Legislature(2001 - 2002)
04/09/2002 03:00 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 9, 2002
3:00 p.m.
MEMBERS PRESENT
Representative Fred Dyson, Chair
Representative Peggy Wilson, Vice Chair
Representative John Coghill
Representative Gary Stevens
Representative Vic Kohring
Representative Sharon Cissna
Representative Reggie Joule
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 407
"An Act relating to the certificate of need program."
- HEARD AND HELD
HOUSE BILL NO. 408
"An Act relating to questionnaires and surveys administered in
the public schools."
- MOVED CSHB 408(HES) OUT OF COMMITTEE
HOUSE CONCURRENT RESOLUTION NO. 23
Proposing amendments to Uniform Rule 20 of the Alaska State
Legislature; and providing for an effective date for the
amendments.
- HEARD AND HELD
PREVIOUS ACTION
BILL: HB 407
SHORT TITLE:CERTIFICATE OF NEED PROGRAM
SPONSOR(S): REPRESENTATIVE(S)COGHILL
Jrn-Date Jrn-Page Action
02/13/02 2232 (H) READ THE FIRST TIME -
REFERRALS
02/13/02 2232 (H) CRA, HES
03/04/02 2469 (H) COSPONSOR(S): JAMES
03/13/02 2530 (H) COSPONSOR(S): SCALZI
03/14/02 (H) CRA AT 8:00 AM CAPITOL 124
03/14/02 (H) Scheduled But Not Heard
03/18/02 2593 (H) COSPONSOR(S): DYSON
03/19/02 (H) CRA AT 8:00 AM CAPITOL 124
03/19/02 (H) Heard & Held
03/19/02 (H) MINUTE(CRA)
03/21/02 (H) CRA AT 8:00 AM CAPITOL 124
03/21/02 (H) Moved Out of Committee
03/21/02 (H) MINUTE(CRA)
03/22/02 2638 (H) CRA RPT 2DP 2NR 3AM
03/22/02 2638 (H) DP: SCALZI, MEYER; NR: GUESS,
HALCRO;
03/22/02 2638 (H) AM: KERTTULA, MURKOWSKI,
MORGAN
03/22/02 2638 (H) FN1: (HSS)
03/26/02 (H) HES AT 3:00 PM CAPITOL 106
03/26/02 (H) Heard & Held
03/26/02 (H) MINUTE(HES)
03/28/02 (H) HES AT 3:00 PM CAPITOL 106
03/28/02 (H) Heard & Held
MINUTE(HES)
04/02/02 (H) HES AT 3:00 PM CAPITOL 106
04/02/02 (H) Heard & Held
MINUTE(HES)
04/04/02 (H) HES AT 3:00 PM CAPITOL 106
04/04/02 (H) -- Meeting Canceled --
04/09/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 408
SHORT TITLE:STUDENT QUESTIONNAIRES AND SURVEYS
SPONSOR(S): EDUCATION
Jrn-Date Jrn-Page Action
02/13/02 2233 (H) READ THE FIRST TIME -
REFERRALS
02/13/02 2233 (H) EDU, HES
02/20/02 (H) EDU AT 8:00 AM CAPITOL 120
02/20/02 (H) Moved Out of Committee
02/20/02 (H) MINUTE(EDU)
02/20/02 2338 (H) EDU RPT 6DP
02/20/02 2338 (H) DP: PORTER, WILSON, GUESS,
STEVENS,
02/20/02 2338 (H) GREEN, BUNDE
02/20/02 2338 (H) FN1: ZERO(EED)
03/26/02 (H) HES AT 3:00 PM CAPITOL 106
03/26/02 (H) Heard & Held
03/26/02 (H) MINUTE(HES)
03/28/02 (H) HES AT 3:00 PM CAPITOL 106
03/28/02 (H) <Bill Canceled>
04/09/02 (H) HES AT 3:00 PM CAPITOL 106
BILL: HCR 23
SHORT TITLE:LEGISLATIVE COMMITTEES:SPLIT HOUSE HESS
SPONSOR(S): EDUCATION
Jrn-Date Jrn-Page Action
02/11/02 2204 (H) READ THE FIRST TIME -
REFERRALS
02/11/02 2204 (H) EDU, HES
02/13/02 (H) EDU AT 8:00 AM CAPITOL 120
02/13/02 (H) Moved Out of Committee
02/13/02 (H) MINUTE(EDU)
02/13/02 2227 (H) EDU RPT 6DP
02/13/02 2227 (H) DP: GREEN, WILSON, JOULE,
GUESS,
02/13/02 2227 (H) STEVENS, BUNDE
02/13/02 2228 (H) FN1: ZERO(H.EDU)
04/04/02 (H) HES AT 3:00 PM CAPITOL 106
04/04/02 (H) -- Meeting Canceled --
04/09/02 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
RYNNIEVA MOSS, Staff
to Representative John Coghill
Alaska State Legislature
Capitol Building, Room 102
Juneau, Alaska 99801
POSITION STATEMENT: Presented the changes encompassed in
Version O of HB 407.
ELMER LINDSTROM, Deputy Commissioner
Office of the Commissioner
Department of Health & Social Services (DHSS)
PO Box 110601
Juneau, Alaska 99811-0601
POSITION STATEMENT: Testified on HB 407 and HB 408.
JOE FAULHABER
989 Senate Loop
Fairbanks, Alaska 99712
POSITION STATEMENT: Indicated the need to maintain the CON
process.
GEORGE LARSON
(No address provided)
POSITION STATEMENT: Expressed the need for the committee to
consider the Matanuska-Susitna Borough's demography and
geography in relation to the 55,000-population delimiter.
DEE SKRIPS, Registered Nurse
Administrator
Health South Alaska
(No address provided)
POSITION STATEMENT: Testified in support of HB 407.
JOSHUA JENSEN, Finance Director
Heritage Place Nursing Home
232 W. Rockwell Avenue
Soldotna, Alaska 99669
POSITION STATEMENT: Testified in opposition to HB 407.
MICHAEL KELLY
1625 Wolverine Drive
Fairbanks, Alaska 99709
POSITION STATEMENT: Testified in opposition to HB 407.
HARRY PORTER
3206 Riverview Drive
Fairbanks, Alaska 99709
POSITION STATEMENT: Testified on HB 407.
SUSAN McLANE, Registered Nurse
Fairbanks Memorial Hospital
1650 Cowles
Fairbanks, Alaska 99701
POSITION STATEMENT: Testified in opposition to HB 407.
JENNIFER HOUSE, Employee
Fairbanks Memorial Hospital
1951 Gilmore Trail
Fairbanks, Alaska 99712
POSITION STATEMENT: Testified in opposition to HB 407.
DR. DAVID McGUIRE, Orthopedic Surgeon
(No address provided)
POSITION STATEMENT: Testified in support of HB 407.
ROBERT GOULD
4820 Drake Street
Fairbanks, Alaska 99709
POSITION STATEMENT: Testified in opposition to HB 407.
JIM LYNCH, Director
Human Resources
Fairbanks Memorial Hospital
105 Bentley Drive
Fairbanks, Alaska 99701
POSITION STATEMENT: Testified in opposition to HB 407.
BRIAN SLOCUM, Administrator
Tanana Valley Clinic
1001 Noble St
Fairbanks, Alaska 99701
POSITION STATEMENT: Testified on HB 407.
MIKE POWERS
1283 View Pointe Drive
Fairbanks, Alaska 99709
POSITION STATEMENT: Testified on HB 407.
APRIL HOTCHKISS, Substance Abuse Counselor
at Juneau-Douglas High School
Juneau Youth Services
1851 Patti Avenue
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 408.
