02/09/2010 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Presentation by the Mat-su Substance Abuse Prevention Coalition. | |
| HJR35 | |
| HB168 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HJR 35 | TELECONFERENCED | |
| += | HB 168 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 9, 2010
3:08 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative Tammie Wilson, Vice Chair
Representative Bob Lynn
Representative Paul Seaton
Representative Sharon Cissna
Representative Lindsey Holmes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
PRESENTATION BY THE MAT-SU SUBSTANCE ABUSE PREVENTION COALITION.
- HEARD
HOUSE JOINT RESOLUTION NO. 35
Proposing amendments to the Constitution of the State of Alaska
prohibiting passage of laws that interfere with direct payments
for health care services and the right to purchase health care
insurance from a privately owned company, and that compel a
person to participate in a health care system.
- HEARD & HELD
HOUSE BILL NO. 168
"An Act relating to state certification and designation of
trauma centers; creating the uncompensated trauma care fund to
offset uncompensated trauma care provided at certified and
designated trauma centers; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HJR 35
SHORT TITLE: CONST AM: HEALTH CARE
SPONSOR(s): REPRESENTATIVE(s) KELLY, KELLER, P.WILSON, GATTO
01/08/10 (H) PREFILE RELEASED 1/8/10
01/19/10 (H) READ THE FIRST TIME - REFERRALS
01/19/10 (H) HSS, JUD, FIN
02/09/10 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 168
SHORT TITLE: TRAUMA CARE CENTERS/FUND
SPONSOR(s): REPRESENTATIVE(s) COGHILL
03/09/09 (H) READ THE FIRST TIME - REFERRALS
03/09/09 (H) HSS, FIN
04/09/09 (H) HSS AT 3:00 PM CAPITOL 106
04/09/09 (H) Heard & Held
04/09/09 (H) MINUTE(HSS)
02/09/10 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
ELIZABETH RIPLEY, Executive Director
Mat-Su Health Foundation;
Chair, Mat-Su Substance Abuse Prevention Coalition
Wasilla, Alaska
POSITION STATEMENT: Presented a PowerPoint and answered
questions about substance abuse in the Matanuska-Susitna
Borough.
STEPHANIE ALLEN, Executive Director
United Way of Mat-Su
Palmer, Alaska
POSITION STATEMENT: Testified and answered questions during the
presentation.
NICOLE JEFFRIES, Student
Wasilla High School
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
ROBYN HILLMAN, Student
Wasilla High School
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
JESSICA TRUMAINE, Student
Valley Pathways School
Sutton, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
HANNAH SMITH, Student
Wasilla High School
Palmer, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
PATRICK GONZER, Student
Wasilla High School
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
DEB HAYNES, Teacher
Wasilla High School
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
DESIREE COMPTON
United Way of Mat-Su
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions about the
Mat-Su Substance Abuse Prevention Coalition and the Alaska
Healthy Kids Survey.
REPRESENTATIVE MIKE KELLY
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As the prime sponsor, presented and
answered questions for HJR 35.
MIKE PRAX
North Pole, Alaska
POSITION STATEMENT: Testified in support of HJR 35.
PEGGY ANN MCCONNOCHIE
National Federation of Independent Business (NFIB)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HJR 35.
CHRISTIE HERRERA, Director
Health and Human Services Task Force
American Legislative Exchange Council (ALEC)
Washington, DC
POSITION STATEMENT: Testified and answered questions in support
of HJR 35.
SENATOR JOHN COGHILL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions as the
prime sponsor of HB 168.
DAVID HULL, Chair
Alaska Council on Emergency Medical Services (ACEMS)
Ketchikan, Alaska
POSITION STATEMENT: Testified in support of HB 168.
DR. FRANK SACCO, Trauma Director
Alaska Native Medical Center;
Chair
Alaska State Trauma Systems Review Committee
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 168.
DR. REGINA CHENNAULT, Chair
American College of Surgeons Committee on Trauma
Alaska Trauma System Review Committee
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 168.
MARK JOHNSON
Alaska Trauma System Review Committee
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 168.
WARD HURLBURT, Chief Medical Officer;
Director
Division of Public Health
Office of the Commissioner
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of HB 168.
