03/10/2011 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HCR1 | |
| HCR3 | |
| HCR5 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HCR 3 | TELECONFERENCED | |
| *+ | HCR 1 | TELECONFERENCED | |
| *+ | HCR 5 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 10, 2011
3:00 p.m.
MEMBERS PRESENT
Representative Wes Keller, Chair
Representative Alan Dick, Vice Chair
Representative Bob Herron
Representative Paul Seaton
Representative Beth Kerttula
Representative Bob Miller
Representative Charisse Millett
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE CONCURRENT RESOLUTION NO. 1
Proclaiming November 2011 to be Pancreatic Cancer Awareness
Month.
- MOVED CSHCR 1(HSS) OUT OF COMMITTEE
HOUSE CONCURRENT RESOLUTION NO. 3
Relating to promoting the safety and protection of older
Alaskans.
- MOVED CSHCR 3(HSS) OUT OF COMMITTEE
HOUSE CONCURRENT RESOLUTION NO. 5
Relating to prevention of disease and to vitamin D.
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HCR 1
SHORT TITLE: PANCREATIC CANCER AWARENESS MONTH
SPONSOR(s): REPRESENTATIVE(s) PETERSEN
01/18/11 (H) READ THE FIRST TIME - REFERRALS
01/18/11 (H) HSS
03/10/11 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HCR 3
SHORT TITLE: SENIOR CITIZEN PROTECTIONS
SPONSOR(s): REPRESENTATIVE(s) MUNOZ
01/24/11 (H) READ THE FIRST TIME - REFERRALS
01/24/11 (H) HSS
03/10/11 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HCR 5
SHORT TITLE: VITAMIN D SUPPLEMENTS
SPONSOR(s): REPRESENTATIVE(s) SEATON
02/11/11 (H) READ THE FIRST TIME - REFERRALS
02/11/11 (H) HSS
03/10/11 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE PETE PETERSEN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HCR 1 as the sponsor of the
bill.
DAVID BREMER, Staff
Representative Pete Petersen
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HCR 1 on behalf of the bill
sponsor, Representative Petersen.
REPRESENTATIVE STEVE THOMPSON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified in support of HCR 1.
REPRESENTATIVE CATHY MUNOZ
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HCR 3 as the sponsor of the
bill.
DENISE DANIELLO, Executive Director
Alaska Commission on Aging
Division of Senior and Disabilities Services
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HCR 3.
MARIE DARLIN, Coordinator
AARP Capital City Task Force
Juneau, Alaska
POSITION STATEMENT: Testified in support of HCR 3.
DIANA WEBER, Ombudsman
Long Term Care Ombudsman
Alaska Mental Health Trust Authority
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HCR 3.
MARY MUNDELL, Pharmacist
Wasilla, Alaska
POSITION STATEMENT: Testified during discussion of HCR 5.
DR. WARD HURLBURT, Chief Medical Officer/Director
Division of Public Health
Central Office
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the discussion of
HCR 5.
ACTION NARRATIVE
3:00:37 PM
CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:00 p.m.
Representatives Keller, Miller, Kerttula, and Seaton were
present at the call to order. Representatives Herron, Dick, and
Millett arrived as the meeting was in progress.
HCR 1-PANCREATIC CANCER AWARENESS MONTH
3:01:30 PM
CHAIR KELLER announced that the first order of business would be
HOUSE CONCURRENT RESOLUTION NO. 1, Proclaiming November 2011 to
be Pancreatic Cancer Awareness Month.
3:02:43 PM
The committee took an at-ease from 3:02 p.m. to 3:04 p.m.
3:04:11 PM
CHAIR KELLER brought the committee back to order.
3:04:58 PM
REPRESENTATIVE PETE PETERSEN, Alaska State Legislature,
explained that this was a resolution to raise awareness of
pancreatic cancer. He reported that although pancreatic cancer
was the fourth leading cause of cancer related death in the U.
S., only 2 percent of the National Cancer Institute's research
funding budget was directed toward it. He shared that
pancreatic cancer was one of the few cancers that had not seen a
dramatic rise in survival rates during the last 40 years. He
reported the average life expectancy to be 3 - 6 months, and
that the percentage for survival was in the single digits. He
read from the Sponsor Statement: [Included in the members'
packets]
Increasing awareness will lead to expanded research
into locating the disease's causes, enhancing early
detection, and developing effective treatments.