JESSICA PARIS, High School Teacher
Juneau-Douglas High School
635 Main Street
Juneau, Alaska 99801
POSITION STATEMENT: Testified on HB 408.
ANDREE McLEOD
3721 Young Street
Anchorage, Alaska 99508
POSITION STATEMENT: Mentioned other ways in which to obtain the
information sought from [anonymous surveys].
BILL DIEBELS, JR., Parent
9342 Betty Court
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 408.
RICHARD BLOCK, Christian Science Committee on Publication
for the State of Alaska
360 W. Benson Boulevard, Suited 301
Anchorage, Alaska 99503
POSITION STATEMENT: Proposed an amendment to tighten the notice
provisions in HB 408.
KATHRYN ARLEN, Member
Board of Directors
Youth on the Streets Action Group;
Member, Meeting the Challenge Advocacy Program;
Volunteer, Detention, Johnson Youth Center
127 S. Franklin Number 127
Juneau, Alaska 99801
POSITION STATEMENT: Testified in support of HB 408.
RIC IANNOLINO, Chair
Youth on the Street
PO Box 21892
Juneau, Alaska 99801
POSITION STATEMENT: Testified in support of HB 408.
MARY TONSMEIRE, Nurse
Adolescent Health Care Coordinator
Juneau-Douglas High School
2204 North Douglas Highway
Juneau, Alaska 99801
POSITION STATEMENT: Testified in support of HB 408.
LISA TORKELSON, Full-time Parent
(No address provided)
POSITION STATEMENT: Testified in opposition to HB 408.
BARBARA BONNER, Teacher
CHOICE
Juneau-Douglas High School;
Member, Youth on the Streets
2812 John Street
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 408.
DEE HUBBARD
PO Box 88
Sterling, Alaska 99672
POSITION STATEMENT: Highlighted the importance of parental
consent [for surveys and questionnaires administered to
students].
SAM TRIVETTE, Parent
7870 Glacier Highway
Juneau, Alaska
POSITION STATEMENT: Testified on HB 408.
KAREN McCARTHY, Staff
to Representative Con Bunde
Alaska State Legislature
Capitol Building, Room 501
Juneau, Alaska 99801
POSITION STATEMENT: As committee aide, testified on behalf of
the sponsor of HB 408, the House Special Committee on Education.
KRISTEN BOMENGEN, Assistant Attorney General
Human Services Section
Civil Division (Juneau)
Department of Law
PO Box 110300
Juneau, Alaska 99811-0300
POSITION STATEMENT: Answered questions regarding HB 408.
ACTION NARRATIVE
TAPE 02-28, SIDE A
Number 0001
CHAIR FRED DYSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:00 p.m.
Representatives Dyson, Wilson, Coghill, Stevens, Kohring, and
Cissna were present at the call to order. Representative Joule
arrived as the meeting was in progress.
HB 407-CERTIFICATE OF NEED PROGRAM
CHAIR DYSON announced that the first order of business would be
HOUSE BILL NO. 407, "An Act relating to the certificate of need
program." Chair Dyson announced his intention to move HB 407
from committee today.
Number 0335
REPRESENTATIVE COGHILL moved to adopt version 22-LS1389\O,
Lauterbach, 4/4/02, as the working document.
REPRESENTATIVE COGHILL explained that on page 2, lines 30-31,
through page 3, line 3, the inserted language clarifies that
when a facility changes and transfers its certificate of need
(CON), that it stay within the same use and bed type.
RYNNIEVA MOSS, Staff to Representative John Coghill, Alaska
State Legislature, continued with the changes in Version O. She
explained that Version O clarifies that when a person replaces a
facility or relocates a facility that was obtained under a CON,
a new CON is not required, although the requirements of the CON
must be followed. This change is on page 3, lines 6-7.
CHAIR DYSON related his understanding that all that is being
required with the change on page 3, lines 6-7, is that the [CON]
contract be followed.
Number 0495
ELMER LINDSTROM, Deputy Commissioner, Office of the
Commissioner, Department of Health & Social Services (DHSS),
thanked the sponsor's staff for the work on HB 407. Mr.
Lindstrom recommended that the committee adopt Version O.
REPRESENTATIVE COGHILL restated his motion to adopt version 22-
LS1389\O, Lauterbach, 4/4/02, as the working document. There
being no objection, Version O was before the committee.
Number 0590
REPRESENTATIVE CISSNA moved that the committee adopt
Amendment 1, which read [original punctuation provided]:
Add new section under temporary law:
The State of Alaska Department of Health and Social
Services shall develop a comprehensive health plan for
the state, making use of, to the maximum extent,
existing health care plans and processes employed by
the Department of Health and Social Services, other
state agencies and local community efforts. A focus
of the plan shall be to develop community specific
health information to assist the Certificate of Need
program in evaluating applications for certificates of
need. A report will be submitted to the legislature
by January 1, 2004.
CHAIR DYSON objected.
REPRESENTATIVE CISSNA specified that Amendment 1 is basically a
conceptual amendment requiring the department to develop a
comprehensive health plan for the state that utilizes what
already exists in every community. She noted that the
January 1, 2004, date specified in the amendment could be an
earlier date. She informed the committee that the state's
current health care plan was developed in 1983. She said health
care is one of the fastest growing industries in the state.
Therefore, Amendment 1 provides the state the chance to review
what is currently on the books and [decide] whether the state is
going in the right direction.
CHAIR DYSON related his understanding that Representative Cissna
didn't want the bill to pick up a fiscal note, which is why
existing staff are being utilized under existing duties.
REPRESENTATIVE CISSNA confirmed that she didn't want a fiscal
note.
REPRESENTATIVE COGHILL acknowledged that the title of HB 407 is
fairly broad, as is [Amendment 1]. However, he indicated the
need to ask whether there would be any legal ramifications with
the adoption of Amendment 1. He said that the request to
develop a plan is outside the scope of HB 407.
Number 0850
MR. LINDSTROM remarked that [Amendment 1] in regard to the title
is probably a "close call." [Amendment 1] might well fit under
HB 407 since one of the focuses of the amendment would be
related to assisting the CON program. Mr. Lindstrom recalled
his testimony in previous hearings regarding the lack of a
comprehensive health care plan. He pointed out that during the
course of the hearings, the committee has heard two very
different views of what HB 407 will do. Mr. Lindstrom said that
he hasn't been very helpful in deciding how to make sense of
those arguments because DHSS doesn't have the data to make the
determination as to which view is correct. "My guess is they
could both well be true and even in the same community, although
at different points in time," he said. Therefore, to the extent
that a [comprehensive] health plan would provide the data to
better evaluate these CONs, [the amendment] would be a good
idea. Mr. Lindstrom said that he wasn't sure what the fiscal
note would look like, although [there would be one].
Number 0982
REPRESENTATIVE COGHILL announced that he would be voting against
the amendment, although he felt some plans should be made by the
state. He noted his struggle with regard to whether the
government always knows best. Representative Coghill said, "I
know we already have comprehensive plans, except for we're
asking this one to be a focus now to develop community specific
health information that's going to assist the CON. And I'm
trying to say we have people doing business plans that do that.
I just struggle with it." He mentioned that perhaps it's
different debate, which he didn't want to include in this bill.
REPRESENTATIVE STEVENS related that he would be more comfortable
if more people were involved in deciding on this matter.
Representative Stevens turned to the timeline in Amendment 1 and
asked why it couldn't be accomplished by January 1, 2003.
REPRESENTATIVE CISSNA responded, "I think that's better than ...
what's happening now, personally." There is huge pressure to
deliver affordable health care. In response to Chair Dyson,
Representative Cissna said that she would accept Representative
Stevens' suggestion to change the date in the amendment to
January 1, 2003, as a friendly amendment.
