02/15/2005 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB1 | |
| HB30 | |
| HB85 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 1 | TELECONFERENCED | |
| + | HB 30 | TELECONFERENCED | |
| *+ | HB 85 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
February 15, 2005
3:05 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Paul Seaton, Vice Chair
Representative Lesil McGuire
Representative Sharon Cissna
Representative Berta Gardner
Representative Tom Anderson
MEMBERS ABSENT
Representative Vic Kohring
OTHER LEGISLATORS PRESENT
Representative Mark Neuman
Representative Carl Gatto
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 1(EDU)
"An Act relating to the base student allocation used in the
formula for state funding of public education; and providing for
an effective date."
- MOVED CSHB 1(HES) OUT OF COMMITTEE
CS FOR HOUSE BILL NO. 30(EDU)
"An Act making appropriations for K-12 education operating and
school debt expenses; and providing for an effective date."
- MOVED CSHB 30(HES) OUT OF COMMITTEE
HOUSE BILL NO. 85
"An Act relating to self-administration and documentation of
certain types of medication prescribed to a child attending
school."
- MOVED CSHB 85(HES) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 1
SHORT TITLE: INCREASE AMT OF BASE STUDENT ALLOCATION
SPONSOR(S): REPRESENTATIVE(S) GATTO
01/10/05 (H) PREFILE RELEASED 12/30/04
01/10/05 (H) READ THE FIRST TIME - REFERRALS
01/10/05 (H) EDU, HES, FIN
01/27/05 (H) EDU AT 11:00 AM CAPITOL 106
01/27/05 (H) Heard & Held
01/27/05 (H) MINUTE(EDU)
02/08/05 (H) EDU AT 11:00 AM CAPITOL 106
02/08/05 (H) Heard & Held
02/08/05 (H) MINUTE(EDU)
02/10/05 (H) EDU AT 11:00 AM CAPITOL 106
02/10/05 (H) Moved CSHB 1(EDU) Out of Committee
02/10/05 (H) MINUTE(EDU)
02/14/05 (H) EDU RPT CS(EDU) 2DP 5NR
02/14/05 (H) DP: GATTO, NEUMAN;
02/14/05 (H) NR: GARA, SALMON, WILSON, THOMAS, LYNN
02/15/05 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 30
SHORT TITLE: APPROP: K-12 EDU OPERATING/DEBT EXPENSES
SPONSOR(S): REPRESENTATIVE(S) HARRIS
01/10/05 (H) PREFILE RELEASED 12/30/04
01/10/05 (H) READ THE FIRST TIME - REFERRALS
01/10/05 (H) EDU, HES, FIN
02/03/05 (H) EDU AT 11:00 AM CAPITOL 106
02/03/05 (H) Heard & Held
02/03/05 (H) MINUTE(EDU)
02/08/05 (H) EDU AT 11:00 AM CAPITOL 106
02/08/05 (H) Heard & Held
02/08/05 (H) MINUTE(EDU)
02/10/05 (H) EDU AT 11:00 AM CAPITOL 106
02/10/05 (H) Moved CSHB 30(EDU) Out of Committee
02/10/05 (H) MINUTE(EDU)
02/11/05 (H) EDU RPT CS(EDU) 2DP 5NR
02/11/05 (H) DP: GATTO, NEUMAN;
02/11/05 (H) NR: GARA, SALMON, WILSON, LYNN, THOMAS
02/14/05 (H) CORRECTED CS(EDU) RECEIVED
02/15/05 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 85
SHORT TITLE: PRESCRIBED MEDICATION FOR STUDENTS
SPONSOR(S): REPRESENTATIVE(S) MEYER
01/19/05 (H) READ THE FIRST TIME - REFERRALS
01/19/05 (H) HES, JUD
02/15/05 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
JENNIE HAMMOND
Nikiski, Alaska
POSITION STATEMENT: Testified in support of increased education
funding.
KATIE MANDLEDORF
Palmer, Alaska
POSITION STATEMENT: Testified in support of increased education
funding.
ANNE KILKENNY
Wasilla, Alaska
POSITION STATEMENT: Testified in support of increased education
funding.
LAUGHTON ELLIOTT
Juneau, Alaska
POSITION STATEMENT: Testified in support of increased education
funding.
DOROTHEA ADAMS, President
Yukon Flats School Board
Beaver, Alaska
POSITION STATEMENT: Testified in support of a new school for
Arctic Village and a new gym in Fort Yukon.
GALEN GILBERT
Beaver, Alaska
POSITION STATEMENT: Testified in support of a new school for
Arctic Village.
ROBERT WELLS, Member
Matanuska-Susitna School Board
Palmer, Alaska
POSITION STATEMENT: Testified in support of a base student
allocation of $4,995.
CARL ROSE, Executive Director
Association of Alaska School Boards
Juneau, Alaska
POSITION STATEMENT: Testified in support of a minimum base
student allocation of $4,995.
JOHN ALCANTRA, Government Relations Director
National Education Association of Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in support of a base student
allocation of $5,315.
MERLE THOMPSON
Matanuska-Susitna Valley, Alaska
POSITION STATEMENT: Testified in support of increased education
funding.
MACON ROBERTS, Member
Anchorage School Board
Anchorage, Alaska
POSITION STATEMENT: Testified in support of an increased base
student allocation.
TOM WRIGHT, Staff
to Representative John Harris
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 30 on behalf of Representative
John Harris, sponsor.
REPRESENTATIVE KEVIN MEYER
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as sponsor of HB 85.
MICHAEL PAWLOWSKI, Staff
to Representative Meyer
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Responded to questions during discussion of
HB 85.
MARGE LARSON, Program Director
American Lung Association of Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 85.
GAIL WHITE, School Nurse
(Address not provided)
POSITION STATEMENT: Testified in support of HB 85.
