                                    
     and across  the nation.  An estimated  57,000 Americans                                                                    
     died from the  colon cancer in 2005.  Screening has the                                                                    
     potential to  drastically reduce this  number. Consider                                                                    
     these facts:                                                                                                               
                                                                                                                                
     When caught through routine  screening at the localized                                                                  
     stage, the  5-year survival rate  from colon  cancer is                                                                  
     over 90%.                                                                                                                
                                                                                                                                
      If not caught until it has distant metastasis, when                                                                     
       symptoms are likely to appear, the 5-year survival                                                                     
     rate is only 10%.                                                                                                        
                                                                                                                                
      Colonoscopy is over 90% effective at detecting colon                                                                    
      cancer and can remove pre-cancerous polyps, actually                                                                      
     preventing cancer from ever developing.                                                                                  
                                                                                                                                
                                                                                                                                
3:54:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON   moved  to  adopt   proposed  committee                                                               
substitute  (CS)   for  HB  393,  Version   24-LS0780\Y,  Bailey,                                                               
2/13/06.   There  being no  objection, Version  Y was  before the                                                               
committee.                                                                                                                      
                                                                                                                                
3:55:36 PM                                                                                                                    
                                                                                                                                
HEATH  HILYARD, Staff  to Representative  Anderson, Alaska  State                                                               
Legislature, explained the key changes  between CSHB 393(L&C) and                                                               
Version Y;  directing the committee's  attention to page  2, line                                                               
3.     This  change  establishes  the   American  Cancer  Society                                                               
standards as the guidelines for  colorectal cancer screening, and                                                               
removes  the  United  States  Preventative  Services  Task  Force                                                               
guidelines reference from the bill.   In addition, he pointed out                                                               
that  the word  "current"  was  removed [in  this  section] as  a                                                               
suggestion  from the  legal drafters,  who opined  that including                                                               
the word  "current" would require  Alaska law to comport  with an                                                               
outside standard; an unconstitutional delegation of authority.                                                                  
                                                                                                                                
3:57:11 PM                                                                                                                    
                                                                                                                                
EMILY  NENON,  Director,  Alaska Government  Relations,  American                                                               
Cancer  Society (ACS),  echoed Representative  Anderson's sponsor                                                               
statement  adding that  with  the  colonoscopy screening  method,                                                               
precancerous polyps  can be immediately removed,  making this the                                                               
only screening tool  that can actually prevent cancer.   She said                                                               
that for the  average risk patient, the  ACS guidelines recommend                                                               
this procedure every  10 years after the age of  50.  She pointed                                                               
out that  this could limit an  insurance plan from having  to pay                                                               
for  more than  two  of these  procedures,  as Medicare  coverage                                                               
would apply after age 65.   She highlighted that the cost savings                                                               
of early  diagnosis and prevention versus  contracting cancer and                                                               
undergoing cancer treatment, are significant.                                                                                   
                                                                                                                                
4:01:27 PM                                                                                                                    
                                                                                                                                
MS. NENON  pointed out that  colon cancer occurs  more frequently                                                               
in Alaska than  in the general U.S. population and  is the second                                                               
leading cause of  cancer death.  She said that  the Alaska Native                                                               
population represents  an anomaly, with the  single highest rates                                                               
of colon cancer  of any population group in  America; double that                                                               
of the  U.S. white  population.   The ACS  and the  Alaska Native                                                               
Tribal  Health   Consortium  are  researching   this  phenomenon;                                                               
however, she  reiterated that the screening  tools and procedures                                                               
are available to prevent this cancer.                                                                                           
                                                                                                                                
4:02:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER asked Ms. Nenon  to estimate the number of                                                               
Alaskan lives  that might be saved  if this bill passes  and what                                                               
the diagnosis frequency represents.                                                                                             
                                                                                                                                
MS.  NENON said  that colon  cancer screening  increases survival                                                               
rates  by 80  percent,  and  provided that  5-10  percent of  the                                                               
general population will develop colorectal cancer.                                                                              
                                                                                                                                
4:04:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GATTO stated that the  cost for screening is about                                                               
$2,500.00, including the hospital fees,  and that about 3 percent                                                               
who  come  in  for  screening  have  polyps  removed  during  the                                                               
procedure.   In  comparison, he  noted  the high  cost of  cancer                                                               
treatment.   He  also noted  that, with  these facts  and figures                                                               
before them,  it is evident  that this bill  is a benefit  to the                                                               
population and the insurance companies.                                                                                         
                                                                                                                                