Number 1175
CHAIR DYSON related that there is a lot of frustration in the
provider community. Therefore, he felt there should be a
specific task force with resources. Although HB 407 is fairly
important, it will have a fairly tough time moving through this
session. Amendment 1 will generate some support for HB 407, but
will also contribute to HB 407 not passing this session. Chair
Dyson announced that he would vote against Amendment 1.
A roll call vote was taken. Representatives Wilson, Stevens,
Cissna, and Joule voted for Amendment 1 [as amended].
Representatives Coghill, Kohring, and Dyson voted against
Amendment 1. Therefore, Amendment 1, as amended, passed by a
vote of 4-3.
Number 1328
JOE FAULHABER testified via teleconference. He announced that
he is an unpaid volunteer representing the people of Fairbanks,
who own the local hospital. Mr. Faulhaber stated that HB 407
isn't about free enterprise and competition. He explained that
Fairbanks residents support the local hospital with hundreds of
thousands of dollars of cash donations. Despite community
support, [the hospital] enjoys nominal excess revenue of
approximately a million dollars, which is scant in the context
of a $100-million budget. "As a practical matter, patients
seldom choose where procedures are to be performed, doctors do,"
he said. Therefore, without CON protection, doctors could
perform profitable procedures in their [office] while performing
money-losing procedures in the community hospital. Furthermore,
if there was a complication during a procedure performed in the
doctor's office, where would that critically ill patient be
taken? Mr. Faulhaber stated, "If our community loses CON
protection, expect to see us in Juneau next year. We'll be
asking for an increase in Medicaid rates and money for capital
projects because you gave away our ability to self-fund."
Number 1453
GEORGE LARSON testified via teleconference. Mr. Larson turned
to the population delimiter, which will impact only three
communities in the state: Anchorage, Fairbanks, and the
Matanuska-Susitna ("Mat-Su") Borough. Mr. Larson stressed the
need for the committee to consider how vastly different the Mat-
Su Borough is from Anchorage and Fairbanks, since it is a
second-class borough that covers an area of 24,000 square miles,
about the size of West Virginia. He further informed the
committee that this size of borough, with an estimated
population of 62,000, results in a population density of about
2.6 persons per square mile. The most heavily developed
portion, the core area, encompasses Palmer and Wasilla and the
developed areas between and around these two communities, which
accounts for approximately 42,000 people. Therefore, the core
area falls well under the 55,000-population delimiter in HB 407.
However, most of the services provided in the borough are
located within this core area. Mr. Larson pointed out that
there is an acute-care facility in Palmer, an outpatient center
in Wasilla, as well as a history of collaboration with the rural
primary-care providers throughout the borough. This
collaboration has assisted in the improvement of the quality of
care and access to remote areas outside the core area. In
summary, Mr. Larson requested that the committee consider the
demography and geography of the Mat-Su Borough.
Number 1580
DEE SKRIPS, Registered Nurse; Administrator, Health South
Alaska, testified via teleconference in support of HB 407. Ms.
Skrips said that Health South Alaska, as a provider of
ambulatory services in all 50 states and internationally, is
very aware of the rising costs of health care as well as the
importance of getting a handle on these costs. As a national
corporation, Health South has an extensive background working in
this state with and without the CON. Ms. Skrips pointed out
that to date, no states have been on record as seeing a negative
effect as a result of the CON. If there have been no adverse
effects to other states without the CON, then it would be
difficult to imagine that it's different in Alaska. She
informed the committee that there is no credible evidence that
the CON has ever increased the cost of health care to those
states without it.
MS. SKRIPS highlighted that ambulatory care, such as Health
South Alaska, is not on a cost-reported schedule like that of
the larger acute-care hospitals. Furthermore, ambulatory-care
facilities don't have the ability to shift costs as acute-care
facilities do. Ambulatory care facilities do have tax
liabilities, and as a for-profit organization taxes are paid on
all aspects of the business. However, nonprofit acute-care
facilities don't pay taxes. "There is a great misunderstanding
that the ambulatory or freestanding surgical centers cherry pick
hand-picked surgical cases," she noted. In conclusion, Ms.
Skrips reiterated her support of HB 407 due to the choice
provided to the patients.
Number 1697
JOSHUA JENSEN, Finance Director, Heritage Place Nursing Home,
testified via teleconference in opposition to HB 407 because the
current CON requirements serve the state's best interest. He
characterized the revisions of HB 407 as confusing. He related
his belief that this issue deserves more review given the
complexities and impact of the legislative action this year.
Therefore, Mr. Jensen urged the committee to not pass HB 407
without careful and considerate review of all the impacts. Mr.
Jensen relayed his knowledge that committee members and the
House leadership are concerned with any legislation that
requires a mandated increase in the cost of state government,
which is illustrated in the fiscal note for HB 407.
Number 1750
MICHAEL KELLY testified via teleconference. Mr. Kelly announced
that he strongly opposes HB 407 because it will harm the system
in Fairbanks. Furthermore, elimination of the CON is risky
experimentation. Because of Fairbanks's size and location, it
has a limited and fragile health care market. Thirty years ago
the health care market in Fairbanks was an absolute mess, and
thus the community organized to form a nonprofit health care
foundation to provide the infrastructure that was necessary.
That organization, under the rules of the CON, has worked
superbly relative to access, cost, and the provision of a broad
range of excellent health care services. Mr. Kelly said HB 407
is about a few doctors who make "six figures" and want to add a
bit more to that. Although that doesn't make those doctors bad,
"you owe a lot more to the 90,000 folks who live here in
Interior Alaska than to be just listening to a few docs," he
said. Furthermore, there is the [push] to build a surgery
facility in order to take the more profitable procedures from
the Fairbanks Memorial Campus. Although the current CON process
isn't perfect, it helps to protect against cherry picking and
profiteering in the limited health care market. Moreover, the
CON process helps to continue the excellent service that has
taken 30 years to build up in Fairbanks. Mr. Kelly concluded by
saying HB 407 is bad law.
Number 1854
HARRY PORTER testified via teleconference. He informed the
committee that he helped create the Fairbanks Memorial Hospital
board. He noted that he has noticed Fairbanks's failure to
change even though there was open competition; he related this
comment to all types of business. (Indiscernible.) He remarked
that in the minutes that it will take to vote on HB 407, "you
could put the skids under the hospital that it took 30 years to
create."
Number 1935
SUSAN McLANE, Registered Nurse, Fairbanks Memorial Hospital,
testified via teleconference in opposition to HB 407. Although
she said she understood the many concerns with the existing CON
program, she agreed it could be difficult. However, she said
she didn't understand the sizable leap from problems with the
process to its complete elimination in three areas of the state.
She indicated the need to double the tax (indisc.) in order to
evaluate the effectiveness of the program and make
recommendations for improvement. She mentioned nationwide and
statewide shortage of nurses, and that the emergence of new
surgery centers in Alaska would further dilute the labor pool.
Ms. McLane closed by suggesting that a task force be appointed
to review this important issue.
Number 2000
JENNIFER HOUSE, Employee, Fairbanks Memorial Hospital, testified
via teleconference in opposition to HB 407. Ms. House began by
saying that HB 407 is based on the erroneous assumption that
health care is a free market and that this legislation will lead
to increased competition and thus result in lower costs to
consumers. However, consumers of health care aren't informed
consumers and have little or no control over the services they
receive. Physicians have the control, which is why there won't
be a decrease in the cost of outpatient services to consumers.