RICHARD MANDSAGER, M.D., Director
Division of Public Health
Alaska Department of Health and Social Services
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 85.
THAD WOODARD, M.D., President
Asthma and Allergy Foundation of America;
and the Alaska Asthma Coalition
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 85.
JANIS BATES, Supervisor
School Nurses
Director of Health Services
Anchorage School District
Anchorage, Alaska
POSITION STATEMENT: Suggested amendments to HB 85.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:05:17 PM.
Representatives Wilson, Seaton, McGuire, Cissna, and Gardner
were present at the call to order. Representative Anderson
arrived as the meeting was in progress.
CHAIR WILSON remarked that the Public Employees' Retirement
System (PERS) and the Teachers' Retirement System (TRS) is in
crisis, and that there is a research paper by Representative
Mike Kelly entitled, "The Coming PERS and TRS Funding Crisis",
which is available to the public. She remarked that the
increase in school funding last year was $82 million, but she
pointed out that $36 million of it went to PERS and TRS, and
therefore did not go directly to the schools. The PERS and TRS
will require an additional $38 million this year, she explained,
and next year they will need another $39 million.
HB 1 - INCREASE AMT OF BASE STUDENT ALLOCATION
3:10:56 PM
CHAIR WILSON [announced that the first order of business would
be HOUSE BILL NO. 1 "An Act relating to the base student
allocation used in the formula for state funding of public
education; and providing for an effective date."]
REPRESENTATIVE SEATON moved to adopt CSHB 1, [Version 24-
LS0001\I, Mischel, 2/15/05] as the working document. There
being no objection, Version I was before the committee.
CHAIR WILSON explained that this CS would increase the base
student allocation to $4,919 per student, therefore increasing
the total by about $70.09 million.
3:12:06 PM
REPRESENTATIVE CISSNA commented that she has an amendment that
she would like to make, but she would prefer to hear public
testimony first.
CHAIR WILSON agreed and turned to public testimony.
3:12:51 PM
REPRESENTATIVE SEATON stated that though there is a CS for a new
base student allotment of $4,919, everything he has been hearing
from the districts and school boards, this isn't the number that
he would choose. He pointed out that a geographic cost
differential study would be coming out in two days, and that the
committee needs to move this bill to the finance committee so
that the base student allocation and the geographic cost
differential can be coordinated with one another. He remarked
that though he supports moving this bill forward, he is not
totally comfortable with the level of the funding.
CHAIR WILSON commented that this was the main reason why the
proposed base student allocation was not any higher than it is.
She stated, "We also have the eroding floor; that's another [$]2
million. ... Because those bills all take a lot more time than
we have time for now and we want to get the bills out, ... I
didn't include more in the bill than I did."
3:14:55 PM
JENNIE HAMMOND stated that she lives in Nikiski and has a
kindergartener and a prekindergartener. She commented:
The school districts from all across the state have
sent in their facts and reasons for increased
education funding. Please listen to them. The Kenai
district is funded to the cap by the Kenai Peninsula
Borough. Every morning when my son goes to school, I
try to remind him of two things: give glory to God for
everything and this will lead you to make good
choices. I tell him that the Bible has an answer for
everything if we open our heart and mind. The story
that comes to me is the master entrusting his servant
with money. Every servant but one multiplies their
money; in other words, the legislation has given the
school district a portion of money to educate the
students. Each district has taken that pool of money
and made it grow by the results of achievement by the
students. It is time for the legislators to entrust
more to the school districts. The school districts
have shown that they are wisely using the money that
is actually less because it has not been inflation-
proofed. Let's truly show the priority of the State
of Alaska: children first. So please remember: kids
first, $5,200, forward funding, and thank you.
3:16:25 PM
KATIE MANDLEDORF, Palmer, stated that she is the parent of three
middle and high school students. She expressed her appreciation
for the education funding last year and for the early movement
of an education bill this year. She stated:
I am here today to support those ideas that we have
not yet heard. ... I will support your courageous
commitment to make sure education is funded at the
beginning of each session and that education can be
adequately funded each year. I would encourage all
legislators to put politics aside and work towards the
honest, bipartisan commitment to ensure each year is a
good year for education and the best we can give to
our children. Last year I researched what our schools
used to have and now don't have in the [Matanuska-
Susitna] School District. Then I went out and talked
to legislators, borough assembly members, parents,
teachers, anyone who would listen. What we needed
last year we still need today. Only now we have an
immediate need for 20 portables to handle the
continued increase in enrollment. Three new
elementary schools and a high school are really
needed. Every legislator I spoke to says they support
education, and I am ever so grateful for that. But
what we really need is a strong voice taking a
visionary lead for education.
MS. MANDLEDORF continued:
Minimum, flat funding leads to mediocre, overcrowded,
poorly maintained schools. Visionary funding opens
the door to exemplary schools and the finest education
our children can get. We have outstanding teachers in
our state. How grand it would be for this strong
united voice to support their gallant efforts with
facilities and the means to offer smaller class sizes
and more variety of classes for our children. Where
is this strong voice? Is fear limiting that voice
from asking for what is really needed because it will
seem like too much and then we'll get nothing? I have
never been fearful to stand up for my children or any
children. That is why I am here today. Will you be
our strong voice? As the PTO president at Palmer
Junior Middle School, I can tell you that our parents
and teachers have a vision for education. We have a
long list of what we need for our schools. We are
working very hard to provide some of the needs, but we
need your help in a very big way. Please listen to
what the parents ... and the teachers are saying. We
are small voices but we are also at the heart of our
schools.