Raising awareness will also lead to more knowledge
about pancreatic cancer among Alaskans and directly
enhance the good [health] and well being of our
state's residents.
3:07:15 PM
REPRESENTATIVE HERRON asked for a reference in the resolution to
the possible causes of pancreatic cancer.
3:07:45 PM
DAVID BREMER, Staff, Representative Pete Petersen, Alaska State
Legislature, in response to Representative Herron, explained
that the risk factors included family history of the disease,
smoking, age, and diabetes.
3:08:11 PM
REPRESENTATIVE HERRON suggested a conceptual amendment to
include a "whereas" for possible causes.
3:08:37 PM
CHAIR KELLER asked Representative Petersen if he was amenable to
a conceptual amendment to include the risk factors.
REPRESENTATIVE PETERSEN said that he was agreeable to this, but
he explained that there was limited research for the areas of
risk.
3:09:10 PM
REPRESENTATIVE HERRON pointed out that pancreatic cancer was
more common in smokers and obese people.
CHAIR KELLER offered wording for the conceptual amendment that
would include "potentially identified risk factors."
3:10:01 PM
REPRESENTATIVE MILLETT asked about the symptoms for pancreatic
cancer.
MR. BREMER, in response, said that the symptoms included weight
loss, abdominal and back pain, loss of appetite, nausea, and
jaundice.
3:10:42 PM
CHAIR KELLER opened public testimony.
3:11:09 PM
REPRESENTATIVE STEVE THOMPSON, Alaska State Legislature, stated
his support for HCR 1, as it would bring awareness to the
disease. He shared his personal experience with his wife's
battle with pancreatic cancer. He pointed out that nothing
could be done, even with early detection.
3:13:04 PM
CHAIR KELLER asked about for a comparison to the other leading
cancers.
3:13:29 PM
MR. BREMER stated that lung cancer accounted for 28 percent,
colon cancer accounted for 10 percent, breast cancer accounted
for 7.5 percent, and pancreatic cancer accounted for 6 percent.
3:14:03 PM
CHAIR KELLER closed public testimony.
3:14:28 PM
REPRESENTATIVE HERRON moved to adopt a conceptual amendment to
add that pancreatic cancer was more common in smokers, and
people who were obese.
3:15:38 PM
There being no objection, it was so ordered.
3:15:52 PM
REPRESENTATIVE MILLETT moved to report HCR 1, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHCR 1(HSS) was
reported from the House Health and Social Services Standing
Committee.
HCR 3-SENIOR CITIZEN PROTECTIONS
3:16:11 PM
CHAIR KELLER announced that the next order of business would be
HOUSE CONCURRENT RESOLUTION NO. 3, Relating to promoting the
safety and protection of older Alaskans.
3:16:56 PM
REPRESENTATIVE CATHY MUNOZ, Alaska State Legislature, explained
that HCR 3 raised awareness to the problem of elder abuse. She
emphasized that elder abuse was on the rise both in Alaska and
nationally. She declared that Department of Health and Social
Services reported a 169 percent increase in the reports of harm
over the last four years, and the office of the Long Term Care
Ombudsman had seen a corresponding increase of 200 percent over
the past three years. She listed the most common allegations to
include self-neglect, abuse, neglect, and financial
exploitation.
3:18:22 PM
CHAIR KELLER asked if Representative Munoz would accept a
conceptual amendment.
3:18:59 PM
REPRESENTATIVE MILLER asked for a definition of elders.
3:19:16 PM
REPRESENTATIVE MUNOZ, in response, stated that it was 60 years
of age and older.
3:19:35 PM
DENISE DANIELLO, Executive Director, Alaska Commission on Aging,
Division of Senior and Disabilities Services, Department of
Health and Social Services (DHSS), clarified that the target age
was 60 years of age and older, as that co-ordinated with the
eligible ages for response by the office of the Long Term Care
Ombudsman. She pointed out that this was also the age to
receive services funded by the Older Americans Act. She noted
that proposed HCR 3 supported a public awareness campaign about
elder abuse and its prevalence, and called for greater
coordination among the agencies serving elders.
3:21:01 PM
REPRESENTATIVE MILLER asked for a definition of abuse.
3:21:22 PM
MS. DANIELLO replied that there were many types of abuse, which
included: physical, sexual, and emotional abuse, abandonment,
withdrawal of support, neglect for the basics of care, financial
exploitation, and self neglect.