She charged that there are no incentives for physicians to
provide these services at lower prices. However, she suggested
that physicians are likely to charge more than the hospital
because the physician is in a unique position to influence the
patient. Cost is rarely an important factor for a patient
determining where to obtain health care services. Furthermore,
Ms. House said that this competition won't cause the hospital to
lower its prices. She charged that it would have little to no
impact in retaining patient volume, but would most likely result
in increased charges that will impact consumers across the
state. Ms. House explained that the CON process is critical in
ensuring that under- and over-capacity in our communities
(indisc.). [Elimination] of the CON process will only benefit
physicians and specialty providers, not the majority of the
population "you" represent.
Number 2090
DR. DAVID McGUIRE, Orthopedic Surgeon, testified via
teleconference in support of HB 407. He said, "The problem with
change is always that everybody who has to suffer change is
opposed to it." Dr. McGuire remarked that the CON was a bad law
to begin with, which the federal government realized in 1987
when it eliminated it. The CON hasn't controlled costs, but
rather has created another bureaucracy and the opportunity to
maintain a monopoly. Dr. McGuire said Fairbanks is an example
of how a good law is applied badly. He pointed out that the
Fairbanks Memorial Hospital was given permission to build its
oncology center without a CON. Dr. McGuire stated that if the
CON process is to work, everyone should have to apply [and be
treated equally under the process].
DR. McGUIRE turned to the assertion that patients are uninformed
health care consumers. He said those aren't the patients that
he sees. "I think, if the hospitals are as good as they say
they are, then a surgery center comes to town, nobody's going to
use it because they recognize the hospitals are better. There
really shouldn't be a problem," he said. Dr. McGuire reiterated
that the CON process is a bad law that hasn't worked in Alaska
and hasn't amounted to anything positive. Furthermore, the way
in which the CON process is applied is unfair. In conclusion,
Dr. McGuire urged the committee to vote for HB 407.
Number 2204
ROBERT GOULD testified via teleconference in opposition to HB
407. Mr. Gould informed the committee that in 2001 the gross
patient revenue of Fairbanks Memorial Hospital was approximately
$147 million and that the net income was approximately $1.4
million, about 1 percent. Mr. Gould said he would begin by
reviewing two reasons why competition won't decrease costs in
Alaska. He recalled that three years ago when the CON
discussions began, Fairbanks Memorial Hospital had the lowest
charges for the most common outpatient surgery. In those three
years, those charges haven't changed. However, during that same
three years, charges [for the most common outpatient surgery]
has increased 22 percent. Mr. Gould noted that Anchorage has
three [ambulatory] surgery centers and thus is the most
competitive market in the state, and yet the prices are higher
than in Fairbanks.
MR. GOULD turned to MRI (magnetic resonance imaging) charges.
Recently in Fairbanks a clinic has opened a good clinic MRI,
although it isn't a hospital-quality MRI. Those clinic MRIs
don't produce the same images nor are those images as clear or
similar quality to that of the hospital MRI. However, the
clinic's charges are 43 percent higher than the hospital
charges. Therefore, it's an example of when physicians control
patient referrals and thus it doesn't matter what is charged.
MR. GOULD suggested that if HB 407 passes, the hospital should
immediately raise its prices 22 percent plus the cost of a plane
ticket to Anchorage in order to compete with Anchorage. "We
won't need to compete with the physicians if they have their own
surgery center because all you're going to do is divide the
market between who does their surgeries at which facility," he
explained. Patients will choose which physician not which
facility. "Immediately, my prices don't matter because the
surgeon that has the share in their own surgery center is not
going to send the profitable surgeries, the ones where we still
get fair reimbursement, over to the hospital; they're going to
do them in their own shop. That's the problem with this bill,"
he said. Mr. Gould concluded by urging the committee to not
throw away 30 years of community planning all for the sake of
increasing revenue to a few individual shareholders. "The
reimbursement system is what's broken, and you're trying to fix
it by eliminating the CON legislation," he stated.
Number 2333
JIM LYNCH, Director, Human Resources, Fairbanks Memorial
Hospital, testified via teleconference in opposition to HB 407.
Mr. Lynch urged the committee to take time to study this issue
thoroughly. He turned to the workforce challenges in
geographically remote locations such as those in Alaska,
specifically, the nursing shortage.
TAPE 02-28, SIDE B
MR. LYNCH stated that individuals such as nurses and
radiologists are hard to find, and their salaries are
increasing. If additional institutions are created without
being able to apply the in-state labor that is necessary, [the
state] will fail miserably at meeting its health care needs at
any reasonable cost. He requested that the committee consider
that factor when considering HB 407.
Number 2330
BRIAN SLOCUM, Administrator, Tanana Valley Clinic, began by
informing the committee that the Tanana Valley Clinic is the
largest entity in the state, with 36 health care providers.
Tanana Valley Clinic has been providing patient care since 1959,
which is ten years prior to the existence of Fairbanks Memorial
Hospital. Mr. Slocum said that there have been some very
concerning claims. The hospitals across the state have been
raising the issue of cherry picking. With respect to the Tanana
Valley Clinic, everyone who shows up for care is served. Due to
that [policy], the clinic has lost 11 of its 28 doctors in less
than two years. Those physicians have left, in part, because
they can't make the living at the clinic that they could at the
hospital.
MR. SLOCUM said 24 percent of the clinic's patients are
Medicare/Medicaid patients, and 9 percent have no insurance at
all; combined, this is one-third of the patients. He mentioned
that over the past three years, the clinic has provided over
$17.7 million in charity care. "To the extent that the other
docs in the community are doing the same thing, then I'll think
you'll find that the charity care provided ... by the doctors
exceeds the free care provided by the hospital, if you add it
up," he said. The clinic can't continue to provide that much
free care and remain a taxpaying for profit business.
Furthermore, such free care can't continue in the face of the
4.5 percent Medicare reduction that occurred in January.
MR. SLOCUM turned to the charge that in those states without the
CON, the patients receive worse care. The only study that he
recalled from testimony was a Florida study that dealt with
cardiac surgery. Mr. Slocum said there is probably some
legitimacy to that because cardiac surgery shouldn't be done by
centers that only do a few each year. Therefore, Mr. Slocum
announced that no cardiac surgery would be performed in [the
clinic's] ambulatory care center. The center only performs
those procedures on the federal government's approved list. Mr.
Slocum informed the committee that there are studies that
[refute the notion] of higher mortality rates in non-CON states.
He noted that the committee packet should include three such
studies illustrating that those states with CON laws or other
regulations limiting the care delivered have significantly
higher mortality and morbidity rates.
MR. SLOCUM pointed out that one of the letters sent to the
[committee] says, "If the CON law is modified, this could very
likely lead to catastrophic increases in cost statewide, and
perhaps even to the closure of some Alaska's most vulnerable
hospitals." However, Mr. Slocum said that he has provided the
committee with two studies proving that there is no increase in
statewide health care costs and no decrease in hospital profits
in all of the states that have eliminated the CON laws. In
regard to the assertion that the elimination of the CON will
result in hospitals being unable to provide charity care, the
studies prove that there is no decrease in hospital profits and
no discernible decrease in the amount of charity care provided
in the 15 states which have eliminated the CON. Therefore, Mr.
Slocum urged the committee to support and pass HB 407.
Number 2054
REPRESENTATIVE WILSON inquired as to the number of doctors and
nurses that the Tanana Valley Clinic employees. She also asked
whether the clinic intends to employ more.