3:19:54 PM
ANNE KILKENNY, Wasilla, complimented the superintendent of the
schools for the Matanuska-Susitna School District for his
honesty in stating that the Mat-Su schools would maintain status
quo with the governor's proposed funding increase. However she
expressed dissatisfaction with status quo both as a mother and
as the president of the parent organization at the middle
school. She commented that there would have been no No Child
Left Behind legislation if the status quo was acceptable. She
said:
It's time that we move ahead. This No Child Left
Behind legislation demands it of us, that we make
improvements and that we educate our children to
rising standards. ... This legislative mandate has so
many requirements that it's necessary to increase
funding to education to enable these rising
expectations and rising standards to be met. I'm
asking that you amend this bill and that you increase
[the base student allocation] to at least $5,086.
[Based on] the testimony given to the [House Special
Committee on Education], half of the students in the
State of Alaska... are in districts that would be able
to function at an improved level with $5,086. It's
not enough for Nikiski, it's not enough for a lot of
places. But it is enough for at least half the kids.
... Our expectations are not wild. Juneau is only
asking to reduce high school classes to 30, and
kindergarten to 20. These are modest goals.
3:22:58 PM
LAUGHTON ELLIOTT stated that the school system needs more
funding. He said that classes are overcrowded due to lack of
teachers, textbooks are broken and have to be shared, and there
is a high dropout rate, which he attributed to the lack of
teachers and attention. Special needs children do not have
enough assistance, he commented, and there are no music or arts
programs in elementary schools. He remarked that it was his
understand that if HB 1 is passed, funds that were previously
cut would be restored. He said, "Alaska is a wealthy state, and
I say we put the money where it's needed."
MR. ELLIOTT, in response to Representative Anderson, stated that
he is a high school freshman.
3:24:34 PM
DOROTHEA ADAMS, President, Yukon Flats School Board, stated that
she supports all of the issues that they are advocating. She is
lobbying for a new school in Arctic Village and she pointed out:
We're currently number 12 on the CIP [Capital
Improvement Project] list for a new school. ... [The
current school] is from the old BIA [Bureau of Indian
Affairs] days; it's saturated with oil, as the boilers
are on the second floor. And the kitchens are right
under, and years and years of spills have occurred so
the building is saturated with oil, making it unsafe
for the students. And we have an asbestos problem at
that school that was temporarily resolved by covering,
but it still needs to taken care of. Our needs are
immediate and real. Our students want to stay in this
community where they are nurtured and raised with
traditional values inherent to the Gwich'in
Athabascan. And I urge you to fund a new school for
Arctic Village.
GALEN GILBERT stated that he is 16 years old and a junior at
Arctic Village High School. He informed the committee that the
school is over 40 years old and is in bad condition; it is
poorly insulated and therefore a lot of money is spent on fuel,
and the pipes freeze. There are 51 students K-12 at the school,
he explained, and they would really like a new school.
MS. ADAMS commented that she is also lobbying for improvements
to the Fort Yukon school gym, which is also 40 years old and has
been condemned. However the building is still used every day by
140 children because there is no other place for their physical
education class. She mentioned that the gym is number 29 on the
major improvement list.
3:28:50 PM
ROBERT WELLS, Member, Matanuska-Susitna School Board, expressed
appreciation to the committee for its effort to move the early
funding House Bill along and to the House Special Committee on
Education, which reported the bill from committee with an
increase. On February 2, the Mat-Su School Board went on record
as supporting a minimum base student allocation of $4,995, he
noted.
3:30:00 PM
CARL ROSE, Executive Director, Association of Alaska School
Boards (AASB), commented that the association has met and has
agreed upon a base student allocation of $4,995, which is about
$85 million total. He reiterated that many of the districts
have needs that exceed the $4,995, but they ask for this amount
as a minimum. He said, "This represents some discipline and ...
a responsible request. It sets an expectation for next year."
He referred to a graph that demonstrated that $46 million of $82
million last year went into construction and operation. He
remarked that while he appreciates the governor's proposal, it
only produces $24 million in terms of instruction and
operational funds, which represents a decline.
3:31:51 PM
JOHN ALCANTRA, Government Relations Director, National Education
Association of Alaska (NEA-Alaska), stated that NEA-Alaska
supports a base student allocation of $5,315 in order to address
the PERS and TRS situation as well as inflation. He noted that
class sizes in Anchorage are large, and that the schools need to
be funded beyond status quo. He said, "Any increases are
supported. Anchorage has a number of [$]5,120, Kenai has a
number of [$]5,200. ... Our number of [$]5,315 represents a real
down payment into the future of adequately funding our schools."
MR. ALCANTRA, in response to Representative Anderson, stated
that this would make a total of $147.8 million, which is about
$85 million above the governor's proposal and about $78 million
above the committee's working document. He pointed out that
every $5 increase to the base student allocation equals about $1
million total statewide.
3:35:47 PM
MERLE THOMPSON stated that he is from the Matanuska-Susitna
Valley and that he is not connected with the schools. He said:
I do realize that we have to fully fund the education
of our children. It's one of the most important
things that a society can do for itself and for its
kids. ... The level we're at now just doesn't get the
job done. I went through my particular area of the
Susitna Valley; I went to a number of the schools. A
library [I used] in high school is almost void of
books. It startled me. I had nearly as many in my
own personal library. ... I sat in on an elementary
school ... class and the teacher explained to me that
she had to buy the shelvings and bookcases to store
the supplies in there because there were no funds for
it. I heard a lot of lip-service during the campaign
about funding education but I think we need a little
less lip and a little more service, and I respectfully
ask that you up this number to where it's reasonable.
We have an unfunded mandate with No Child Left Behind;
it just doesn't make any sense. We can do a lot
better. According to 20/20 Alaska, we rank 50th in
the nation in the percentage of our state budget that
goes towards education. And I think that's pretty
pitiful.