ACTION NARRATIVE
3:08:23 PM
CO-CHAIR BOB HERRON called the House Health and Social Services
Standing Committee meeting to order at 3:08 p.m.
Representatives Herron, Keller, T. Wilson, and Cissna were
present at the call to order. Representatives Lynn, Seaton, and
Holmes arrived as the meeting was in progress.
^Presentation by the Mat-Su substance abuse prevention
coalition.
Presentation by the Mat-Su substance abuse prevention coalition.
3:08:44 PM
CO-CHAIR HERRON announced that the first order of business would
be a presentation by the Mat-Su Substance Abuse Prevention
Coalition.
3:10:27 PM
CO-CHAIR KELLER introduced the coalition.
3:11:27 PM
ELIZABETH RIPLEY, Executive Director, Mat-Su Health Foundation;
Chair, Mat-Su Substance Abuse Prevention Coalition, said that
substance abuse impacts every sector of our community and our
economy. She pointed to the economic and emotional toll on
families and individuals, and declared that the cost was
staggering. She directed attention to each of the coalition
members and the various reasons for their involvement. The
attending members included Nicole Jeffries, Robyn Hillman,
Jessica Trumain, Hannah Smith, Patrick Gonzer, Desire Compton,
Deb Haynes, and Gretchen Geist, and each shared their reason for
becoming involved with the Coalition.
3:16:27 PM
MS. RIPLEY endorsed that a key to breaking the cycle of
substance abuse was to engage youth, and she commended each of
the people who contributed to make this presentation. She
directed attention to the PowerPoint, "Mat-Su Substance Abuse
Prevention Coalition Data Project." [Included in the committee
packet.]
3:16:52 PM
MS. RIPLEY described slide 1, "Mission," and declared that the
focus was on youth in the local community.
3:17:13 PM
MS. RIPLEY introduced slide 2, "Overview" and slide 3, "Brief
History," and detailed the history of the coalition. She shared
that United Way of America had tasked the local United Way
groups to become community impact organizations. She further
explained that the model of engagement was to determine "what
hurts your community, or what changes could you make at your
local level that you could measure progress in to effect change
in quality of life." She stated that this affected every member
agency of United Way. She reported that the first step had been
to meet with the local behavioral health providers where it was
agreed that the problem had to be addressed at the community
level to have any impact. She reported that, after this
meeting, a substance abuse summit was held in December, 2006,
and four goals were set: form a coalition using tobacco use
cessation as a model, be data driven for measureable progress,
coordinate a community response, and provide leadership at the
state level.
3:22:26 PM
MS. RIPLEY moved to slide 4, "Method," and reported that the
council had reviewed the existing data on substance abuse in
Mat-Su; as very little data existed, a five year retrospective
study of local data was commissioned, with input from the local
providers to determine meaningful data. She stated that the
Youth Risk Behavior Survey (YRBS) data from 2005-06 reflected an
insufficient sample size. She shared the importance of the new
data survey, both as a benchmark and a measurement of progress.
She remarked that the group commissioned its own survey, "The
Alaska Healthy Kids Survey," (AHKS) and tested it to be
culturally appropriate and valid as a survey tool. She
clarified that it was financed by the Mat-Su Health Foundation,
with no federal or state funds.
3:24:29 PM
STEPHANIE ALLEN, Executive Director, United Way of Mat-Su,
recognized slide 5 "Alaska Healthy Kids Survey," and explained
each of the survey components, which included demographic
information, and information on the behaviors and attitudes of
substance abuse. She noted the segments on alcohol, tobacco,
drug use, violence, harassment, safety, and crime. She talked
about the External Assets component which examined resilience
factors, protective factors, and positive assets associated with
a decrease in risky behaviors. She presented slide 6, "Survey
Demographics," and shared that the survey was administered to
all seventh, ninth, and eleventh graders throughout the school
district, which included Christian schools, home schools, and
homeless and at-risk youth. She detailed that 2435 of the 4000
surveys, 61 percent, were valid responses.
MS. ALLEN, in response to Co-Chair Herron, said that the YRBS
survey was very broad and included questions about health,
exercise, sexual activity, and substance abuse behaviors. She
explained that this survey focused on substance abuse and youth
use.