MR. SLOCUM answered that the clinic has a total of 28 doctors
and 10 mid-level providers who are nurse practitioners or
physicians assistances. The clinic is losing two doctors next
week who will be replaced. The clinic recruited four doctors
last year and will recruit five more this year. He informed the
committee that it costs about $50,000 per new doctor brought
into the community. Without the clinic providing these costs,
the state would be faced with them. He explained that there are
about 1.5 to 2 nurses per physician. Those nurses are often
brought in through out-of-state recruitment and nursing
magazines, and locals who come as part of the Fort Wainwright or
Eielson Air Force Base contingent. In further response to
Representative Wilson, Mr. Slocum said, "We continue to grow ...
because we seem to be the only entity other than the hospital in
Fairbanks that continues to be able to step up to the plate and
deal with these issues." He mentioned that nurses assistants,
medical assistants, LPNs, RNs, et cetera are utilized as well.
REPRESENTATIVE WILSON pointed out that the nursing shortage is
the biggest workforce shortage in the state now. Therefore,
[the nursing shortage] might dilute the situation as well.
Representative Wilson indicated that she is conflicted on this
issue.
MR. SLOCUM acknowledged that he has often heard that the
[clinic] shouldn't offer new services to the patient population
in the community because of a lack of technical clinical people.
At its simplest the [question] becomes whether doctors should be
brought in to provide health care services to the community
[even though there is a] struggle to find nurses. To that
question, the answer is yes; the doctors need to be brought in
to serve the needs of those leaving doctors.
Number 1930
MIKE POWERS, Fairbanks Memorial Hospital, testified via
teleconference. Mr. Powers commented on the difficulty with
this issue in that professional friends are on opposite sides of
this economic issue. This is tearing apart the community, he
said. Mr. Powers acknowledged that the Tanana Valley Clinic is
a good neighbor in that it takes Medicare and Medicaid patients,
which not every physician in Fairbanks does. However, the
Tanana Valley Clinic isn't the largest property taxpayer but
rather the Greater Fairbanks Community Hospital Foundation is
with its physician office building. He stressed that there is
no profit in the foundation as there are considerable capital
costs associated.
MR. POWERS turned to the testimony regarding the Tanana Valley
Clinic's mention of a 4.5-percent reduction in Medicare, while
the hospital faces a 17-percent reduction this year. In regard
to the Florida study, Mr. Powers explained that the study is
important relative to the CON because in states that with CONs
there is higher efficiency, efficacy, and equality. With regard
to unreimbursed care, Fairbanks Memorial Hospital provided $34.5
million in unreimbursed care. He pointed out that of the 37
states that have CONs, two of those states that have repealed
the CONs brought them back due to a proliferation of ambulatory
surgery centers and cherry picking.
MR. POWERS concluded by saying that this is a very divisive
issue and that the community needs to work together to develop a
health plan and recruit physicians. This is all an effort to
eliminate barriers so that physicians can do what they do best
while [allowing] hospitals to provide technical components of
services that no one else provides. Mr. Powers stressed that
[Alaska] is in a fragile state because every community, save
Anchorage, has one hospital. The numbers alone don't
substantiate the need for fundamental changes to the CON law.
Therefore, Mr. Powers urged the committee give this much study
in order to develop a CON law that addresses the needs of a
rural state.
Number 1757
MR. LINDSTROM commented that Version O is an improvement over
the previous [versions]. Mr. Lindstrom noted his appreciation
of the changes in Section 1 relative to conversion. However, he
continued to express reservations about the basic notion of
dividing the state into communities larger than 55,000 or
smaller. There is no data to determine whether such makes
sense. He referred to page 2, lines 3-10, subsection (e), and
said he didn't understand the language. He related his belief
that subsection (e) appears to be contradictory or subsumed
within subsection (d). Section 2 regarding the ability to
replace a facility without going through a CON is still cause
for concern, particularly in smaller communities.
MR. LINDSTROM indicated he also didn't understand the language
on page 2, lines 30-31, and page 3, lines 1-2. Although he
wasn't sure it would allay all of the [department's] concerns,
Mr. Lindstrom suggested that the language could say that nursing
home or psychiatric beds couldn't be replaced without a CON.
That language would get at the department's issue with the
department being the primary payer of those two types of
facilities.
MR. LINDSTROM informed the committee that he had a draft fiscal
note to Version J, which he believes remains relevant to
Version O. He noted that some of the verbiage would require
change, and thus those changes would be made and the fiscal note
resubmitted. The estimated costs are significant. He directed
attention to page 3 of the fiscal note, which identifies those
facilities that the department believes might generate those
additional costs. Mr. Lindstrom said, "I cannot stand before
you and say that I have any high degree of confidence that this
is the exact number for a fiscal note, because on all of these,
it assumes that we know what a Providence or a Fairbanks
Memorial ... are ultimately going to do as their own business
decisions." However, Mr. Lindstrom related his belief that HB
407 will have a significant impact as has been related
throughout the testimony.
Number 1555
REPRESENTATIVE WILSON asked if the bill will proceed to the
House Finance Committee since a fiscal note has been attached.
CHAIR DYSON informed the committee that the committee can accept
the department's fiscal note or zero it out, or can forward the
bill with several fiscal notes. In regard to the latter case,
the Speaker of the House has the authority to decide which
fiscal note the legislation has. Chair Dyson related his
understanding that legislation with a fiscal note mandates a
Finance Committee referral.
The committee took an at-ease from 4:10 p.m. to 4:12 p.m.
CHAIR DYSON announced that the vote on HB 407 would be delayed
until Thursday, per the request of the bill sponsor. He further
informed the committee that there will be discussions with those
carrying the companion bill to HB 407, in order to develop some
congruence between the bills. [HB 407 was held over.]
The committee took an at-ease from 4:13 p.m. to 4:18 p.m.
HB 408-STUDENT QUESTIONNAIRES AND SURVEYS
CHAIR DYSON announced that the next order of business would be
HOUSE BILL NO. 408, "An Act relating to questionnaires and
surveys administered in the public schools."
Number 1397
APRIL HOTCHKISS, Substance Abuse Counselor at Juneau-Douglas
High School (JDHS), Juneau Youth Services, informed the
committee that although she usually doesn't become politically
involved, this legislation impacts how well she can do her job.
Ms. Hotchkiss announced her support of HB 408 because it allows
the Youth Risk Behavior Survey (YRBS) to be done. She explained
that she attends many meetings with parents, teachers, and the
community. At [those meetings], one of the major questions is
in regard to the drug situation at [Juneau-Douglas High School].
She said she couldn't comfortably answer that question because
she would be guessing the answer, since there is no proof with
regard to how JDHS is doing with the drug problem. Also, this
is problematic because it leaves Ms. Hotchkiss, as a
professional, guessing what [the students] need. For example,
she informed the committee that she has heard a rumor that
cocaine is "big" at JDHS now. With that information, she
redirected her focus on cocaine awareness education. She
reiterated that she is just guessing.
MS. HOTCHKISS informed the committee that many kids she sees
aren't drug users, but only look like them. Therefore, many
assumptions are being made. She said, "People tend to assume a
lot. And without an anonymous test to know where we stand and
what we do need to focus on, we tend to be spinning our wheels."
In summary, Ms. Hotchkiss said, "Without identifying what the
problem is, it is hard to be able to work the solution out."
Number 1290
JESSICA PARIS, High School Teacher, Juneau-Douglas High School,
testified in support of HB 408. Ms. Paris said she felt that
society is often naive about the problems youth are facing and
the risky behaviors in which they choose to participate.
Without the 1999 YRBS, Ms. Paris said that she would've never
thought that about half of the juniors and seniors and about one
in four freshmen at JDHS are having sex. She expressed the need
to do a better job of educating [students] how to say "No."
Although there are programs that attempt to confront these
issues, there need to be accurate statistics in order to
evaluate the need and effectiveness of the programs. The
current law has hampered the [school's] ability to administer a
survey that will judge whether these programs are effective.