3:37:49 PM
MACON ROBERTS, Member, Anchorage School Board, stated that the
Anchorage School Board passed a resolution supporting a base
student allocation of $5,120. He commented that the No Child
Left Behind mandate will require schools to spend more money
than last year. He also mentioned some of the unfunded mandates
for the students with special needs. He said, "I will not be
disappointed if you didn't make this figure that I'm
recommending, ... but I would be appreciative if you somehow ...
see fit to fund more than the [$]4,915."
3:41:05 PM
REPRESENTATIVE MCGUIRE asked Mr. Roberts to give the committee a
few examples of increased costs due to No Child Left Behind, and
also asked him to explain why Anchorage does not tax up to its
cap.
3:42:05 PM
MR. ROBERTS explained that due to No Child Left Behind, teachers
and teachers' assistants have additional expenses to become
"fully qualified" and the districts are paying for those
expenses. He mentioned the transportation of students to Title
One schools. He clarified that Title One schools are determined
by the income level of the families, particularly for those
students that are qualified for free lunches. He also pointed
out that in the coming years more students will be added and
therefore there will be more expenses.
MR. ROBERTS stated that the cap is set by the municipal charter
and even if public officials wanted to raise the tax cap they
wouldn't have the ability to do it. He commented that his
understanding was that there would have to be a municipality-
wide vote to change it.
3:46:01 PM
CHAIR WILSON closed public testimony.
3:46:19 PM
REPRESENTATIVE CISSNA moved to adopt Conceptual Amendment 1.
REPRESENTATIVE SEATON objected for discussion purposes.
3:47:14 PM
REPRESENTATIVE CISSNA explained that Conceptual Amendment 1
would delete the number $4,919 for the base student allocation
and replace it with $5,120. She remarked that $5,120 is nowhere
near high enough for many of the schools in Alaska, but it is a
reasonable number, and she considers it to be the minimum
number. She said that [the legislature] doesn't want to fail by
not investing enough in the students and schools.
3:49:47 PM
REPRESENTATIVE GARDNER endorsed Conceptual Amendment 1. She
reiterated an earlier witness who said that if the status quo
were adequate there would be no need for No Child Left Behind.
She said, "We need to get beyond status quo. We need to address
the issue of reducing class sizes and talk about, not how much
money we're going to spend, but what it costs to meet the needs
of the children in this state."
REPRESENTATIVE MCGUIRE stated that she does not support
Conceptual Amendment 1, but noted that "this bill has a long way
to go. ... Oftentimes it's very difficult when you're watching
one part of a legislative process to see that there are a lot of
pieces that fit together."
3:51:55 PM
REPRESENTATIVE ANDERSON commented:
At first blush, I support to $5,120 base student
allocation on the merits that it would increase
funding statewide, but as Representative McGuire
stated, this budget process is in progress and
forming, and we have the PERS and TRS issues, we have
so many other issues in concert with this that I think
this is the wrong time.... I think we need to keep
assessing this before we amend the bill and have more
dialogue and listen to exactly the accountability and
security measures for where the spending will be. But
I do agree that the amount ultimately will be raised
higher and it'll depend on what I think the finance
committee dictates and where they can secure funding
from. And I just don't think HHES is the place to
change that this early. So I won't support the
amendment of the bill.
3:55:02 PM
REPRESENTATIVE SEATON reiterated that he sees the need for
coordination between this and the geographic cost differential
study, and stated that he does not support Conceptual Amendment
1.
CHAIR WILSON, regarding Conceptual Amendment 1, said:
The numbers are wonderful and I don't argue with them
even, except that going through the process, we've got
the cost differential study, we've got the PERS and
TRS, we've got the eroding floor, we've got the debt
reimbursement. There's a lot that we have to deal
with yet and I don't want to jeopardize any of that.
A roll call vote was taken. Representatives Gardner and Cissna
voted in favor of Conceptual Amendment 1. Representatives
McGuire, Anderson, Seaton, and Wilson voted against it.
Therefore, Conceptual Amendment 1 failed by a vote of 2-4.
3:57:00 PM
REPRESENTATIVE MCGUIRE moved [to report CSHB 1, Version 24-
LS0001\I, Mischel, 2/15/05] from committee with individual
recommendations and attached fiscal notes. Representative
Gardner objected for purposes of discussion.
3:58:13 PM
REPRESENTATIVE GARDNER stated that she understood the urgency of
moving the bill and she understood the arguments of other items
that impact the ultimate base student allocation funding
decisions. She said that she had intended to introduce another
amendment but in the interest of time, she had decided not to do
so. She noted that she looks forward to a bill that would
eliminate the eroding floor, which is still hurting school
districts, she opined. She remarked that she hopes that
ultimately any education funding plan is not only adequate for
current needs of all classrooms, but also eliminates the eroding
floor.
REPRESENTATIVE CISSNA commented:
I'm going to vote in favor of this bill, but ... with
enormous trepidation and reservations because ... the
very schools that will suffer the most by ... not
making sure that we are at top dollar for these
schools, the schools that will be hurt the most are
the ones that ... are at most risk, are getting the
lowest scores in No Child Left Behind, have the
highest costs, and they're the ones that are being
hurt the most by present circumstances. So I'm going
to say yes with an enormous leap of faith that there
is going to be a huge effort to try to solve these
problems ... this year.
3:59:14 PM
REPRESENTATIVE MCGUIRE moved [to report CSHB 1, Version 24-
LS0001\I, Mischel, 2/15/05] from committee with individual
recommendations and attached fiscal notes. There being no
objection, CSHB 1(HES) was reported from the House Health,
Education and Social Services Standing Committee.
HB 30 - APPROP: K-12 EDU OPERATING/DEBT EXPENSES
CHAIR WILSON announced that the next order of business would be
HOUSE BILL NO. 30, "An Act making appropriations for K-12
education operating and school debt expenses; and providing for
an effective date."