3:27:19 PM
MS. ALLEN noted that slide 7,"Demographics," was a demographic
breakdown of the students' surveyed.
3:27:30 PM
MS. RIPLEY, in response to Representative Seaton, said that the
demographics did correlate to the Mat-Su families with youth,
but was slightly different than the community as a whole.
MS. ALLEN considered slide 8, "Results," and reported that after
receiving the data, the Coalition met with stakeholder groups,
enlisted feedback from more than 130 community members, and
developed the priorities for a strategic plan. She turned the
presentation over to the youth leaders.
3:29:16 PM
CO-CHAIR HERRON asked that each presenter detail "what surprised
them and what did not surprise them."
3:29:41 PM
NICOLE JEFFRIES, Student, Wasilla High School, explained the
slide format: the question at the top, its definition in the
middle, and the results from middle and high school students at
the bottom. She referred to slide 9, "Meaningful participation
from adults in the community," and listed the definitions to
each included involvement outside the home and school: with
personal interests, with group activities, and/or with helping
other people. She shared that only 20 percent of middle school
students and 18 percent of high school students felt involvement
with adults in the community.
MS. JEFFRIES moved to slide 10, "Meaningful participation with
adults at home," which included doing fun things with parents,
doing things at home that made a difference, and making
decisions with the family. She reported that only 25 percent of
middle school students and 21 percent of high school students
felt involved with adults at home.
3:31:15 PM
MS. JEFFRIES provided slide 11, "Meaningful participation with
adults at school," which included doing interesting activities,
deciding things like class activities and rules, and doing
things at school that make a difference. She disclosed that
only 6.4 percent of middle school and 5.5 percent of high school
students felt engaged with adults at school.
3:31:43 PM
MS. JEFFRIES furnished slide 12, "Recommendation 1," and noted
that data suggested youth turn to substances because of boredom.
She recommended that providing meaningful relationships with
youth would result in their stronger resilience to challenges.
3:32:14 PM
ROBYN HILLMAN, Student, Wasilla High School, supplied slide 13,
"Are parents talking to their kids about substance use?" and
ascertained from the pie graph that 36 percent of middle school
and 42 percent of high school students did not talk with their
parents about substance use.
3:32:39 PM
MS. HILLMAN reviewed slide 14, "What age do our youth start
using?" and slide 15, "Age at first use," and noted the
comparative use of alcohol, cigarettes, smokeless tobacco,
marijuana, and other illegal drugs by youth ages 10 and under,
14 and under, and 15 - 18.
3:33:21 PM
MS. HILLMAN introduced slide 16, slide 17, and slide 18, all
entitled "Parent Perception of Use." The slides reflected the
response to asking how parents would feel about drinking
regularly, smoking cigarettes, or smoking marijuana. She
acknowledged that one parent could supply many students with
cigarettes, alcohol, or marijuana. She pointed out that
prevention needed to begin in the elementary schools.
3:34:33 PM
MS. HILLMAN continued on to slide 19, "Recommendation 2," which
suggested to "Increase parental involvement in prevention and
early intervention measures in the Mat-Su Community."
3:34:54 PM
JESSICA TRUMAINE, Student, Valley Pathways School, explained
slides 20 - 22, all entitled "Are substances difficult to get?"
and discussed the access to tobacco, alcohol, and marijuana.
She referred to the pie graphs on each slide, and noted that 54
percent of youth surveyed deemed tobacco easy to obtain, 56
percent deemed alcohol easy to obtain, and 47 percent stated
marijuana was easy to obtain.
3:36:09 PM
MS. TRUMAINE shared that slide 23, "Recommendation 3," was to
reduce the access to these substances. She related that Mat-Su
youth were using a variety of substances and the majority of
students reported that alcohol, tobacco, and marijuana were easy
to obtain.