4:07:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON,  pointing  out   whom  this  bill  will                                                               
effect,  stated  that  current  State  of  Alaska  employees  are                                                               
already  covered  for  this screening,  along  with  other  self-                                                               
insured employers such as Providence  Medical Center, adding that                                                               
this bill targets  retirees.  He also noted that  there are three                                                               
types   of  screening   procedures,  with   various  degrees   of                                                               
invasiveness.                                                                                                                   
                                                                                                                                
MR. HILYARD added  that this screening is subject  to policy plan                                                               
provisions already in place with  regard to co-pay and deductible                                                               
requirements.                                                                                                                   
                                                                                                                                
4:10:21 PM                                                                                                                    
                                                                                                                                
MARIANNE  BURKE stated  strong support  for HB  393, saying  that                                                               
this  coverage  should  be  mandated.    She  said  that  from  a                                                               
humanistic and financial  point of view, "it is  a no-brainer" to                                                               
mandate  insurance coverage  for a  procedure that  can eliminate                                                               
colon cancer.   Having served as the director of  the Division of                                                               
Insurance for the  State of Alaska, she said that  she has upheld                                                               
the belief that  personal choice issues should not  be covered by                                                               
statute.    However, she  opined,  that  this issue  goes  beyond                                                               
personal choice given the fiscal and life-saving impacts.                                                                       
                                                                                                                                
REPRESENTATIVE  ANDERSON  asked  whether  Ms.  Burke,  as  former                                                               
director  of the  Division of  Insurance, would  concur with  the                                                               
zero fiscal note issued from the Division of Insurance.                                                                         
                                                                                                                                
MS. BURKE  said that  she would concur,  and further  stated that                                                               
there would  be no impact on  the state as the  state's insurance                                                               
coverage is not affected by this bill.                                                                                          
                                                                                                                                
4:14:31 PM                                                                                                                    
                                                                                                                                
REED STOOPS, Lobbyist, Aetna and  American Health Insurance Plans                                                               
(AHIP), presented  a proposal  for an  amendment to  HB 393.   He                                                               
said  that the  amendment will  serve to  reflect the  updates of                                                               
screening standards by  ACS and prevent the need  to change state                                                               
statute  accordingly.   He also  proposed an  amendment to  allow                                                               
health  plan  administrators  to  notify  policyholders  of  this                                                               
screening  coverage   in  conjunction  with  other   health  care                                                               
communications/mailings.   He pointed out that  this mandate will                                                               
only apply to  a small number of Alaskans who  are not insured or                                                               
whose coverage  does not  already encompass  this procedure.   In                                                               
answer to  a question, he  clarified that the  "legislature can't                                                               
mandate  coverages  on  any  self-insured  program  or  federally                                                               
funded  programs  that don't  come  through  the  state."   To  a                                                               
further question, he  stated that it is hard to  project who will                                                               
take advantage of this screening coverage.                                                                                      
                                                                                                                                
4:20:02 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON directed  the  committee's attention  to                                                               
the amendment to CSHB 393(L&C).                                                                                                 
                                                                                                                                
4:20:43 PM                                                                                                                    
                                                                                                                                
MR. HILYARD  described the  two versions  of the  same amendment,                                                               
explaining  that the  concern was  who would  be responsible  for                                                               
notification of  coverage to policyholders  and the  frequency of                                                               
notification.   He  pointed out  that the  amendment inserts  the                                                               
word "annually," and the word "current" is omitted.                                                                             
                                                                                                                                
4:22:21 PM                                                                                                                    
                                                                                                                                
VICE CHAIR SEATON   moved to adopt Amendment 1,  which read [with                                                               
handwritten changes]:                                                                                                           
                                                                                                                                
     Page 2, Lines 21-25                                                                                                        
                                                                                                                                
     (f) Each  [HEALTH CARE INSURER OR]  health benefit plan                                                                    
     shall  notify each  enrollee annually  of the  coverage                                                                    
     for  colorectal  cancer   screenings  and  provide  the                                                                    
     [CURRENT]  American   Cancer  Society   guidelines  for                                                                    
     colorectal  cancer screenings.    The  notice shall  be                                                                    
     [DELIVERED  BY  MAIL  UNLESS THE  ENROLLEE  AND  HEALTH                                                                    
     CARRIER HAVE AGREED ON  ANOTHER METHOD OF NOTIFICATION]                                                                    
     included in health benefit handbooks  or be provided by                                                                  
     written  or  electronic  communication  between  health                                                                  
     plan administrators and enrollees.                                                                                       
                                                                                                                                