4:00:07 PM
REPRESENTATIVE SEATON moved [to adopt CSHB 30, Version 24-
LS0193\I, Utermohle, 2/15/05 as the working document]. There
being no objection, Version I was before the committee.
TOM WRIGHT, Staff to Representative John Harris, Alaska State
Legislature, testified on behalf of Representative Harris, the
sponsor of the bill. He explained that CSHB 30 is the
appropriation bill that goes along with CSHB 1; it funds the
foundation program and boarding home grants. He added that
contingency language is included in the bill based on the
passage of legislation to increase the base student allocation
to $4,919. He noted that the bill also includes $86.4 million
for school bond debt reimbursement.
4:01:30 PM
CHAIR WILSON opened public testimony.
4:02:58 PM
CHAIR WILSON [closed public testimony].
REPRESENTATIVE ANDERSON moved to report CSHB 30(EDU), Version
24-LS0193\F from committee with individual recommendations.
4:03:21 PM
REPRESENTATIVE SEATON objected for discussion purposes. He
asked for clarification as to whether Representative Anderson
had actually intended to move CSHB 30(EDU) Version F.
REPRESENTATIVE ANDERSON clarified that he wished to move CSHB
30, Version 24-LS0193\I, Utermohle, 2/15.05 with individual
recommendations.
4:03:39 PM
REPRESENTATIVE SEATON objected for discussion purposes. He said
that he appreciates the fact that the foundation formula as well
as pupil transportation, special schools, and the other items in
K-12 education; he remarked that it's good that the committee is
moving forward with all of these subjects together so that there
are no holes left in the K-12 budget. He then removed his
objection.
4:04:20 PM
CHAIR WILSON stated that there being no objection, CSHB 30(HES)
was reported from the House Health, Education and Social
Services Standing Committee.
HB 85 - PRESCRIBED MEDICATION FOR STUDENTS
4:05:10 PM
CHAIR WILSON announced that the final order of business would be
HOUSE BILL NO. 85, "An Act relating to self-administration and
documentation of certain types of medication prescribed to a
child attending school."
REPRESENTATIVE KEVIN MEYER, Alaska State Legislature, testified
as sponsor of HB 85. He pointed out that an estimated 9.2
million children in the U.S. have asthma, and they sometimes
experience symptoms or asthma attacks while in school. He noted
that students miss about 14 million days of school each year
because of this disease. With the attendance requirements in
the No Child Left Behind Act, he noted that asthma and allergy-
related absences can have a significant impact on the child's
performance in school. He said that a recent survey of school
nurses indicated that asthma was more disruptive of school
routines than any other chronic condition.
REPRESENTATIVE MEYER stated that several children have died in
school from asthma or allergic reactions that could have been
prevented if the students had their inhalers with them. To
address this issue, Congress passed the Asthmatic School
Children's' Treatment and Health Management Act in 2004, he
explained, and federal law requires the Secretary of Health and
Human Services to give preference in awarding grants to the
states that allow students to self-administer asthma medication,
and many states have taken advantage of this.
REPRESENTATIVE MEYER said that the bill also protects the
schools, the parents, and the children with two essential
provisions. He stated that the first provision allows children
with a parent or guardian and health care provider's
certification to self-administer the medication to treat asthma
or other threatening allergies. The school must allow self-
administration if the school receives written authorization from
the parent or guardian, written certification from the student's
health care provider that the student has the health condition
and has received instruction on how to properly use the
medication and is able to self-administer the medication. He
remarked that by making the health care provider provide written
certification of the student's capability to self-administer,
there is insurance that the child is so capable.
REPRESENTATIVE MEYER continued:
It puts the decision ... squarely on the shoulders of
the parents and the doctors, and not on the schools.
... The second [provision is that] ... the decision to
allow the child to self-administer in schools is put
on the parents and the health care providers; it
removes the schools from any civil liability.... While
HB 85 helps Alaska qualify for these federal grants I
mentioned earlier, the real purpose behind this bill
is to give parents, doctors, and schools the ability
to ensure that our children are safe as they possibly
can be at school.
REPRESENTATIVE MEYER mentioned that he had heard from a lot of
doctors, school nurses, parents, and advocacy groups about the
importance of the bill.
4:10:05 PM
REPRESENTATIVE SEATON pointed out that "life-threatening
illness" is used in Section 1, page 1, lines 8 and 14, and
compared this with Section 1, page 2, line 13 which mentions
inhalers and autoinjectable epinephrine. He asked if these two
medications would be the only ones allowed in the classification
of other potentially life-threatening illnesses; he commented
that this might be too restrictive for such a broad
classification.
MICHAEL PAWLOWSKI, Staff to Representative Meyer, Alaska State
Legislature, explained that the language of the bill was based
on a similar bill that was passed in Hawaii. He said:
Part of it was to give leeway to new and developing
medications, and to cover illnesses that carry similar
thresholds of a life-threatening illness, and so they
were included in the bill. ... Because [the bill is]
being generic with "life-threatening illness," the
statute didn't go into detail on every potential
different type of medication you might be able to
carry. That might be left to regulation and
discussion.
CHAIR WILSON clarified that the epinephrine is usually called an
EpiPen and is portable. She gave an example: if someone who is
allergic to bees is stung by a bee, it is possible that the
anaphylactic shock would start so quickly that it could close
off the airway and the child would not be able to breathe and
could die.
4:13:16 PM
CHAIR WILSON, in response to Representative Gardner, stated that
an EpiPen would also be useful in the case of a child with
severe food allergies.
REPRESENTATIVE GARDNER concluded that the term "autoinjectable
epinephrine" applies to a variety of substance reactions.
REPRESENTATIVE SEATON stated that he is concerned that the
language in Section 1, page 2, line 13 would restrict the type
of medication so that if a child had a life-threatening illness
and needed to take pills that were prescribed by the doctor,
they won't be able to carry the pills under this bill because
the bill only allows for the inhaler and the autoinjectable
epinephrine.