Under HB 408, parents will still be able to refuse permission
for their child to participate in an anonymous survey and
students will maintain the right to refuse to participate.
Under the current law, parents of students and students who want
to participate in an anonymous survey can't if the student
doesn't remember to return the consent form, which is a large
problem.
Number 1145
ANDREE McLEOD, testifying via teleconference, began by saying
that committee members have asked her ways, other than the YRBS,
that this information could be obtained from students. Ms.
McLeod said that although she didn't have the wherewithal to
answer [this question], the Department of Health & Social
Services (DHSS) and EED both have the financial and human
resources to answer this question. She suggested using a key
informant survey or a random stratified sampling to find out
[more accurate results]. Ms. McLeod felt that a 10 percent
[response] from surveys isn't so bad; the [current response] is
at 30 percent. Ms. McLeod related her belief that surveying
minors without written parental consent is a form of abuse,
which is unacceptable. Ms. McLeod requested that DHSS and EED
find other ways to gather this information. She charged the
departments with negligence in not doing so before now.
Number 0897
BILL DIEBELS, JR., Parent, informed the committee that he is
moderately involved in support activities at school. Mr.
Diebels noted that he recently learned how difficult it is to
gather statistically valid data on drug, alcohol, and sex
problems due to the logistical nightmare of obtaining parental
consent before conducting anonymous surveys. Without this
information, Mr. Diebels related that one can't be sure that
resources are being targeted where they're most needed.
Furthermore, the effectiveness of the programs can't be
measured. Mr. Diebels announced his support of HB 408 and urged
the adoption of its intent. However, Mr. Diebels pointed out
that Section 2 says in part, "the school district shall provide
each student's parent or legal guardian the opportunity to
submit to the school principal a written denial of permission to
take the questionnaire or survey."
MR. DIEBELS said it would be a shame for future arguments
regarding what constitutes "opportunity" to diminish the intent
of this legislation. Therefore, he suggested the following
language:
If a school district administers an anonymous
questionnaire or survey, written permission from a
student's parent or legal guardian is not required,
but the school district shall not ask any student to
participate in such a survey if that student's parent
or legal guardian has submitted to the school
principal a written denial of permission to take the
questionnaire or survey.
Number 0785
RICHARD BLOCK, Christian Science Committee on Publication for
the State of Alaska, testified via teleconference. He informed
the committee that the federal law [20 U.S.C. Section 1832 and
20 U.S.C. 1232h] has a direct bearing on [HB 408]. He
characterized the thrust of those laws as the parental right to
be informed with regard to what's going on in school with
respect to the curriculum, surveys, and questionnaires, as well
as the right of parents to prevent their children from
participating in these surveys. Therefore, he found it curious
that there have been grants that were denied on the basis of
failing to provide information [obtained through these
questionnaires and surveys].
MR. BLOCK reported that in researching this claim, he discovered
that one of the grants that was applied for was denied not by
the federal government but rather by EED, because of the failure
to provide data supporting [the need for the grant]. In his
discussion with the department, any data substantiating the
[grant] request would've been satisfactory; the data didn't
necessarily have to result from a questionnaire. He recalled
Ms. McLeod's testimony that this data could be gathered from
police reports, absentee reports, and disciplinary reports from
the schools. He informed the committee that through his inquiry
of these surveys as they relate to grant requests he could see
that there is probably a value to these surveys. Therefore, an
absolute barring of these surveys may not be in the best
interest of the schools. However, he recognized why there is a
great deal of concern with regard to the content of these
surveys, including the YRBS.
MR. BLOCK turned to his view as a parent, and related his
concern that the content of the survey may be inappropriate in
the eyes of some parents because the questions seem to propose
that there's a certain amount of propriety to the things being
asked. In conclusion, Mr. Block specified that his concern is
not in regard to whether surveys should be given or not given
but rather that parents be adequately informed in order to
provide sound judgment. Therefore, he proposed an amendment to
tighten the notice provisions by requiring that the notice be
mailed directly to the parent. The amendment specifies that the
notice be mailed two weeks in advance via First Class mail.
Number 0456
KATHRYN ARLEN, Member, Board of Directors, Youth on the Streets
Action Group; Member, Meeting the Challenge Advocacy Program;
Volunteer, Detention, Johnson Youth Center, noted [that the
committee packet should include] her written testimony. Ms.
Arlen also noted her agreement with Mr. Block's suggestion to
provide parental notification via the mail. She highlighted her
agreement that every parent should be informed. However, she
noted her concern with regard to "active" versus "passive"
parental consent.
MS. ARLEN turned to her experiences through volunteering. She
informed the committee that a great deal of young people come
from "fractured, rearranged, repartnered families." Therefore,
she questioned who the parent would be [that would be charged]
with signing and returning the parental consent notification.
Ms. Arlen related her experiences with young people who are
suffering the consequences of risky behavior. She noted that
the young people with whom she works requested that she relay
the following message: "We need to get things off our chests.
We need to have the right to answer questions just like our
parents do and a lot of times ... our parents don't care or they
don't want everyone else to know what's really going on." Ms.
Arlen said that she strongly urged the passage of HB 408.
Number 0146
RIC IANNOLINO, Chair, Youth on the Street, testified in support
of HB 408. He commented that any survey that is anonymous and
voluntary does not violate either the protection of people's
rights, known as the Buckley Amendment, or family education
rights and the Privacy Act of 1974.
TAPE 02-29, SIDE A
Number 0001
MARY TONSMEIRE, Nurse, Adolescent Health Care Coordinator,
Juneau-Douglas High School, began by saying that there are many
angles she could take in supporting HB 408. Although she
expressed the importance of parent notification, she [conveyed
the need for passage of HB 408] in order to obtain a true cross-
section of the population that would afford the ability to
determine the trends in JDHS as well as the state. Ms.
Tonsmeire informed the committee that last year the high school
started the Postponing Sexual Involvement (PSI) program in which
peer educators are trained. This program comes out of Emory
University in Atlanta, Georgia. The statistics from Atlanta
illustrate that there should be some significant reductions in
attitudes toward becoming sexually involved at an early age. At
this point, there is no mechanism by which to evaluate whether
that is true. Therefore, Ms. Tonsmeire expressed the need to
see whether the youth hold the lessons that their peers taught
them a year or two earlier. Ms. Tonsmeire concluded by saying
that is merely one of many issues.
Number 0177
LISA TORKELSON, Full-time Parent, testified via teleconference
in opposition to HB 408. Ms. Torkelson emphasized that passive
consent isn't consent at the bank, school, or the grocery store.
"Only our signatures are consent," she highlighted. Therefore,
surveys shouldn't be treated any differently. Ms. Torkelson
pointed out that students can't go on a field trip or obtain
aspirin without parental permission and surveys shouldn't be any
different. She informed the committee that there are sources of
documented evidence that anonymity doesn't exist when surveying
students in school. Furthermore, she said there is a list of
places where reliable data can be obtained without surveying
students. Ms. Torkelson related that the federal government
doesn't make money contingent upon the provisions of specific
survey data. Moreover, federal law also prohibits making the
sharing of personal data mandatory when tied to grants. She
stressed that self-reported data isn't reliable.
MS. TORKELSON said that if HB 408 passes, [Alaska school
districts] will be open to potential lawsuits. Currently, New
Jersey is facing this issue in court. Lawsuits are much more
expensive than most grants. Ms. Torkelson pointed out that HB
408 doesn't limit questions to those in the YRBS. "There's
documented evidence that any topic is and has been open for
discussion within the confines of the survey," she charged.
