03/29/2012 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB202 | |
| SCR16 | |
| HB319 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 202 | TELECONFERENCED | |
| + | SCR 16 | TELECONFERENCED | |
| *+ | HB 319 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 29, 2012
3:01 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
MEMBERS ABSENT
Representative Charisse Millett
COMMITTEE CALENDAR
SENATE BILL NO. 202
"An Act relating to resuscitation protocol documents that may be
adopted by reference in regulations."
- MOVED SB 202 OUT OF COMMITTEE
SENATE CONCURRENT RESOLUTION NO. 16
Proclaiming May 2012 to be Celiac Disease Awareness Month.
- MOVED SCR 16 OUT OF COMMITTEE
HOUSE BILL NO. 319
"An Act requiring a study of the health effects of airport
security screening."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 202
SHORT TITLE: RESUSCITATION PROTOCOL DOCUMENTS
SPONSOR(s): SENATOR(s) EGAN
02/17/12 (S) READ THE FIRST TIME - REFERRALS
02/17/12 (S) HSS
03/05/12 (S) HSS AT 1:30 PM BUTROVICH 205
03/05/12 (S) Moved SB 202 Out of Committee
03/05/12 (S) MINUTE(HSS)
03/06/12 (S) HSS RPT 4DP
03/06/12 (S) DP: DAVIS, MEYER, EGAN, DYSON
03/16/12 (S) TRANSMITTED TO (H)
03/16/12 (S) VERSION: SB 202
03/19/12 (H) READ THE FIRST TIME - REFERRALS
03/19/12 (H) HSS
03/29/12 (H) HSS AT 3:00 PM CAPITOL 106
BILL: SCR 16
SHORT TITLE: CELIAC DISEASE AWARENESS MONTH
SPONSOR(s): SENATOR(s) GIESSEL
01/17/12 (S) READ THE FIRST TIME - REFERRALS
01/17/12 (S) STA
02/07/12 (S) STA AT 9:00 AM BUTROVICH 205
02/07/12 (S) Moved SCR 16 Out of Committee
02/07/12 (S) MINUTE(STA)
02/08/12 (S) STA RPT 5DP
02/08/12 (S) DP: WIELECHOWSKI, KOOKESH, PASKVAN,
MEYER, GIESSEL
03/16/12 (S) BEFORE THE SENATE ON FINAL PASSAGE
03/16/12 (S) TRANSMITTED TO (H)
03/16/12 (S) VERSION: SCR 16
03/19/12 (H) READ THE FIRST TIME - REFERRALS
03/19/12 (H) HSS
03/29/12 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 319
SHORT TITLE: STUDY HEALTH EFFECTS OF AIRPORT SCREENING
SPONSOR(s): REPRESENTATIVE(s) CISSNA
02/10/12 (H) READ THE FIRST TIME - REFERRALS
02/10/12 (H) HSS, FIN
03/29/12 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
SENATOR DENNIS EGAN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced SB 202 as the prime sponsor of
the bill.
RICHARD ETHERIDGE, Chief
Capital City Fire and Rescue;
Second Vice President, State Fire Chief Association
Juneau, Alaska
POSITION STATEMENT: Testified during discussion of SB 202.
KEN ZAFREN, Medical Director
State EMS (Emergency Medical Services) Council
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 202.
DAVID HULL, Chair
Governor's Alaska Council on Emergency Medical Services (ACEMS)
Ketchikan, Alaska
POSITION STATEMENT: Testified in support of SB 202.
WARD HURLBURT, M.D., Chief Medical Officer/Director
Division of Public Health
Central Office
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 202.
SENATOR CATHY GIESSEL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced SCR 16 as the prime sponsor of
the resolution.
BRANDY WENDLER, RN
Alaska Nurse Practitioner Association
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of SCR 16.
TERESA NEENO
Allergist
Allergy, Asthma, and Immunology Center of Alaska
Anchorage, Alaska
POSITION STATEMENT: Testified during discussion of SCR 16.
ANNA WHITE, Staff
Representative Sharon Cissna
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 319 for Representative
Cissna, the prime sponsor of the bill.
REPRESENTATIVE SHARON CISSNA
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Explained the details of HB 319 as the
prime sponsor of the bill.
MARILYN GUTTENBERG
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 319.
DIANE SCHENKER, Co-Director
Alaskans' Freedom to Travel USA
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 319.