4:15:08 PM
REPRESENTATIVE MEYER responded that inhalers and autoinjectable
epinephrine are listed in the bill because they have an
immediate effect, whereas pills take some time to have an
effect.
REPRESENTATIVE MCGUIRE remarked, "It ... gets to the point of
absurdity that we have to introduce legislation to do this. ...
This is a life-saving use of an inhaler and an EpiPen..., and
it's obviously the result of litigation." Representative
McGuire pointed to Section 1, page 2, line 3: "is able to self-
administer the medication safely." She said that her concern is
that it might give rise to litigation in a way that no one
anticipated. She said that the language in the federal law
states "the student has demonstrated to the health care
practitioner or the practitioner's designee the skill level
necessary to use this medication and any device that is
necessary to administer such medication."
CHAIR WILSON commented that the bill will also go through the
House Judiciary Standing Committee.
REPRESENTATIVE MCGUIRE remarked that Section 1, page 2, line 15,
may be misinterpreted to exclude other misuses.
4:18:35 PM
REPRESENTATIVE GARDNER pointed out that the committee has
written testimony from Patricia Senner from the Alaska Nurses
Association, and she read the following from it:
It might be advisable to add a section to the bill
that would allow the school district to require a
student to provide a back-up inhaler to be left in the
office.
REPRESENTATIVE GARDNER asked if it was necessary to add that as
an amendment to the bill to require it, because it can be done
without it being part of the legislation.
REPRESENTATIVE MEYER replied that it wouldn't hurt to add it to
the bill.
CHAIR WILSON commented that there is a cost involved; some
people may only be able to afford one.
REPRESENTATIVE GARDNER agreed and said that in mild conditions
one inhaler may be adequate.
4:20:27 PM
REPRESENTATIVE SEATON asked if there is a part in the bill that
requires the doctor to notify the school about the type of
medication the child will be self-administering.
MR. PAWLOWSKI said, "I don't believe there is a specificity on
the exact medication ... within the bill."
REPRESENTATIVE SEATON said that the sponsor might want to
consider adding a notification to the school so that everyone
knows what medication the doctor is prescribing and allowing to
be self-administered.
REPRESENTATIVE MCGUIRE said that in the federal act there are
two additional requirements; the health care provider formulates
a written treatment plan for managing asthma and anaphylaxis
episodes for the student and the medication during school hours.
[She would like to add this into HB 85 as an Amendment.] The
second amendment she offered would be that the student's parent
or guardian must complete and submit to the school any written
documentation that is required by the school.
4:23:04 PM
CHAIR WILSON asked that Representative McGuire identify where
she is finding this information.
REPRESENTATIVE MCGUIRE clarified that this information is from
H.R. 2023 from the 108TH Congress 2D Session.
4:23:36 PM
REPRESENTATIVE MCGUIRE moved to adopt Conceptual Amendment 1 to
HB 85 to have the bill language comport with the federal
language. She explained the amendment:
New [subparagraph] (C), we would delete out, "is able
to self-administer the medication safely", and insert,
"has demonstrated to the health care provider the
skill necessary to use the medication in any device
that is necessary to administer such medication as
prescribed." ... (D) would be, "the health care
practitioner formulates a written treatment plan for
managing asthma or anaphylaxis episodes of the
student, and for medication use by the student during
the school hours." And subsection (e) would be, "the
student's parent or guardian has completed and
submitted to the school any written documentation
required by the school" ... "including the treatment
plan formulated under" ... "Section D and other
documents."
4:25:14 PM
CHAIR WILSON asked if there were any objections. There being no
objection, [Conceptual Amendment 1] was adopted.
4:26:45 PM
MARGE LARSON, Program Director, American Lung Association of
Alaska, stated that she was testifying on behalf of the Alaska
Asthma Coalition. She said:
Asthma is on the rise and we don't know why. No one knows
for sure what causes asthma and there's no known cure, and
an asthma attack at any age can be fatal. Data indicate
that pediatric asthma has increased by 40 percent over the
last four years. And we know asthma is the leading cause
of missed school days, negatively impacting academic
performance. Asthma is a disease that when triggered,
restricts the airways to the lungs, making it difficult to
breathe. And ... when you can't breathe, nothing else
matters. The Center for Disease Control and Prevention
(CDC) Asthma Control Program recommends that states build
and sustain statewide asthma coalitions as an effective
strategy to address this growing public health issue.
Under CDC guidance and with funding from a congressional
earmark, American Lung Association of Alaska spearheaded
the generation of the Alaska Asthma Coalition a year ago.
The long-term goals of the Alaska Asthma Coalition are to
reduce morbidity and mortality, control the cost of care,
and improve the quality of life for Alaskan patients and
families affected by asthma. With members across Alaska
and in partnership with the Department of Public Health,
the coalition is developing a state plan to address asthma,
including scientific interventions, both clinically and
environmentally based, as well as surveillance, public
provider and patient education, and asthma-friendly policy
changes.
MS. LARSON continued:
In 2004, ... Congress passed legislation encouraging the
states to enact asthma-friendly laws allowing students to
carry asthma inhalers and EpiPens. Asthma cannot be cured
but it can be controlled. There are safe medications
available and simple steps people can take to reduce their
exposure to environmental asthma triggers. But rescue
inhalers for immediate relief of asthma symptoms will
continue to be a life-saving, critical part of asthma
management. Consistent with patient asthma education, at
Asthma Camp we teach children as young as seven to carry
their rescue medications at all times, and we give them a
fanny pack to carry them in.... However, right now not all
Alaskan students can follow that advice at the place where
they spend a great deal of their time: at school. HB 85 is
supported by the Association of Alaska School Boards, the
Alaska Nurses Association, the Allergy and Asthma Network,
Mothers' of Asthmatics, the National Association of School
Nurses, the Alaska Chapter of American Academy of
Pediatrics, the Asthma and Allergy Foundation of America
Alaska Chapter, and the American Lung Association of
Alaska, in addition to the Alaska Asthma Coalition.