3:36:43 PM
HANNAH SMITH, Student, Wasilla High School, directed attention
to slide 24, "Data comparisons," and explained that the next
series of slides would show graphs comparing data of tobacco,
alcohol, and marijuana use from three separate surveys: Alaska
Healthy Kids Survey (AHKS), Monitoring the Future (MTF), and
Youth Risk Behavior Survey (YRBS). She summarized slide 26,
"Tobacco Lifetime Cigarette Use," slide 27, "Tobacco 30 Day
Cigarette Use," slide 28, "Tobacco Lifetime Smokeless Tobacco
Use," and slide 29, "Tobacco 30 Day Smokeless Tobacco [Use]."
She pointed out that each graph illustrated the percentage of
use by study and by school grade.
MS. SMITH, in response to Representative Seaton, explained that
MTF was a national survey, but was not conducted in Alaska.
MS. SMITH, referring to slide 28, opined that "we have a very
large issue with smokeless tobacco." She pointed out that high
school use of smokeless tobacco in the Mat-Su community was
higher than in the nation. She offered her belief that young
students were using smokeless tobacco and that "if we wait, we
are missing the train, we are completely missing them if we wait
until middle school and high school to talk to them, they are
already doing it, they have already tried it."
MS. TRUMAINE, in response to Co-Chair Herron, said that the
substances, especially alcohol and cigarettes, were in the homes
and easy to get. She said that older friends were also able to
provide these.
MS. SMITH added that prescription pills are often easily
accessible in home medicine cabinets.
MS. SMITH, in response to Co-Chair Herron, said that tobacco use
was "not a big deal." She disclosed that only a handful of kids
felt that tobacco was not good for you, and strongly advocated
against the use.
3:44:23 PM
REPRESENTATIVE LYNN asked if both use and increase was equal for
both sexes.
MS. SMITH replied that she would supply that data.
3:45:17 PM
PATRICK GONZER, Student, Wasilla High School, introduced slide
30, "Alcohol," listing the negative effects of alcohol which
included impaired judgment, liver disease, cancer, and
dependence. He summarized slide 31, "Alcohol Lifetime Alcohol
Use," slide 32, "Alcohol 30 Day Alcohol Use," and slide 33,
"Alcohol 30 Day Binge Drinking." He directed attention to the
AHKS survey, and noted that 68 percent of his peers drink
alcohol. He expressed his surprise to the high percentage of
alcohol use among seventh graders. He described binge drinking
as "the typical party scene" and shared that the survey defined
it as five or more drinks in one sitting.
3:47:15 PM
MR. GONZER discussed slide 34, "Marijuana," and noted the
negative effects to be impaired judgment, problems with
intellectual functioning, and a greater risk of lung infections.
He indicated slide 35, "Lifetime Marijuana Use," and slide 36,
"30 Day Marijuana Use," and expressed his concern that 46
percent of his peers had used marijuana. He ascertained that
almost 18 percent of seventh and ninth graders had used
marijuana.
3:48:24 PM
MR. GONZER, in response to Co-Chair Herron, declared that more
than 2400 students at Houston, Wasilla, Valley Pathways, and
Burchell High Schools, as well as home schools, at-risk youth,
and Christian school students, had participated in the survey.
3:49:03 PM
MS. TRUMAINE observed that the discussion to this point had been
about alcohol, tobacco, and marijuana. She offered slide 37,
"Substance Use Totals," and noted that 68 percent of eleventh
graders used alcohol. She moved on to slide 38, "Substance use
Totals," and pointed to meth, cocaine, heroin, ecstacy, and
hallucinogen use for ninth and eleventh graders. She compared
that although hallucinogens had a 13 percent use by eleventh
graders, alcohol use was substantially higher. She expressed
her surprise that so many under 14 youth were using alcohol, and
determined that the focus [for reduced use] should begin with
alcohol. She opined that alcohol was in every home and was
easily accessible.
3:51:17 PM
MS. TRUMAINE summarized slide 39, "Recommendation 4," and
suggested that it was necessary to increase community awareness
and get the community more involved. She pointed out that on a
national scale, Alaska ranked second for illicit drug use, and
sixth for binge drinking among adults. She offered her belief
that binge drinking was the "very normal party scene" and that
it would continue.