Although she acknowledged that those in support of HB 408 speak
of the importance of parental notification, she said she hasn't
found where [parental notification] would occur under HB 408.
She concluded by urging the committee to protect the right to
privacy and thus she suggested not passing HB 408.
Number 0385
BARBARA BONNER, Teacher, CHOICE, Juneau-Douglas High School;
Member, Youth on the Streets, informed the committee that CHOICE
is a program for at-risk students. Ms. Bonner announced her
support of HB 408. Ms. Bonner informed the committee that JDHS
conducted a survey last year for which parental permission forms
were sent home for the parents to sign. Only those students
returning the permission forms were able to take the survey. In
her classroom of 27 sophomores, there was one student who could
take the survey. That one student doesn't represent the other
students in the classroom, which included some of the neediest
students in the district. If surveys are conducted in this
manner, it's not representative of what is really happening with
the youth. Therefore, she urged the committee to support HB
408.
Number 0468
DEE HUBBARD testified via teleconference. She pointed out that
HB 70 didn't say that surveys couldn't be done; rather, it
specified that parents must be asked first. Ms. Hubbard related
a quote from Carol Nunn (ph) in North Carolina regarding a New
Jersey statute that "married" 20 U.S.C. Section 1232h:
A parent's silence should never constitute consent. A
school district should never second-guess why a parent
has not sent back a consent form. Passive consent is
an oxymoron, and only a moron would rely on passive
consent when surveying minor children without their
parent's informed, active, and written consent.
Number 0579
SAM TRIVETTE, Parent, informed the committee that his son took
these surveys when they were still permitted. His son related
to him that he and his friends were fairly thoughtful when
taking the survey and, in fact, answered the questions
truthfully because the survey was anonymous. Therefore, Mr.
Trivette related that he didn't believe these surveys were
problematic if they are anonymous. He noted that he worked for
the Department of Corrections for 33 years and was involved with
surveys, and therefore he said he understood the need to have
good information to make good decisions on educational issues.
It is critical to obtain this information. Mr. Trivette related
that the parents who attended a parent group meeting [at JDHS]
were all supportive of these surveys.
Number 0708
KAREN McCARTHY, Staff to Representative Con Bunde, Alaska State
Legislature, speaking as the committee aide for the House
Special Committee on Education, sponsor of HB 408, reiterated
that this is a voluntary, anonymous survey, which is in sharp
contrast to the New Jersey court case and the federal law. Ms.
McCarthy pointed out that 20 U.S.C. Section 1232h [protects the
rights of parents and students] because it says that "schools
and contractors have to obtain written parental consent before
the minor students are required to participate." However, the
survey in HB 408 is completely voluntary. As the law is
written, school districts and social service agencies are losing
grants that are meant to help prevent and combat risky behavior
in young people. That situation needs to be changed, she said.
The students who are at most risk for such behavior are those
whose parents aren't involved in their children's lives, and
those parents don't return active-consent forms. Ms. McCarthy
concluded by relating Representative Bunde's hope that HB 408
would move from this committee today.
REPRESENTATIVE STEVENS recalled hearing that school districts
can decide whether to conduct these surveys via questionnaire.
MS. McCARTHY answered that such was her understanding, and added
that it's completely voluntary. In further response to
Representative Stevens, she agreed that taking the survey is
also voluntary with regard to the child. She specified that a
child may review the survey in total and refuse to take it or
the child may decide not to answer a particular question.
REPRESENTATIVE JOULE inquired as to the penalties for breach of
confidentiality.
Number 0899
KRISTEN BOMENGEN, Assistant Attorney General, Human Services
Section, Civil Division (Juneau), Department of Law, answered
that she didn't know what the specific penalty would be.
However, she said that a number of methods for recovery would be
available for individuals if [breach of confidentiality]
resulted in individual privacy issues. She surmised that using
confidential information would be in violation of an employment
contract. She noted that there may other specific penalties in
federal education law and state law of which she is not aware.
Number 0954
ELMER LINDSTROM, Deputy Commissioner, Office of the
Commissioner, Department of Health & Social Services (DHSS),
related his belief that EED and DHSS both have clear statutory
obligations relative to the preservation of confidentiality. He
deferred to Tammy Green, Epidemiology Section, who agreed with
Ms. Bomengen's comments. Mr. Lindstrom said that he could
provide the committee with a written response tomorrow.
MS. McCARTHY, in regard to the penalties for breach of
confidentiality, informed the committee that a complaint can be
filed with the Professional Teaching Practices Commission
(PTPC). Furthermore, federal law [20 U.S.C. Section 1232h]
says:
(d) Enforcement
The Secretary shall take such action as the Secretary
determines appropriate to enforce this section, except
that action to terminate assistance provided under an
applicable program determines that
(1) there has been a failure to comply with such
section; and
(2) compliance with such section cannot be
secured by voluntary means.
MS. McCARTHY summarized that per federal law the U.S. Secretary
of Education could cut off funding to the school district.
CHAIR DYSON, upon determining that no one else wished to
testify, closed the public hearing on HB 408.
Number 1071
REPRESENTATIVE WILSON recalled her nine-and-a-half years
teaching in a school system of 4,000 students, and remarked on
how few of the permission slips are returned [for various
things]. Therefore, [the school district] went to passive
permission. She emphasized the importance of having proof [of
the effectiveness] in regard to what is taught. Representative
Wilson urged everyone to vote for HB 408.
REPRESENTATIVE STEVENS recalled testimony that the denial of
grants isn't really an issue because one of the grants that was
denied was denied by EED. However, the testimony from the
professionals is that there are numerous grants that have been
lost due to the lack of information.
REPRESENTATIVE CISSNA, as a parent and foster parent, remarked
that one can only find out what teenagers are thinking by asking
them. Furthermore, [the school districts/the state] can't
afford to pay for programs unless there is knowledge with regard
to what and how those programs are doing.
CHAIR DYSON recalled that Version C [22-LS1458\C, Ford, 3/21/02]
was adopted [March 26, 2002].
Number 1238
REPRESENTATIVE JOULE said that he would like an answer to his
question regarding the penalties for breach of contract, even if
that answer comes after HB 408 has moved to the next committee
of referral. Representative Joule related the importance of
obtaining a snapshot of what students are facing [in order] to
make adjustments and review [those adjustments that have already
been made]. However, Representative Joule remained concern with
regard to anonymity. He related his belief that the penalties
for breach of confidentiality would be fairly severe.
REPRESENTATIVE COGHILL remarked that in the smaller communities,
anonymity would be even more important. Representative Coghill
said although he understands the need to know, he struggles with
the societal question of whether the school should [have to] fix
[problems related] to family struggles. He didn't view the
school as fixing these problems. Representative Coghill
questioned whether [HB 408] is about dollars or families. That
is, when is it more important for the parents to acquiesce so
that the survey can be done in order to obtain grants to do
social engineering. "At what point does the government [public
schools] have to fix it all," he asked. He noted his refusal to
believe that the school is the only place to fix these problems.
Therefore, Representative Coghill informed the committee that he
wouldn't be supporting HB 408. He stressed the need to obtain
active permission.
REPRESENTATIVE JOULE said he didn't necessarily view this as
[something] the government should fix. Once the information is
obtained by the school districts, the schools should be able to
review the information in order to inform the community of the
results. Therefore, [there would be] the type of community
involvement to which Representative Coghill alluded.
Representative Joule said he didn't view HB 408 as a way in
which to obtain grant money. He encouraged the local school
districts to bring [the information obtained from
questionnaires] back to their local school councils.
REPRESENTATIVE STEVENS remarked that he would agree with
Representative Coghill if this were a perfect world and every
child had two supportive and active parents in their lives.