4:30:04 PM
REPRESENTATIVE SEATON asked if there are any other medications
that Ms. Larson thought should be incorporated into the bill.
MS. LARSON deferred to the chair of the Alaska Asthma Coalition,
who is a pediatrician.
4:31:08 PM
GAIL WHITE, School Nurse, commented that HB 85 is a great bill.
She noted, "(Medication) only works when the children have
remembered to bring their inhaler and their epinephrine
EpiPens." She also remarked that the committee should consider
how a child can be protected in a situation where the child has
lost the inhaler when it is needed. She emphasized that it is
important for children to have a backup inhaler in the nurse's
office, and mentioned the idea of legislation allowing a school
nurse to keep a general albuterol rescue inhaler in the office
for use by any child who is a known asthmatic who has permission
to carry an inhaler, but who may have lost or forgotten it.
MS. WHITE, in response to CHAIR WILSON, noted that in the
Anchorage School District students are currently allowed to
carry EpiPens and inhalers with parental and health care
provider authorization. She stated that in the 1998-1999 school
year in the Anchorage School District there were 57 students
with EpiPens at school. In the 2003-2004 school year there were
338 students with EpiPens at school.
MS. WHITE commented that she read a study showing that, for
children who had experienced anaphylactic reactions, the
children are more likely to die at school because a reaction was
not recognized quickly.
4:36:07 PM
REPRESENTATIVE SEATON asked if the designation of inhalers and
EpiPens fully covers the variety of treatments that a doctor
might want a student to self-administer. He asked if diabetes
injections or any other medications should also be covered under
this bill.
MS. WHITE stated that she thinks all students who have EpiPens
at school also should have oral Benadryl at school because some
allergic reactions are strictly skin reactions or rashes. She
noted that a diabetes injection can only be given by a nurse.
4:39:09 PM
RICHARD MANDSAGER, M.D., Director, Division of Public Health,
Alaska Department of Health and Social Services, stated that
this is a very important issue. He commented that when he
worked as a pediatrician in Anchorage, he saw about 125 patients
with asthma and he was thankful that the children were able to
carry their medications to school. He said:
I have suggested that if this bill passes, that one of
the ways the Division of Public Health could help is
that the forms that have been developed between the
asthma groups in Anchorage and the school nurses in
the Anchorage School District and the pediatricians
could be modified for statewide use and could ... be
hosted on the website, potentially, and other school
districts could then use them. For example, in
Anchorage we've been using something called an Asthma
Action Plan that goes to the school nurse at the
beginning of the year that lists all the medicines a
child is on, which ones that it's recommended they be
able to self-administer, which ones the school nurse
should keep. ... The school nurse knows what medicines
the child is on, in addition to the ones they're self-
administering. ... Our goal for kids with asthma
should be zero days lost from school due to asthma. I
think the medicines are good enough, and that with
education of kids and parents in avoiding
environmental triggers as much as possible, that ought
to be our goal.
DR. MANDSAGER remarked that he thinks this bill is a substantial
improvement over the status quo. He stated:
The other thing I think this is important for is
helping kids more toward self-management. This isn't
a disease that is likely going to go away; they need
to learn how to take care of this illness, and as they
move through their school years, to learn to take care
of it [themselves]. This is an important part of
their self-management skills. The age ... is
variable; some kids very young, some kids as seventh
graders ... it's an individual decision. Finally ...
I do think that diabetes is an example of a
potentially life-threatening illness. Insulin
management today, kids, especially high school kids,
are self-administering; some of them are turning
pumps, where they have a needle in all the time.
Others are self-administering insulin every four
hours. ... That's the only other example I can think
of ... where immediate treatment is necessary.
REPRESENTATIVE SEATON asked if the addition of insulin injection
device to the bill would cover the diabetes cases.
DR. MANDSAGER answered that this is correct.
4:43:22 PM
CHAIR WILSON remarked that the bill language should cover
students who attend schools without school nurses as well.
DR. MANDSAGER commented that his understanding is that the
Department of Education also supports this bill.
4:44:11 PM
THAD WOODARD, M.D., President, Asthma and Allergy Foundation of
America, and the Alaska Asthma Coalition, stated that he has
been a practicing pediatrician in Anchorage for over 20 years.
He said, "I can only echo what's been said to this point.
Everybody is right on except for some of the details that ...
you're working on." He also remarked, "The amendment that was
recommended makes infinite sense to me so that there is some
very clear guidelines on what medications are being discussion."
He pointed out that any time medications are being discussed the
risks need to be evaluated; there are some hazards with kids
being able to self-administer. However he said that it's far
riskier to not have the medication available.
DR. WOODARD pointed out that self-administering insulin is far
more dangerous than the inhalers and EpiPens. He commented that
he cannot think of any other types of medication used in a life-
threatening situation other than insulin. He said that a full
definition of a life-threatening illness may need to be spelled
out in the bill. He recommended that the bill be passed.
4:47:40 PM
REPRESENTATIVE ANDERSON mentioned that after an epileptic fit
medication needs to be administered to the patient.
DR. WOODWARD replied that those medications would not be self-
administered.
REPRESENTATIVE ANDERSON commented on the idea of full coverage,
where the school nurse holds a second EpiPen or inhalers. He
asked if perhaps that type of policy should be left to the
school boards.
DR. WOODARD noted that 10 to 15 percent of anaphylactic
reactions will start up again 15 minutes to two hours later.
Therefore having the ability to evacuate the child to a safer
situation or to have the ability to administer epinephrine a
second time would be very important. He commented that he
wasn't sure if the school district should supply the back-up
medications or if the parents should be responsible for it.