3:52:03 PM
DEB HAYNES, Teacher, Wasilla High School, said that she was also
a private mental health practitioner. She confirmed that slide
40, "Experiences from Alcohol and Drugs," described high school
students' reactions when they used drugs and alcohol. She noted
that about 25 percent said that they did not have any problem,
but that 75 percent had a variety of experiences. She pointed
to the small number of students who needed therapy, and
reflected that these were the "very high end users" as it
required a lot of use to get into therapy. She shared that
students often confided in her, as she was a human relations and
psychology teacher.
3:55:23 PM
REPRESENTATIVE HOLMES, responding to a remark by Ms. Haynes
during her testimony, asked if confidentiality was allowed for
high school athletes and who the athletes could speak with.
MS. HAYNES replied that that there was not any confidentiality
privilege for athletes, as teachers and counselors had an
obligation to report knowledge that any athlete was a user. She
acknowledged, in response to Representative Holmes, that this
was a state rule. She opined that it was extremely troublesome
for her to have to report any athletes who confided in her. She
clarified that she made her obligation clear before anyone
confided in her.
3:57:08 PM
MS. HAYNES reported the reason for the collection of this data
was because the YRBS data was not made available to them.
3:57:49 PM
DESIREE COMPTON, United Way of Mat-Su, explained that the
community had set up the Mat-Su Substance Abuse Prevention
Coalition to address issues at a community level in a culturally
appropriate and cost-effective way. She furnished slide 41,
"Coalitions are an effective solution" and pointed to the graph
which reflected that the Drug Free Coalition (DFC) coalition
areas had significantly lower substance use rates than the
national average. She affirmed that the Coalition was applying
for DRC grants to aid its funding and teaching. She indicated
slide 42, "Our Coalition," and detailed that the Coalition
included leaders from 12 sectors of the community, and focused
on prevention by identifying the risk factors and underlying
problems. She shared that the Coalitions utilized data and
information from the community leaders, as well as environmental
strategies, to influence community standards and policies. She
emphasized that the direction was to change the social norms
about drinking. She advocated for law and policy changes, which
included increasing parental awareness. She highlighted its
effort to coincide with the state plan to reduce underage
drinking by utilizing youth leaders for local messaging
campaigns.
4:01:30 PM
REPRESENTATIVE T. WILSON asked if allowing students to
participate in surveys would effectively disconnect parents.
MS. COMPTON opined that parents would still be able to not allow
participation in any given survey.
4:02:14 PM
MS. COMPTON remarked on slide 43, "Call to Action," and urged
for an understanding of the law and the powerful messages that
it demonstrated, involvement with the local coalition's goals,
and support of funding for local research and prevention.
4:04:03 PM
CO-CHAIR KELLER lauded the efforts of the Coalition. He opined
that the economic cost of substance abuse was "mind-blowing,"
and he issued a challenge for other communities to move forward.
The committee took an at-ease from 4:05 p.m. to 4:08 p.m.
HJR 35-CONST AM: HEALTH CARE
4:08:26 PM
CO-CHAIR HERRON announced that the next order of business would
be HOUSE JOINT RESOLUTION NO. 35 Proposing amendments to the
Constitution of the State of Alaska prohibiting passage of laws
that interfere with direct payments for health care services and
the right to purchase health care insurance from a privately
owned company, and that compel a person to participate in a
health care system.
4:09:10 PM
REPRESENTATIVE MIKE KELLY, Alaska State Legislature, discussed
the proposed national health care system and the backlash to the
mandated single payer system. He noted that 35 other states
were also in opposition to the proposed national health care
system. He explained that HJR 35 would protect the right to
choose participation in any given health care system, and would
prohibit and fines or penalties for failure to participate; it
would protect the right to purchase or provide lawful medical
services without government fines, interference or penalties.
He emphasized that HJR 35 would place these rights in the
Constitution of the State of Alaska. He offered his belief that
the majority of Alaskans opposed mandated health care, and that
this mandate could result in a lawsuit. He opined that the U.
S. Supreme Court would lean toward the protection of personal
choice of health care.
4:14:03 PM
REPRESENTATIVE SEATON declared that he recognized the intent of
HJR 35, and he directed attention to the proposed Section 2,
which stated in part: "no law shall be passed that compels a
person, employer, or health care provider to participate in a
health care system..." He asked if this would not allow the
state to initiate a new tier of the retirement system.