PATRICIA ANDERSON, Co-Director
Alaskans' Freedom to Travel USA
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 319.
JOE MCLAUGHLIN, MD, MPH
Chief and State Epidemiologist
Section of Epidemiology
Division of Public Health
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HB 319.
ACTION NARRATIVE
3:01:05 PM
CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:01 p.m.
Representatives Keller, Seaton, Miller, and Dick were present at
the call to order. Representatives Herron and Kerttula arrived
as the meeting was in progress.
SB 202-RESUSCITATION PROTOCOL DOCUMENTS
3:01:38 PM
CHAIR KELLER announced that the first order of business would be
SENATE BILL NO. 202, "An Act relating to resuscitation protocol
documents that may be adopted by reference in regulations."
3:02:00 PM
SENATOR DENNIS EGAN, Alaska State Legislature, explained that
proposed SB 202 addressed CPR (Cardiopulmonary Resuscitation)
standards and resuscitation protocol. He explained that,
although CPR standards were regularly updated based on new
research, the process for changing the state agency regulations
remained slow. He noted that the current state regulations
referenced outdated and incorrect CPR standards. He directed
attention to AS 47.05.012 which allowed the Department of Health
and Social Services (DHSS) to adopt certain health materials and
standards by reference. He reported that proposed SB 202 would
add the findings of the International Liaison Committee on
Resuscitation (ILCOR), an international group of scientists that
review studies, make treatment recommendations, and publish the
findings, to the list of documents included in statute. He
noted that the current resuscitation regulations were adopted in
2002, with the standard being administration of 15 chest
compressions and 2 breathes. Today, he stated, it was
recommended to train rescuers to use 2 breathes for every 30
compressions, while the average bystander was now taught to only
use compressions. He declared that proposed SB 202 would ensure
that emergency medical services instructors in Alaska would now
teach the most current and appropriate resuscitation standards
without the burdensome revision of agency regulations.
3:04:12 PM
REPRESENTATIVE SEATON, commenting on resistance to national
standards, asked if Legislative Legal and Research Services had
any concerns with the proposed bill.
3:04:47 PM
SENATOR EGAN, in response, said that, as the proposed bill took
the ILCOR findings into consideration, Legislative Legal and
Research Services were satisfied.
3:05:48 PM
REPRESENTATIVE SEATON clarified that he was in favor of the
legislation, but he relayed the concerns for varying standards
voiced by different groups during past legislation.
3:06:53 PM
RICHARD ETHERIDGE, Chief, Capital City Fire and Rescue, Second
Vice President, State Fire Chief Association, declared that the
proposed bill was a greatly needed change in regulations and
statutes as it would assist in saving lives through CPR. He
reported that CPR standards were updated regularly from
scientific research by ILCOR and the American Heart Association.
He explained that Alaska would fall behind in updates of
standards as the current regulations were written into Alaska
statute, which required the legislative process to be updated.
He said that the proposed bill would place the CPR standards
into regulations that would allow DHSS to update them. He
declared that the CPR changes worked, and he shared that five to
nine people were saved in Juneau annually. He pointed out that
the proposed bill impacted the daily lives of the providers as
re-certifications were now to a national standard. He declared
his support for SB 202.
3:10:23 PM
CHAIR KELLER asked if there were any ramifications for risk to
the fire department or the State of Alaska if the standards were
not updated.
CHIEF ETHERIDGE replied that he was not aware of any additional
risk.
3:11:09 PM
CHIEF ETHERIDGE, in response to Representative Herron, said that
he was a citizen of Juneau. In response to another question
from Representative Herron, he said that he was not aware if
Senator Egan was currently certified to perform CPR.
3:11:44 PM
REPRESENTATIVE SEATON asked if there was a time lag between the
latest protocol based on ILCOR standard and local teaching, and
if this would cause any unintended consequence.
3:13:27 PM
CHIEF ETHERIDGE replied that existing standards were maintained
until an agency recognized, updated, and trained to the new
standards, although this was usually a very short time.
3:14:25 PM
KEN ZAFREN, Medical Director, State EMS (Emergency Medical
Services) Council, declared his support for proposed SB 202, as
it would allow EMS agencies in Alaska to update resuscitation
techniques based on the latest recommendations. He said that
ILCOR reviewed all the research, then made its recommendations,
which were put into guidelines by the American Heart Association
and the European Resuscitation Council. He pointed out that
these two sets of guidelines were usually similar though not
necessarily identical. He explained that that the proposed bill
based the recommendations on those from ILCOR, as it gave EMS
more flexibility for a choice of guidelines to best serve the
state.