3:24:40 PM
MARIE DARLIN, Coordinator, AARP Capital City Task Force, stated
that AARP supported HCR 3. She offered her belief that proposed
HCR 3 would better focus public awareness on the problems. She
directed attention to the AARP policies for education,
awareness, and enforcement and suggested that the committee
review these for guidance.
3:27:52 PM
DIANA WEBER, Ombudsman, Long Term Care Ombudsman, Alaska Mental
Health Trust Authority, Department of Revenue, expressed support
for proposed HCR 3 as it would raise the profile of elder
maltreatment with the public. She emphasized that it
communicated the priority for this to all the state agencies.
3:29:18 PM
CHAIR KELLER closed public testimony.
3:29:37 PM
REPRESENTATIVE MILLETT declared that it was devastating to hear
about elder abuse.
3:30:31 PM
REPRESENTATIVE HERRON, directing attention to page 2, lines 14
and 18, regarding the percentage of reports filed, asked if the
State of Alaska was still responding with appropriate levels of
intervention.
CHAIR KELLER re-opened public testimony.
3:31:31 PM
MS. DANIELLO suggested the question be directed to the Long Term
Care Ombudsman office.
3:31:51 PM
MS. WEBER reported that a response, especially for imminent harm
issues, was within one working day. She asserted that the
bigger concern was for the lack of available time to continue
the individual support for each senior.
3:32:58 PM
CHAIR KELLER closed public testimony.
CHAIR KELLER moved to adopt Amendment 1, which read [original
punctuation provided]:
Page 2, Line 23: insert "families and" before the
word communities"
Page 2, Line 28: Insert new (2) "Recognizes that
family and community can provide the essential source
of security and well being for vulnerable older
Alaskans."
(re-number following paragraphs)
Page 3, Line 4: insert new paragraph (n) to read:
"supports efforts by HSS to enable independent living
and supporting family services to enable independent
living."
(ties with the first whereas)
REPRESENTATIVE MILLETT objected for discussion.
CHAIR KELLER read proposed Amendment 1 and expressed his
willingness for any wordsmithing.
3:34:41 PM
REPRESENTATIVE MILLETT removed her objection.
There being no objection, Amendment 1 was adopted.
3:34:57 PM
REPRESENTATIVE DICK moved to report HCR 3, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHCR 3(HSS) was
reported from the House Health and Social Services Standing
Committee.
3:35:30 PM
The committee took an at-ease from 3:35 p.m. to 3:38 p.m.
HCR 5-VITAMIN D SUPPLEMENTS
3:38:28 PM
CHAIR KELLER announced that the final order of business would be
HOUSE CONCURRENT RESOLUTION NO. 5, Relating to prevention of
disease and to vitamin D.
3:38:33 PM
REPRESENTATIVE SEATON, sponsor of HCR 5, emphasized its
importance as it encouraged the transition from a "treatment of
disease model of health care to a prevention of disease model."
3:39:28 PM
REPRESENTATIVE SEATON pointed to the shortage of Vitamin D in
Alaska. He explained that nanograms per milliliter referenced a
measurement in the blood level for converted Vitamin D. He
pointed out that Vitamin D was made in the skin, from the
ultraviolet B radiation of direct sunlight. He noted that the
low horizon sunshine common to Alaska did not allow ultraviolet
B to penetrate the atmosphere for most of the year. He surmised
that Alaskans had the lowest levels of Vitamin D in the U.S. He
explained that Vitamin D2 was plant based and only available
through prescription, whereas Vitamin D3 was converted in the
skin to a pre-hormone, 25 (OH)D.
3:42:52 PM
REPRESENTATIVE SEATON directed attention to a PowerPoint
entitled "Vitamin D Its role in promoting public health and
decreasing the incidence of disease." [Included in members'
packets] He announced slide 1, "What is Vitamin D?"
3:43:16 PM
REPRESENTATIVE SEATON moved on to slide 2, "UV and Dietary
sources," and shared that wild salmon had far more IU
(international units) of Vitamin D content than farmed salmon.
He emphasized that most food sources had insufficient IU amounts
of Vitamin D. He mentioned that Caucasian skin produced 10,000
IU of Vitamin D when 40 percent of the skin was exposed to sun
for 20 - 30 minutes, and acknowledged the difficulty of this for
Alaskans. He reported that older people and people with darker
pigmentation required more sun exposure to get similar amounts
of Vitamin D.