There being no objection, Amendment 1 was adopted.                                                                              
                                                                                                                                
REPRESENTATIVE CISSNA  asked for clarity regarding  how the state                                                               
will be informing policyholders of this benefit.                                                                                
                                                                                                                                
CHAIR  WILSON  explained  that  the  state  plan  already  covers                                                               
employees for colorectal screening  procedures and this bill will                                                               
encompass state retirees as well.                                                                                               
                                                                                                                                
REPRESENTATIVE CISSNA said she was  inquiring about the broadcast                                                               
of information regarding colorectal  screening procedures and the                                                               
screening coverage.                                                                                                             
                                                                                                                                
CHAIR WILSON said  that Amendment 1 specifies  that each enrollee                                                               
will have to  be notified annually of the  coverage provided from                                                               
colorectal  cancer screenings  and provide  the ACS's  guidelines                                                               
for colorectal cancer screening.                                                                                                
                                                                                                                                
REPRESENTATIVE ANDERSON offered that  Aetna and Blue Cross should                                                               
not  be  mandated  to provide  monthly/annually  notification  to                                                               
policyholders   versus   the    electronic   correspondence   and                                                               
[edited/issued policy pamphlet].                                                                                                
                                                                                                                                
4:26:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CISSNA clarified  that she  wants to  ensure that                                                               
the  ACS  guidelines are  contained  in  the current  information                                                               
provided to state employees.                                                                                                    
                                                                                                                                
MR.  HILYARD stated  that this  information is  currently in  the                                                               
state insurance pamphlet.                                                                                                       
                                                                                                                                
4:27:47 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON reiterated that in  the long run this procedure will                                                               
save  human suffering  and the  insurance company's  money.   She                                                               
relayed   her  personal   experiences   relating  to   colorectal                                                               
screening and cancer.                                                                                                           
                                                                                                                                
4:30:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  moved to  report  CSHB  393, Version  24-                                                               
LS0780\Y,  Bailey, 2/13/06,  as  amended, out  of committee  with                                                               
individual  recommendations  and  the  accompanying  zero  fiscal                                                               
notes.                                                                                                                          
                                                                                                                                
REPRESENTATIVE GATTO objected  to the effective date  of the bill                                                               
and asked how this date was established.                                                                                        
                                                                                                                                
MR.  STOOPS  explained  how  the   employees,  who  sign  up  for                                                               
insurance  after  this  legislation   passes,  will  receive  the                                                               
information in their handbook at that  time.  The bill allows for                                                               
"other communication," which  may be used by  the employer during                                                               
the interim of issuing the updated annual handbook.                                                                             
                                                                                                                                
REPRESENTATIVE GATTO removed his objection.                                                                                     
                                                                                                                                
4:32:29 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON stated that there  being no objection, CSHB 393(HES)                                                               
was  reported  out  of  the House  Health  Education  and  Social                                                               
Services Standing Committee.                                                                                                    
                                                                                                                                
HB 414-INTERCEPTION OF MINOR'S COMMUNICATIONS                                                                                 
                                                                                                                                
CHAIR WILSON announced that the  final order of business would be                                                               
HOUSE BILL  NO. 414,  "An Act  relating to  allowing a  parent or                                                               
guardian of  a minor to  intercept the private  communications of                                                               
the minor and to consent  to an order authorizing law enforcement                                                               
to intercept the private communications of the minor."                                                                          
                                                                                                                                
4:33:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON moved  to adopt  the proposed  committee                                                               
substitute (CS) for HB 414,  Version 24-LS1565\G, Wayne, 2/13/06,                                                               
as the  working document.   There being  no objection,  Version G                                                               
was before the committee.                                                                                                       
                                                                                                                                
REPRESENTATIVE  PETE  KOTT as  prime  sponsor  introduced HB  414                                                               
paraphrasing  from his  sponsor  statement [original  punctuation                                                               
provided]:                                                                                                                      
                                                                                                                                
     The  Committee  substitute  for  House  Bill  414  will                                                                    
     protect  minors from  predators and  other insalubrious                                                                    
     characters.   HB  414 amends  AS 12.37.030  to allow  a                                                                    
     parent  or  guardian  of  a minor  to  consent  to  the                                                                    
     interception  of  communications  of  the  minor  under                                                                    
     certain, specific  circumstances.   Specifically, where                                                                    
     the  parent  of   the  minor  has  a   good  faith  and                                                                    
     objectively reasonable belief that  it is necessary for                                                                    
     the welfare, and  in the best interest of  the minor to                                                                    
     do so, he or she may  consent on behalf of the child to                                                                    
     the interception of a communication  by the minor.  The                                                                    
     parent's properly  given consent  may be utilized  by a                                                                    
     judge to grant an ex  parte order permitting the proper                                                                    
     authorities  to  monitor   and  intercept  the  minor's                                                                    
     communications.                                                                                                            
                                                                                                                                