4:15:27 PM
REPRESENTATIVE KELLY replied that he would research that
question.
4:16:20 PM
REPRESENTATIVE HOLMES referred to Medicare, Indian Health
Services, and other similar medical plans, and pointed out that
these had limits which violated the language of HJR 35. She
expressed concern that this would tie the hands of legislators
for any future changes and pointed specifically to the language
in Section 2 (b) which stated: "prohibits a person from or that
penalizes a person for making direct payment to a health care
provider for tendering health care services."
4:18:08 PM
REPRESENTATIVE KELLY offered his belief that HJR 35 did not have
any effect on programs already in place. He reiterated that it
reinforced personal choice.
4:20:05 PM
CO-CHAIR HERRON asked Representative Kelly where the House
Health and Social Services Standing Committee should focus its
policy debate, and then where he believed that the House
Judiciary Standing Committee would focus.
4:20:32 PM
REPRESENTATIVE KELLY suggested that each committee should look
at whether HJR 35 was "in the best overall health care interest
of the state."
4:22:07 PM
CO-CHAIR HERRON clarified that proposed HJR 35 would be held in
the committee until the following week, and he suggested that
the House Health and Social Services Standing Committee debate
the health and social services aspect of it.
4:22:33 PM
REPRESENTATIVE CISSNA cited that more than 100,000 Alaskans did
not have health coverage. She shared that there were already
capacity problems within the health care system, and she voiced
"that we are a state that is addicted to addictions." She asked
how HJR 35 addressed the health care problems in Alaska. She
noted the difficulty of access to health care for many Alaskans.
4:25:22 PM
REPRESENTATIVE KELLY, in response to Representative Cissna,
disclosed that he had served on a hospital foundation for 20
years. He agreed that the current health care system was in
need of improvement. He opined that the government element was
a disincentive for doctors and that the more separated the
patient was from the provider and the cost, the worse the
situation became. He offered his belief that the heart of the
problem for the health care system was government centralized
control.
4:28:43 PM
REPRESENTATIVE SEATON asked for clarifications that HJR 35 would
not prevent the federal government from passing a law, but that
it would stop future legislatures from adopting a federal
program.
4:30:40 PM
REPRESENTATIVE KELLY replied that the least effect of HJR 35
would be to send a signal to the federal government that Alaska
was against additional federal controls over medical choices.
He said the strictest application would be Alaska's refusal to
comply with a federal mandate.
4:32:43 PM
REPRESENTATIVE SEATON asked to clarify that HJR 35 was an
amendment to the Constitution of the State of Alaska to restrict
the legislature from passing a law, even if that law was in the
public interest. He questioned if the proposed resolution would
prevent the state from adopting a medical plan without passing
or repealing a constitutional amendment.
4:33:58 PM
REPRESENTATIVE KELLY agreed.
4:34:03 PM
REPRESENTATIVE T. WILSON asked if Representative Kelly had heard
any concerns from the public.
4:34:25 PM
REPRESENTATIVE KELLY replied that worries about a "head butt
with the federal government" and complications to existing
programs were the two concerns.
4:34:51 PM
REPRESENTATIVE T. WILSON asked if those two concerns were
stronger than the "fear that people have with being forced into
a program that they don't want and us sitting back as a state
acting like we don't care."
4:35:15 PM
REPRESENTATIVE KELLY offered his belief that the overwhelming
response was in support of HJR 35.
4:35:23 PM
CO-CHAIR KELLER, as a prime co-sponsor of the bill, reported
that Arizona had vetted this legislation, and that most of the
questions had already been answered. He said that "precisely
what the bill does, it forbids any law that we have would be
unconstitutional that would forbid an individual in the State of
Alaska from securing medical care outside of the required
medical system that is there." He opined that the constitution
was the law of the land and that this resolution would be voted
on by the people.
4:37:19 PM
CO-CHAIR HERRON opened public testimony and said that he would
hold it open.
4:37:33 PM
MIKE PRAX offered his support for HJR 35 as it "might set up a
confrontation between the state and the federal government over
this particular issue." He opined that the federal
administration assumed it had absolutely authority and power.