3:45:28 PM
REPRESENTATIVE SEATON addressed slide 4, "Vitamin D Shortage,"
and said that when there was short supply of Vitamin D in the
tissues and cells, it was difficult for the body to make enough
calcitriol to adequately open the DNA libraries. He discussed
some videos to view for further information.
3:46:23 PM
REPRESENTATIVE SEATON pointed to slide 5, "What are the
consequences?" which listed bone diseases, hypertension, cardiac
disease, diabetes, periodontal disease, various cancers, and an
increased risk of multiple sclerosis.
3:47:55 PM
REPRESENTATIVE SEATON addressed slide 6, "State Health policy,"
and asked if Alaska needed a new statewide health policy which
concentrated on prevention of disease as opposed to the focus on
treatment.
3:48:08 PM
REPRESENTATIVE SEATON spoke about slide 7, "Colon Cancer
Mortality Rates, USA," and stated that the Northeastern US had
the highest mortality rates, as it had less sunshine.
3:49:23 PM
REPRESENTATIVE SEATON shared slide 8, "Risk of Colon Cancer by
serum 25(OH)D," and noted the 50 percent reduction of risk for
colon cancer was directly related to the higher levels of
Vitamin D.
3:50:05 PM
REPRESENTATIVE SEATON referred to another study, depicted on
slide 9, "Risk of Colon Cancer by serum 25(OH)D," which
reflected a 50 percent reduction of colon cancer when the
Vitamin D level was higher than 38 ng/ml.
3:51:05 PM
REPRESENTATIVE SEATON pointed to slide 10, "Meta-analysis,"
which combined all the studies, and projected the likelihood of
a 50 percent reduction in colon cancer with 34 ng/ml of Vitamin
D.
3:51:27 PM
REPRESENTATIVE SEATON acknowledged slide 11, "Colon Cancer
mortality risk by prediagnostic serum," which reflected the
relative risk of death for those diagnosed for colon cancer with
various ng/ml of Vitamin D.
REPRESENTATIVE SEATON spoke about slide 12, "Colorectal cancer
death hazard rations by serum 25(OH)D," and defined a double
blind randomized control study. He stated that these studies
looked at the relative risk for the population as a whole.
3:53:35 PM
REPRESENTATIVE SEATON moved on to slide 13, "Breast cancer
mortality in the USA," and noted a decrease of risk with an
increase of sunshine.
3:53:54 PM
REPRESENTATIVE SEATON shared slide 14, "Women's Health
Initiative Nested Study," which also projected a 50 percent
reduction of breast cancer when, at least 22 ng/ml of Vitamin D
was measured.
3:54:29 PM
REPRESENTATIVE SEATON pointed to slide 15, "Meta-analysis of
breast cancer risk," and slide 16, "Breast cancer risk by
25(OH)D." He stated that each individual study was slightly
different but the meta-analysis combined the results.
REPRESENTATIVE SEATON explained that slide 17, "Hazard of death,
512 women with breast cancer," reflected that women with a blood
serum level of more than 30 ng/ml had a 40 percent less chance
of dying.
3:55:50 PM
REPRESENTATIVE SEATON directed attention to "Vitamin D:
Mechanism of Action," slide 18, the study by Dr. Heaney.
REPRESENTATIVE SEATON reflected on slide 19 and slide 20,
"Vitamin D & Influenza," which reported on studies of 208
African American women and 334 Japanese school children and the
resulting decrease in influenza rates with the increase of
Vitamin D.
REPRESENTATIVE SEATON stated that slide 21, "Diabetes &
25(OH)D," depicted a 70 - 80 percent lower risk for diabetes
with higher serum 25(OH)D.
3:58:09 PM
REPRESENTATIVE SEATON discussed a website presentation, "Can
Diabetes be prevented with Vitamin D?" as shown on slide 22.
REPRESENTATIVE SEATON reflected on a 30 year study in Northern
Finland, slide 23, "Infants' Vitamin D Supplementation Dose and
Incidence of Type 1 Diabetes in Children in Northern Finland."
3:59:38 PM
REPRESENTATIVE SEATON pointed to slide 24, "Annual age adjusted
incidence rates of type 1 diabetes," which charted over 50 years
the increased incidence rates of diabetes as the recommended
intake of Vitamin D had been reduced.
4:00:39 PM
CHAIR KELLER asked about the supporting scientific evidence.
REPRESENTATIVE SEATON agreed that these were population studies
that showed that the relative risk was much less with increased
Vitamin D in the blood.