     HB 414  also amends AS  42.20.320 to permit  the parent                                                                    
     of the  minor in  question to  himself or  herself [to]                                                                    
     intercept  the communication  without fear  of criminal                                                                    
     prosecution.  Under  current law, no person  who is not                                                                    
     party to  the communication  may intercept  any portion                                                                    
     of  a   communication  between  others.     To   do  so                                                                    
     constitutes a  criminal offense in  Alaska.   Section 3                                                                    
     of HB 414  creates an exception that  allows the parent                                                                    
     of  a   minor  child  to  intercept   a  minor  child's                                                                    
     communications.                                                                                                            
                                                                                                                                
     With passage of this  legislation, we allow parents and                                                                    
     guardians  to protect  their children,  and we  provide                                                                    
     them the tools to do so.                                                                                                   
                                                                                                                                
REPRESENTATIVE KOTT  pointed out that  in Section 4 of  the bill,                                                               
"minor" is  defined as under the  age of 18 and  not emancipated;                                                               
emancipated minors are exempt from HB 414.                                                                                      
                                                                                                                                
4:36:20 PM                                                                                                                    
                                                                                                                                
CHAIR WILSON  asked if a parent  observed a child in  an Internet                                                               
chat room  and deemed the  content inappropriate, will  this bill                                                               
allow the parent to call the police for investigative purposes.                                                                 
                                                                                                                                
REPRESENTATIVE   KOTT  answered   that   HB   414  provides   for                                                               
appropriate parental intervention, although  there is an inherent                                                               
weakness  in this  legislation given  our state's  constitutional                                                               
right to privacy.   He submitted that privacy is  not an absolute                                                               
right when  given the compelling  need to override that  right to                                                               
protect   children.     He  stated   that  certain   insalubrious                                                               
individuals  prey on  children over  the  Internet, and  although                                                               
there are  computer programs for  purchase to  provide monitoring                                                               
capabilities,  using these  programs  does not  allow parents  to                                                               
intercept  the  messages or  intervene  on  a  legal level.    He                                                               
maintained that  HB 414  will assist parents  who are  faced with                                                               
raising today's children and provide  them with the tools and the                                                               
authority  to  act  responsibly  on their  child's  behalf.    He                                                               
explained  that while  parents are  legally  responsible for  the                                                               
actions  of  their minor  children,  they  are not  provided  the                                                               
"tools" to assist them in  monitoring their child's activity in a                                                               
way that  could help to  stem a  situation.  He  provided several                                                               
examples  of how  parents are  at a  disadvantage due  to today's                                                               
technologically  connected children.   He  assured the  committee                                                               
that this  bill does not run  afoul of the federal  Omnibus Crime                                                               
Control and Safe Streets Act [1968].   Although not tested in the                                                               
9th Circuit Court  of Appeals, he opined, that  if these measures                                                               
are  placed  in  statute  and challenged  they  would  be  viewed                                                               
favorably in the courts.                                                                                                        
                                                                                                                                
CHAIR WILSON  instructed the committee  to look at this  bill not                                                               
in a  judicial light, but  whether HB  414 creates a  good policy                                                               
for the state.                                                                                                                  
                                                                                                                                
4:41:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARDNER stated  support for HB 414  as it provides                                                               
a  formalization and  legal authority  to  what here-to-fore  has                                                               
been a parent's assumed privilege  in providing for their child's                                                               
safety and well-being.  She  maintained that when parents are not                                                               
afforded appropriate means to manage  their child's welfare, they                                                               
are crippled and may abdicate responsibility.                                                                                   
                                                                                                                                
REPRESENTATIVE KOTT acknowledged the  importance of the informal,                                                               
nonconsensual,  eavesdropping measures  historically employed  by                                                               
parents.                                                                                                                        
                                                                                                                                
REPRESENTATIVE CISSNA  interjected that there is  a difference in                                                               
what occurs  at home informally,  and what is being  discussed in                                                               
HB  414;  information  that  may be  gathered  and  presented  as                                                               
evidence in a  court case.  She asked how  this bill would effect                                                               
a situation involving a divided home with opposing parents.                                                                     
                                                                                                                                