3:17:48 PM
DAVID HULL, Chair, Governor's Alaska Council on Emergency
Medical Services (ACEMS), expressed his support for the proposed
legislation. He explained that ILCOR was the CPR procedure. He
agreed with Chief Etheridge that the latest standards would be
taught when people returned for recertification. He declared
that the proposed bill would allow EMS instructors in Alaska "to
teach the most current, appropriate resuscitation standards as
they are published, without having to go through the regulatory
changes to adopt new curricula for our training programs."
3:20:41 PM
WARD HURLBURT, M.D., Chief Medical Officer/Director, Division of
Public Health, Central Office, Department of Health and Social
Services, testified in support of SB 202, as it allowed the use
of contemporary recommendations to determine the preferred
methodology for training and teaching CPR, as well as the
flexibility to make modifications if the methodology was updated
by ILCOR. He pointed out that, as there was not any monitoring
of CPR, individuals would use the training method that they had
learned, and would continue to save lives with CPR. He opined
that the proposed bill would not create any confusion.
3:23:14 PM
CHAIR KELLER closed public testimony.
3:23:37 PM
REPRESENTATIVE SEATON said that his concern for the timing of
the certification to the new procedures was alleviated.
3:24:18 PM
REPRESENTATIVE DICK moved to report SB 202 out of committee with
individual recommendations and the accompanying zero fiscal
notes. There being no objection, SB 202 was forwarded from the
House Health and Social Services Standing Committee.
SCR 16-CELIAC DISEASE AWARENESS MONTH
3:24:43 PM
CHAIR KELLER announced that the next order of business would be
SENATE CONCURRENT RESOLUTION NO. 16, Proclaiming May 2012 to be
Celiac Disease Awareness Month.
3:25:15 PM
SENATOR CATHY GIESSEL, Alaska State Legislature, stated that
proposed SCR 16 would designate May 2012 as Celiac Disease
Awareness Month. She explained that celiac disease, though
often erroneously referred to as gluten intolerance, was a
genetic disease in which exposure to gluten actually damaged the
intestinal walls. She reported that gluten was a protein found
on wheat, rye, and barley, and that 1 out of 133 Americans, more
than 5,000 Alaskans, was estimated to have celiac disease, even
though almost 97 percent were not aware of it. She shared that,
as the symptoms were vague, often it was not immediately
diagnosed. She pointed out that, as there was not a cure, only
a strict gluten free diet could treat it. She reported that
beer, cold cuts, soy sauce, and some cosmetics all contained
gluten.
3:28:04 PM
CHAIR KELLER expressed his appreciation for the proposed
resolution.
3:28:30 PM
REPRESENTATIVE KERTTULA shared that she also had celiac disease,
and she offered her support for the proposed resolution.
3:28:47 PM
BRANDY WENDLER, RN, Alaska Nurse Practitioner Association,
stated that she has celiac disease, possibly since her freshman
year in high school, although it took ten years for her to get
the diagnosis. She explained that the ingestion of gluten
caused an auto-immune reaction, and in the small intestine this
resulted in an inability to absorb nutrients from food. She
shared that, even though she was in the medical field, she had
not been able to get an appropriate diagnosis. She declared
that the raising of awareness was "pivotal in saving people the
suffering" and the money which resulted from mis-diagnosis.
3:30:59 PM
TERESA NEENO, Allergist, Allergy, Asthma, and Immunology Center
of Alaska, said that, as numerous people had food allergies,
diagnosis for celiac disease was often missed. She explained
that the removal of gluten from the diet made the tests for
celiac disease non-reactive. She declared that the raising of
awareness for celiac disease would increase that conversation
between providers and patients, and allow for earlier diagnosis.
3:32:18 PM
CHAIR KELLER asked if it was celiac disease or its awareness
that was increasing. He asked what was the cause for a genetic
disorder.
3:33:09 PM
DR. NEENO, in response to Representative Keller, said that the
prevalence was not increasing, but that there was more awareness
of the disease. She agreed that awareness allowed for earlier
diagnosis, as the tests were then given. She pointed out that
failure to have the tests could lead to more complications from
other auto immune disorders, often seen in conjunction with
celiac disease. She stated that, although these were different
than allergies, food was a commonality to both.