4:02:32 PM
CHAIR KELLER, referring to slide 24, pointed out that other
variables may have had an effect.
REPRESENTATIVE SEATON replied that it was only possible to look
at the correlations, as this program was administered by the
Finnish National Health Care in compliance with the recommended
dosages.
4:04:30 PM
REPRESENTATIVE MILLETT asked if there was any supplement to take
in conjunction with Vitamin D to aid in better absorption.
REPRESENTATIVE SEATON replied that calcium and Vitamin D were
integral to each other. He stated that many cancers were
related to epithelial cells. He pointed out that magnesium was
also important in conjunction with calcium.
4:07:04 PM
CHAIR KELLER offered his belief that slide 24 merely reflected
an increase in the incidence of diabetes, which could not be
scientifically tied to the decrease in recommended Vitamin D
dosages.
REPRESENTATIVE SEATON agreed that these were observational
studies showing relative risks for populations.
4:08:56 PM
REPRESENTATIVE HERRON asked if HCR 5 should contain a resolve
that Vitamin D could be used in conjunction with standard
medical treatments for increased effectiveness.
REPRESENTATIVE SEATON offered his belief that the medical
community would testify for the prescription of Vitamin D in
conjunction with standard medical treatment.
4:11:50 PM
REPRESENTATIVE HERRON asked about whether a resolve should
specify Vitamin D 3, instead of Vitamin D 2.
REPRESENTATIVE SEATON, in response to Representative Herron,
said that the medical community had stipulated that both were
effective without a recognizable difference in the outcomes;
however, Vitamin D 2 was only available with a prescription.
4:13:17 PM
REPRESENTATIVE SEATON directed attention to slide 25, "Cancer
Risk (All)," stated that there was 69 percent lower risk for any
kind of cancer for individuals with more than 29 ng/ml of
Vitamin D. He pointed out that an individual's blood serum
level was the defining factor, not the daily dose of Vitamin D.
4:16:43 PM
REPRESENTATIVE SEATON spoke about slide 26 and slide 27,
"Vitamin D & Tuberculosis," which compared a study of the use of
anti-biotics in conjunction with Vitamin D, and the use of anti-
biotics with a placebo. He pointed to the results which showed
the Vitamin D group to be 100 percent bacteria free, while the
placebo group was only 78 percent bacteria free. He declared
that this study showed that Vitamin D worked in conjunction with
other treatments for better results.
4:18:31 PM
REPRESENTATIVE SEATON, in response to Representative Kerttula,
said that this was the standardized treatment in a completely
controlled study.
4:19:08 PM
REPRESENTATIVE SEATON moved on to slide 28, "Vitamin D Intake &
Toxicity," explaining that toxicity did exist, but that it was
the result of extremely high blood levels, more than 200 ng/ml.
He compared this to Southern California lifeguards, whose
Vitamin D blood level measured about 180 ng/ml. He pointed out
that this required dosages of 30,000 IU/day.
4:20:44 PM
REPRESENTATIVE SEATON indicated slide 29 and slide 30 "Summary,"
which concluded that the optimal blood level range for Vitamin D
was 40 - 60 ng/ml. He demonstrated the blood test kits for
Vitamin D.
4:22:19 PM
REPRESENTATIVE SEATON directed attention to slide 31, "Disease
Incidence Prevention by Serum 25(OH)D Level," which graphed the
relative percentage decrease to a variety of diseases if blood
level Vitamin D were at least 25(OH)D.
4:23:28 PM
REPRESENTATIVE SEATON concluded with slide 32 and slide 33,
"Vitamin D Resources," which listed numerous information sites.
4:24:00 PM
CHAIR KELLER proposed to review HCR 5.
REPRESENTATIVE SEATON offered that the scientific paper
background was available for each "whereas" in HCR 5.
4:24:42 PM
REPRESENTATIVE MILLER asked if there were readily available
natural sources of Vitamin D.
REPRESENTATIVE SEATON replied that the only populations with
sufficient dietary Vitamin D were Alaskan Native groups eating a
traditional diet of wild game and fatty foods, as Vitamin D was
fat soluble. He confirmed that it was not necessary to maintain
daily doses of Vitamin D, but that larger doses could be taken
less often, such as weekly or bi-weekly.
4:27:51 PM
REPRESENTATIVE MILLER shared his research on the potency of
vitamins, and asked if there were more potent types of Vitamin
D.