He asked that the resolution be passed to protect "the
individual right to make decisions."
4:39:21 PM
PEGGY ANN MCCONNOCHIE, National Federation of Independent
Business (NFIB), shared that she and her husband were small
business owners. She offered her belief that the single payer
health care system did not fit for Alaskans, as it did not
provide lower cost, greater availability, or choice. She
emphasized that she was totally against what the federal
government was trying to do. She offered her opinion that small
business owners would easily go out of business with additional
federal fees. She encouraged the protection of small businesses
from unreasonable taxation, and any mandates for health care for
employees.
4:42:25 PM
CHRISTIE HERRERA, Director, Health and Human Services Task
Force, American Legislative Exchange Council (ALEC), explained
that ALEC was a non-partisan organization of lawmakers. She
offered support for HJR 35. She offered the belief that it
would ensure continued access to health services and the right
to pay directly for health services. She opined that it would
stop mandates that did not work, as a government requirement for
health insurance was ineffective, bureaucratic, and costly. She
summarized that the cornerstone of any reform was the protection
of patients' rights.
4:45:38 PM
REPRESENTATIVE SEATON directed attention to the proposed Section
2, which stated in part: "no law shall be passed that compels a
person, employer, or health care provider to participate in a
health care system..." He asked if this issue had arisen in any
other jurisdiction and would it restrict the state's ability to
initiate a new tier of the state retirement system.
MS. HERRERA agreed with Representative Kelly that this was a
forward looking bill, and would not affect current programs.
She stated that there was no intent to affect any safety net
programs. She agreed that it would preclude the state from
enacting an individual or an employer mandate to purchase health
coverage.
4:47:07 PM
CO-CHAIR HERRON stated that he would keep public testimony open.
[HJR 35 was held over.]
HB 168-TRAUMA CARE CENTERS/FUND
4:48:03 PM
CO-CHAIR HERRON announced that the final order of business would
be HOUSE BILL NO. 168, "An Act relating to state certification
and designation of trauma centers; creating the uncompensated
trauma care fund to offset uncompensated trauma care provided at
certified and designated trauma centers; and providing for an
effective date."
SENATOR JOHN COGHILL, Alaska State Legislature, explained that
HB 168 created an account for improving trauma care delivery.
He explained that the Department of Health and Social Services
(DHSS) commissioner would create regulations based on national
standards for trauma care, and evaluate each delivery system.
He referenced the packet, "Alaska Trauma Center," [Included in
the members packets] which the information presented during the
prior year. He shared that this was just one incentive
suggested by the College of Surgeons to the State of Alaska. He
reported that DHSS had created a trauma response systems
administrator. He detailed that he had met with the Emergency
Medical Services Council, and was encouraged by its focus on
response systems, especially in remote areas. He expressed the
need to better coordinate emergency response systems. He
detailed the desire to create a fund to incentivize hospitals to
enhance trauma care. He suggested putting money toward
uncompensated care as it would allow hospitals to contract with
more doctors for emergency trauma care. He pointed out that
Alaska had 24 acute care hospitals, but only 1 Level Two trauma
center. He requested a systemic approach to emergency response
systems, and opined that creating incentives was a good place to
begin. He pointed out that discussions were taking place with
military doctors for a licensing structure to allow them to work
with the civilian hospitals. He summarized that the two most
critical issues were equipping the medical personnel in the
remote parts of Alaska, and creating a fund to incentivize the
hospitals to enhance the trauma care.
4:55:37 PM
CO-CHAIR HERRON opened public testimony.
4:55:52 PM
CO-CHAIR HERRON read a statement from Representative Cissna
[original punctuation provided]:
"Mr. Chair: I have an unavoidable conflict and won't
be able to remain in this meeting. Broadening the
discussion with all stakeholders would be an
improvement. Increasing other incentives also would
be beneficial. I am in favor of passage of this bill
(as well as strengthening the bill.)"