REPRESENTATIVE KOTT  answered that the  intent of the bill  is to                                                               
provide for  the welfare and safety  of a child, and  protect the                                                               
child  from  engaging  in  dangerous   behavior.    He  conceded,                                                               
however,  that  it  does  not  ensure  against  opposing  parents                                                               
construing the opportunity  for their own interests.   He pointed                                                               
out that  some states do  have variations  of this bill  in place                                                               
and their  circuit courts generally uphold  the vicarious consent                                                               
ruling; other states maintain the two-party consent rule.                                                                       
                                                                                                                                
4:46:37 PM                                                                                                                    
                                                                                                                                
JOSH  FINK, Director,  Office of  Public Advocacy,  Department of                                                               
Administration (DOA),  stated that  adding the exception  for the                                                               
minor's attorney or  guardian ad litem was  an important addition                                                               
to this bill.  He called  the committee's attention to the Alaska                                                               
Rules of Evidence  501-506, where the policy decision  as to what                                                               
communications  are confidential  has previously  been addressed.                                                               
He explained that the Rules  expand the confidentiality exemption                                                               
to cover  discussions with a therapist,  physician, or clergyman,                                                               
and he asked  the committee to consider what  exception policy it                                                               
would deem appropriate.                                                                                                         
                                                                                                                                
4:48:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  asked,  considering custody  and  divorce                                                               
situations, should the language on  page 1, [line 9], include the                                                               
term "custodial" prior to parent or guardian.                                                                                   
                                                                                                                                
DEAN GUANELI,  Chief Assistant  Attorney General,  Legal Services                                                               
Section, Criminal  Division, Department  of Law  (DOL), clarified                                                               
that  in  custody   situations  one  of  the   parents  is  often                                                               
restricted to visitation rights, and  either parent may have some                                                               
need to monitor  conversations in the child's best  interest.  He                                                               
stated:                                                                                                                         
                                                                                                                                
     There's  certainly a  good policy  basis for  extending                                                                    
     these same rights  to someone who has  legal custody as                                                                    
     opposed to simply physical custody.   ... It would come                                                                    
     as a shock  to ... parents that they can't  ... pick up                                                                    
     the  phone and  listen in  to a  conversation, or  read                                                                    
     their child's  e-mail, or  tape record  a conversation,                                                                    
     but given our eavesdropping statute and the breadth of                                                                     
      it ... all of those things are problematical ... and                                                                      
     this bill fixes that.                                                                                                      
                                                                                                                                
REPRESENTATIVE  SEATON  explained   the  importance  of  ensuring                                                               
against  custodial manipulation  that may  result in  overturning                                                               
parental custody of  a child; stressing the need  for this aspect                                                               
to  be addressed  as a  policy or  clarified/considered when  the                                                               
bill is reviewed by the House Judiciary Standing Committee.                                                                     
                                                                                                                                
MR. GUANELI stated that there is  an option to provide the rights                                                               
of HB 414 only to the  parent with physical custody.  In agreeing                                                               
that  this  area  of  the bill  requires  further  attention,  he                                                               
explained  that  when parental  rights  have  been terminated  by                                                               
court  order   it  presents  a   different  question   than  when                                                               
visitation is allowed.  In response  to a question of how parents                                                               
might manipulate  this right to monitor  communications between a                                                               
child and the opposing parent, he  answered that the way the bill                                                               
is written either  parent would have the ability to  listen in on                                                               
conversations.   He  stated that  the  issue to  consider is  how                                                               
information is gathered,  by whom it is gathered, and  how it may                                                               
be used in a court of law.   Further, he questioned the wisdom to                                                               
"allow a  system to persist if  it is a disincentive  for parents                                                               
to fully exercise their parental rights..."                                                                                     
                                                                                                                                
4:56:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked that  the bill sponsors  clarify the                                                               
eavesdropping  language of  HB 414  between parents  in custodial                                                               
situations  in  which  one parent  may  inadvertently  have  more                                                               
rights than the other.                                                                                                          
                                                                                                                                
4:57:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  ANDERSON moved  to report  CSHB 414,  Version 24-                                                               
LS1565\G,  Wayne,  2/13/06,  out  of  committee  with  individual                                                               
recommendations  and the  accompanying zero  fiscal note.   There                                                               
being no  objection, CSHB  414(HES) was  reported from  the House                                                               
Health, Education and Social Services Standing Committee.                                                                       
                                                                                                                                
4:58:01 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health, Education and Social Services Standing Committee meeting                                                                
was adjourned at 4:58 p.m.                                                                                                      

Document Name Date/Time Subjects