REPRESENTATIVE SEATON replied that Vitamin D was inexpensive to
manufacture, and maintained its potency for about 18 months.
4:30:22 PM
REPRESENTATIVE SEATON, in response to Chair Keller, explained
that cholecalciferol was manufactured Vitamin D 3, and that
ergocalciferol was the natural Vitamin D 2.
4:31:09 PM
CHAIR KELLER, referring to page 1, line 10, suggested inserting
"in numerous studies" after "vitamin D".
REPRESENTATIVE SEATON agreed.
CHAIR KELLER, referring to page 3, lines 22 - 26, offered his
belief that a preventative treatment of Vitamin D contrasted the
use of vaccines. He suggested that this would create
resentment.
4:32:45 PM
REPRESENTATIVE SEATON declared that, as the State of Alaska had
abandoned its universal vaccines for influenza for the
population, it was important to promote preventative medicine
for everyone. He compared the various studies of effectiveness
for vaccines and Vitamin D treatment.
4:35:33 PM
CHAIR KELLER suggested to insert "potentially" on page 5, line
25, after "could"; again, on page 6, line 2, after "awareness of
the" and on line 6, after "elderly to".
CHAIR KELLER, directing attention to page 6, line 2, suggested
inserting "blood" in front of "testing".
CHAIR KELLER, pointing to page 6, line 6 and line 12, expressed
his concern with "provide".
4:38:01 PM
REPRESENTATIVE SEATON, in response to Chair Keller, stated that
HCR 5 was a resolution of request, not requirement, to the
state.
4:38:34 PM
CHAIR KELLER asked to clarify the intent of "investigate" on
page 6, line 9.
4:39:29 PM
REPRESENTATIVE SEATON suggested a substitution of "study" for
"investigate".
4:40:26 PM
CHAIR KELLER offered his belief that it was "new territory" for
the government to provide vitamins and food supplements.
REPRESENTATIVE SEATON stated that a government provision of
supplements was currently in effect for pregnant women.
CHAIR KELLER replied that studies supported other vitamins, as
well.
4:41:30 PM
REPRESENTATIVE DICK, commenting on the traditional diet for
natural Vitamin D and the recent awareness of the hydrogen cyst,
declared that he had curtailed his ingestion of the organs of
wild game.
4:42:26 PM
MARY MUNDELL, Pharmacist, shared that she was also a board
member of the [Alaska] Board of Pharmacy. She reported that the
prescription version of Vitamin D 2 had never been covered by
the federal government, as it was considered a nutrient. She
further noted that the State of Alaska Medicaid would
discontinue its coverage without a prior authorization approval
for Vitamin D through a physician. The physician must state
that the patient had failed with other Vitamins D's. She
pointed out that there was no other Vitamin D 2 available,
except by prescription. She specified that proposed HCR 5
encouraged Department of Health and Social Services (DHSS) to
provide and promote awareness, yet DHSS would no longer "cover
the drug."
4:44:28 PM
DR. WARD HURLBURT, Chief Medical Officer/Director, Division of
Public Health, Central Office, Department of Health and Social
Services, stated that the official position of the
administration was neutral. He expressed concern with the loss
of funding for preventative influenza vaccine. He offered his
belief that the legislature was not a good place to make
clinical decisions. He observed that inappropriate therapies
had been adopted by other state legislatures. He agreed that
Vitamin D was essential, necessary, and beneficial for bone
disease. He summarized a report from the National Institute of
Health which stated that Vitamin D was necessary for bone
related conditions, including osteoporosis, but that there was
insufficient evidence for other recommendations. He observed
that there was a difference of opinion to the broad scope of
benefits from Vitamin D.
4:49:13 PM
CHAIR KELLER asked Dr. Hurlburt to review the resolution for any
implication of clinical description.
REPRESENTATIVE SEATON established that proposed HCR 5 did not
mandate, but proposed that DHSS investigate and follow up to
judge the appropriateness for Alaskans. He expressed his desire
that proposed HCR 5 would produce answers and generate funding
to improve the health of Alaskans.
4:50:56 PM
DR. HURLBURT, in response to Representative Miller, said that he
did know of a fatal dosage of vitamins, specifically with
Vitamin D, when Arctic explorers ate raw polar bear liver and
died.
REPRESENTATIVE MILLER replied that he also knew of that
incident, and he questioned whether the fatal dosage was that of
Vitamin A.
DR. HURLBURT agreed.
[HCR 5 was held over.]
4:52:39 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:52 p.m.