4:56:15 PM
DAVID HULL, Chair, Alaska Council on Emergency Medical Services
(ACEMS), testified that he was speaking on behalf of ACEMS. He
opined that trauma calls were increasing every year. He defined
trauma as any bodily injury from an external source, and that it
could be accidental or intentional. He quoted statistics for
death and hospitalizations. He shared that a study in 2004
revealed that the hospital stay for trauma patients was more
than $73 million, and that 1 in 4 was not compensated care. He
defined a trauma system as a "pre-determined, organized, multi-
disciplinary response to managing the care and treatment of
severely injured people," and that a statewide system provided
"a framework for disaster preparedness and response." He
emphasized that the most important time frame for survival of a
severely injured person was the time between injury and
definitive care, "the Golden Hour." He opined that it was
necessary for increased hospital participation for the statewide
trauma system to function optimally. He shared that the goal of
the statewide trauma system was to ensure that every hospital in
Alaska was a designated trauma center. He testified in support
of funding for the development of trauma centers, incentives for
trauma care designation, and uncompensated patient care. He
offered support for HB 168.
4:59:31 PM
DR. FRANK SACCO, Trauma Director, Alaska Native Medical Center;
Chair, Alaska State Trauma Systems Review Committee, explained
that trauma was the leading cause of death for Alaskans under 44
years of age, and that Alaska had the second highest rate of
trauma in the U.S. He opined that a good trauma system would
decrease the mortality by 15-25 percent. He reflected on prior
legislation which was only voluntary with no incentives, and
consequently, there was only one Level 2 Trauma Center in
Alaska. He summarized an American College of Surgeons review
that "the achievements to date have been largely unplanned with
limited coordination; as the result, incongruity exists with the
current trauma system." He commended the Alaska Native health
facilities for working toward trauma designation, but he decried
the lack of commitment for "achieving nationally recognized
standards of trauma care" from most health facilities. He
stated that Alaska was the only state without a Level 2 Trauma
Center for the majority of the population, and that Anchorage
was the largest city in the United States without a designated
Level 1 or Level 2 trauma center for the majority of the
population. He expressed support for HB 168, and declared that
it was not a partisan issue.
5:04:06 PM
DR. REGINA CHENNAULT, Chair, American College of Surgeons
Committee on Trauma, Alaska Trauma System Review Committee,
expressed concern that Alaska did not have a designated trauma
hospital for the general public. She reported that Alaska had a
lot of trauma, with a lot of domestic violence. She requested
that an organized, systems approach to trauma care be
implemented as soon as possible.
5:05:30 PM
MARK JOHNSON, Alaska Trauma System Review Committee, opined that
[trauma] care would be improved if more hospitals met the
national standards. He referred to the 2008 American College of
Surgeons review of Alaska hospitals which included 70
recommendations, of which 16 were listed as priority. He
supported the incentives within HB 168.
5:07:30 PM
WARD HURLBURT, Chief Medical Officer; Director, Division of
Public Health, Office of the Commissioner, Department of Health
and Social Services (DHSS), shared his personal experience as a
trauma physician. He shared that trauma was the third highest
cause of death in Alaska, and the highest cause for ages up to
44 years. He reflected on the American College of Surgeons
trauma system review and noted with concern that the "trauma
infrastructure's unplanned, under developed, under resources,
and lacks sufficient coordination and integration." He also
expressed the administration's concern that Anchorage was the
largest city in the U.S. without Level 1 or 2 trauma centers.
He shared that the administration encouraged collaboration among
the health care systems and the development of a "more mature
trauma system." He stated that the administration was neutral
on HB 168.
5:11:55 PM
CO-CHAIR HERRON noted a proposed amendment for funding.
5:12:23 PM
SENATOR COGHILL replied that it was a good amendment, but that
the funding would be drawn from the general fund.
5:12:48 PM
[HB 168 was held over.]
5:13:28 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:13 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HJR35pkt.PDF |
HHSS 2/9/2010 3:00:00 PM |
|
| hb168r09a.PDF |
HHSS 2/9/2010 3:00:00 PM |
HB 168 |
| hb168r09b.PDF |
HHSS 2/9/2010 3:00:00 PM |
HB 168 |
| hb168r10.PDF |
HHSS 2/9/2010 3:00:00 PM |
HB 168 |
| MSAPC.PDF |
HHSS 2/9/2010 3:00:00 PM |