4:50:00 PM
REPRESENTATIVE GARDNER stated that if the committee were to
incorporate the parts of the federal law regarding a written
treatment plan, that could include the follow up for those
conditions in which the child might have a second episode.
4:51:04 PM
REPRESENTATIVE SEATON, referring to testimony, asked Dr. Woodard
if Benadryl should be kept in the nurse's office or if it should
be included in the bill.
DR. WOODARD answered that keeping Benadryl in the nurse's office
would be [sufficient].
4:51:40 PM
JANIS BATES, Supervisor of School Nurses, Anchorage School
District noted that she is also the Director of Health Services,
a board member for AFFA [ph] Alaska, and on the Asthma
Coalition. She stated that she supported the bill, however she
did not think that insulin should be included in the bill. She
recommended that the phrase "or other life-threatening
conditions" should be removed from the bill. She said:
What you're talking about with asthma is a metered-
dose inhaler; there's no measurement involved. When
you're talking about an EpiPen, you're talking about
an autoinjector; there's no measurement involved.
With a dosage of insulin you're talking about a
specific skill where a child has to draw back on a
syringe, has to draw back a specific number of units
to be able to inject the insulin. ... When you use ...
an insulin pump there are carbohydrates that are
calculated based on the food intake. There's usually
some counseling with the parent about what was eaten
earlier. The nurse also works with the carb count
with the child, and then a specific dosage is
administered with the pump with insulin. So I do not
feel that insulin and diabetes belong in this bill. I
think that we can deal with that by simply taking out,
"or other potentially life-threatening conditions" and
deal with this bill from the perspective of why it was
introduced; it was introduced for asthma and for
anaphylaxis, two conditions where we have rescue
medications that are readily available in the
marketplaces and that children can be taught to self-
administer. Yes, children can be taught to self-
administer insulin, but that's after lots of
counseling and lots of teaching ... and it requires a
lot more skill. It is a lot more dangerous if it's
injected into someone else. I really believe that the
bill as it's written for asthma and anaphylaxis is
appropriate. Adding other medications such as insulin
I don't think is appropriate. I'm also in total
support of the written treatment plan and the parent
or the guardian submitting the documentation. I also
like the idea of the demonstrated skill to the
provider....
MS. BATES continued:
One of the things that I think is really important in
looking at this bill is teaching the child that they
need to tell someone when they've used their
medication. In a breathing or an allergy emergency
... they made need to use the inhaler again, sometimes
in 20 minutes. Same thing with an EpiPen. ... In the
Anchorage School District we do currently allow
students to self-administer inhalers and medications
for anaphylaxis. The reason that there still is a
need for the bill is that we're dealing with a
community of educators that is not trained in medicine
and oftentimes as part of the authoritative role, a
principal may say that all students have to bring the
medication to the office, not knowing the nuances of
the fact that Section 504 of the Rehabilitation Act of
1973 allows children to be able to carry medications
that may assist them in school. And by having this
bill it will take away some of the gray area where an
administrator may impose a school site-based policy on
a family, which resulted in the death of a child in
California when there was an unwritten policy that ...
the children could carry an inhaler there, and this
eleven year old boy, his mother didn't know it and he
ended up dying. ... In settlement the school district
paid $2.2 million for that mistake, and I'm sure that
every parent is notified now that children can carry
inhalers. I also read about another situation in the
state of Washington where a child had both asthma and
anaphylaxis to peanuts. And the child was on a field
trip. Both of the medications were on the field trip
but the child was only treated for the asthma; he died
from the anaphylaxis, which really speaks to the
importance of ... training children, training
teachers, training people about what to look for.
There are a lot of skills that are involved in
identification of an emergency problem and some people
may know some of the information. Getting children to
wear identification bracelets is important and ... we
could have that as part of the bill to make it safer
for children. ... Students with asthma or other airway
constricting diseases need to be able to self-
administer their medication upon approval of their
parents and the prescribing physician. These are
potentially life-saving medications for students. I
don't recommend adding any other medications to the
bill.
4:58:17 PM
DR. MANDSAGER, in response to Representative Seaton, recommended
that the bill should be limited to asthma and anaphylaxis.
MS. WHITE commented that not even registered nurses are allowed
to administer insulin without the dosage being confirmed by a
colleague. She added that the Massachusetts Department of
Education has a document called, "Managing Life-Threatening Food
Allergies in School," which she said is excellent and accessible
on the internet.
5:01:21 PM
REPRESENTATIVE SEATON moved to [adopt Conceptual Amendment 2],
which he explained as follows:
Strike ", or other potentially life-threatening
illnesses" on page 1, line 8, and also ", or
potentially life-threatening illnesses" lines 13 and
14 on page 1.
There being no objection, [Conceptual Amendment 2 was adopted].
REPRESENTATIVE GARDNER noted that on lines 7 and 13 the comma
after "asthma" would need to be removed.
REPRESENTATIVE ANDERSON pointed out that legal services would
take care of this since it is a conceptual amendment.
REPRESENTATIVE MCGUIRE asked Representative Meyer to consider
language that would include an amendment to reflect the
testimony regarding standing orders from families to be kept on
file with school nurses. These standing orders would allow for
the inhalers or injections to be administered in the event that
a child forgets the medication at home. She also stated that
she would like to hear if the school nurses think anything else
should be addressed "in the area of liability and exposure that
they face."
CHAIR WILSON reminded the committee that not all schools have
school nurses.
5:04:59 PM
REPRESENTATIVE SEATON moved to report HB 85 as amended out of
committee with individual recommendations and the accompanying
fiscal note. There being no objection, CSHB 85(HES) was
reported from the House Health, Education and Social Services
Standing Committee.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:05:33 PM.
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