However, there are children that are falling through the cracks,
and [the state] has an obligation to those children as well as
those with active parents. He reiterated earlier testimony that
these [surveys] are voluntary.
REPRESENTATIVE COGHILL agreed that there are "some broken places
in society." However, he charged that just because there are
parents who don't participate, "we" are going to turn a "blind
eye" to those parents who are involved. In so many areas of
law, everyone pays the price for the broken portions of society.
The voluntariness is being taken out of the hands of the parents
[under HB 408].
Number 1610
REPRESENTATIVE KOHRING noted his agreement with Representative
Coghill's remarks. Representative Kohring related the following
from Lisa Torkelson's e-mail: "In conclusion, House Bill 408
when it comes up for a vote, please retain parental rights and
vote 'Do Not Pass.' After all, isn't it the school districts
who say they desperately want parental involvement?" With
regard to funding, Representative Kohring said he wasn't
convinced [the legislature] should be concerned with the passage
of measures tied to the funding of grants.
REPRESENTATIVE WILSON echoed earlier testimony that [HB 408]
isn't just about obtaining grants, but is about the school
system's trying to determine whether its [programs] are working.
Number 1672
CHAIR DYSON informed the committee that a few years ago the
legislature passed HB 70 with a 39-0 vote in the House and a 19-
1 vote in the Senate, and was immediately signed by the
governor. That legislation was viewed as a major strengthening
of parental rights with regard to the invasive and private
questions that a school can ask. He said that some of the
questions [that are asked] are outrageous, and there isn't
anything in HB 408 that limits the scope of the outrageous
questions that might be asked. When the Anchorage School
District came forward because it couldn't obtain enough active
parental permission to obtain the data necessary to know what is
happening with the students and to evaluate the efforts to
remediate, he agreed to hear the bill.
CHAIR DYSON noted that he has a letter from the president of the
Anchorage Parent Teacher Association (PTA), which says they
never even heard about [HB 408]. In the past, the Council of
PTAs has been opposed to passive parental permission.
Furthermore, the Anchorage School District's web site doesn't
mention the problem either.
CHAIR DYSON emphasized that passage of HB 408 merely requires
notification of anonymous surveys. There is no specification as
to how the notification will occur. Therefore, a student could
still be given a form to take home and return to the school.
Chair Dyson noted his strong objection to that. Furthermore,
Chair Dyson noted his belief that by-and-large HB 408 is about
money. He echoed earlier testimony that federal law prohibits
disqualification from grants if there is a problem with parental
consent. Therefore, he didn't view that as a problem.
Furthermore, the federal law says that questions violating a
child's Fourth and Fourteenth Amendment [rights] can't be asked.
Children can't be asked to incriminate themselves.
CHAIR DYSON said he interpreted the New Jersey case to mean that
it's not voluntary when a voluntary survey is given to the
students and [those administrating the survey] stress the need
[for the students to take the survey] and everyone else is doing
it. Such a situation is compelled speech in violation of the
First Amendment. He informed the committee that under the
federal law [individuals] may not be asked [questions regarding]
their political affiliation; mental and psychological problems;
sex behavior and attitudes; illegal, antisocial, and self-
incriminating or demeaning behavior; critical appraisals of
other individuals; legally recognized privileged or analogous
relationships; and income. Furthermore, the New Jersey Third
Circuit Court of Appeals decision dated December 10, 2001, seems
to mean that if [HB 408] passes as written, it will be in
violation of federal law.
CHAIR DYSON turned to the issue of anonymity. He said that very
experienced teachers have related to him that there is no such
thing as anonymity with a survey conducted in a classroom. He
expressed his hope that these surveys would be conducted in
large groups in order to minimize the loss of anonymity. Chair
Dyson pointed out that information pertaining to specific
children won't be available because of the anonymity, and
furthermore street kids don't take surveys. Although he agreed
that "we" want to know what is going on in society, he stressed
that those willing to vote in favor of HB 408 are willing to
sacrifice the parents' rights in order to obtain more data.
Chair Dyson informed the committee that he has had some high-
ranking educators come into his office and tell him that their
districts are in favor of HB 408, but they, as parents, weren't.
Chair Dyson announced that he would be voting against HB 408.
Number 2008
REPRESENTATIVE CISSNA asked, "Did I understand you to say that
if I don't vote the way you think, I am violating someone's
rights because that's the way you think?"
CHAIR DYSON replied no, and said that if he'd said that, he
didn't mean it. He clarified that from his reading of the New
Jersey decision, the law would be in violation of the federal
law and that passage of HB 408 will result in no good definition
of notification. Furthermore, HB 408 guts many protections put
in place by HB 70.
REPRESENTATIVE WILSON related her understanding that currently
parents can inform the school that their children cannot take a
survey without the parents' permission, and that this would
continue under HB 408.
CHAIR DYSON said he believes that is true. He recalled that
during the passage of HB 70, it was clear that [the schools]
could obtain blanket permission, perhaps with an additional box
on an existing form that is vital to enrollment. This has not
been done.
REPRESENTATIVE WILSON specified that such is done in some school
[districts].
CHAIR DYSON clarified that it isn't done in the school
[district] in his area.
Number 2151
REPRESENTATIVE CISSNA related her understanding that a child
could choose, as he/she is taking the survey, not to answer
specific questions. She asked whether being forced to respond
is different from having a paper full of questions.
CHAIR DYSON said he wasn't the best person to ask the question,
but reminded everyone that the public testimony had been closed.
However, he clarified that the argument in New Jersey is [that
being forced to respond isn't different than having a paper full
of questions].
REPRESENTATIVE CISSNA related the following [information] from
Mr. Iannolino: "First, the situation in New Jersey was entirely
different. The New Jersey school district used federal funds
for a survey in which at least some students believed
participation was mandatory. However, the order to remand the
case back to the district court was based on the plaintiff's
inability to conduct discovery, and that the main parties in the
suit could be sued." Therefore, the New Jersey case seems to be
a different situation from that in Alaska, were HB 408 to pass
and perhaps even before.
CHAIR DYSON said that in the New Jersey case they argued that
due to the manner in which the survey was conducted, some
students felt compelled. Although the defense argued that the
survey was voluntary and the students were informed as such, it
was determined that it wasn't adequate. Therefore, he
understood the ruling to have been that there was compelled
speech. Therefore, HB 408 relies upon the school district to
ensure that every student understands that they have the right
to refuse to take the survey/questionnaire.
REPRESENTATIVE CISSNA said, "I'm assuming that ... our votes:
we can feel as if they're not mandatory and that we have the
freedom to answer in the way we feel."
CHAIR DYSON replied yes.
REPRESENTATIVE COGHILL remarked that it comes down to the
convenience of the schools [over] parental rights, to which he
objected.
Number 2255
REPRESENTATIVE JOULE moved to report CSHB 408, Version C [22-
LS1458\C, Ford, 3/21/02], out of committee with individual
recommendations and the accompanying fiscal notes.
REPRESENTATIVE COGHILL objected.
A roll call vote was taken. Representatives Stevens, Cissna,
Joule, and Wilson voted to report CSHB 408, Version C, out of
committee. Representatives Coghill, Kohring, and Dyson voted
against it. Therefore, CSHB 408(HES) was reported out of the
House Health, Education and Social Services Standing Committee
by a vote of 4-3.
HCR 23-LEGISLATIVE COMMITTEES:SPLIT HOUSE HESS
CHAIR DYSON announced that HOUSE CONCURRENT RESOLUTION NO. 23,
Proposing amendments to Uniform Rule 20 of the Alaska State
Legislature; and providing for an effective date for the
amendments, would be taken up on Thursday, April 11, 2002.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:28 p.m.
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