CHAIR KELLER expressed his surprise to the prevalence.
DR. NEENO said that there were a lot of alternatives to diet,
and there was a lot of information for gluten free products on
line.
3:35:31 PM
REPRESENTATIVE KERTTULA asked if celiac disease was more
prevalent in Scandinavians.
DR. NEENO replied that she was unaware of the prevalence in
populations around the world, but that there was more gluten
sensitivity in the northern tiers, such as the Irish. She
declared it likely there was a selective advantage at some point
in time. She shared that, although a genetic study was
available, a positive test only increased the likelihood, as
celiac disease was more common in Caucasian populations. She
declared that celiac disease was clearly a genetic disease with
some groups having a greater predisposition.
3:37:49 PM
CHAIR KELLER closed public testimony.
3:38:17 PM
REPRESENTATIVE KERTTULA asked about the connection of celiac
disease in cosmetics.
3:38:37 PM
REPRESENTATIVE DICK moved to report SCR 16 out of committee with
individual recommendations and the accompanying zero fiscal
notes. There being no objection, SCR 16 was reported from the
House Health and Social Services Standing Committee.
3:39:35 PM
The committee took an at-ease from 3:39 p.m. to 3:44 p.m.
HB 319-STUDY HEALTH EFFECTS OF AIRPORT SCREENING
3:44:11 PM
CHAIR KELLER announced that the final order of business would be
HOUSE BILL NO. 319, "An Act requiring a study of the health
effects of airport security screening."
3:45:00 PM
ANNA WHITE, Staff, Representative Sharon Cissna, Alaska State
Legislature, paraphrased from the sponsor statement:
HB 319 requires the Department of Health and Social
Services to conduct a study to determine the health
consequences of the federal Transportation Security
Administration's (TSA) procedures in Alaska. The
study will indicate the physical, mental health and
emotional impacts on Alaskans who are traveling
through locations that require TSA procedures.
Many Alaskans who have traveled outside Alaska since
October 2010 have experienced full-body scanners and
invasive physical exams given by TSA in larger
airports throughout the United States. However,
starting in December of last year, body scanners were
installed at the international airports in Anchorage,
Fairbanks, Juneau and Ketchikan.
The software in these machines makes the image less
personal that those of older machines, but the
scanner's millimeter wavelength technology has drawn
health concern from some passengers, and there is
insufficient independent scientific verification to be
assured of their safety.
If a scanner detects anything irregular in the
person's body, or if a passenger refuses to be
scanned, TSA procedures call for a hands-on exam by a
TSA employee. People who have previously been
subjected to events, either from work, environmental,
medical treatment or physical assault related can be
re-traumatized by this type of touching.
Unfortunately, trauma is pervasive in Alaska.
Increase in physically invasive touch on a population
leading the nation in trauma of many kinds requires
study to assess the mental health impacts on Alaska's
population. The cost of those impacts also needs to
be examined.
In addition to emotional reactions, there is concern
for protecting the public health. Among these
concerns is the need for advanced health training of
TSA workers who touch private and possibly surgically
or otherwise injured body parts that may also have
communicable diseases. These issues are critical to
travel in Alaska. Alaskans not only travel eight
times more than the national average, and a study is
needed to critically assess the possible impacts of
TSA procedures on the mental, emotional and physical
health of Alaskans.
3:47:11 PM
REPRESENTATIVE SHARON CISSNA, Alaska State Legislature, declared
that Alaska had high levels of trauma, behavioral problems, and
domestic violence, and consequently, that many Alaskans were
more sensitive to being touched in an inappropriate way.
Reporting that the "pat downs" started in October 2010, she
declared these to be "a physical exam by someone who did not
know what they were doing, and it was beyond invasive." She
relayed that, after she had gone public with her reactions to
the use of a body scanner a few months later, she had received
about 1000 e-mails. Since that time, she stated that she had
received an additional 1000 e-mails, calls, and letters relating
personal stories of airport experiences. She said the vast
majority of the respondents had not reported their experiences
to TSA. She explained that the proposed bill would have the
Department of Health and Social Services (DHSS) conduct a study
of the impacts that occur [from airport screenings], and review
"health in a broader way than some people would." She professed
that this would identify the psychological trauma, especially to
those suffering from post-traumatic stress disorder, from the
airport screening. She explained that this re-traumatization
from the screenings could reverse any prior therapies for
trauma. She offered a personal experience. She declared that
the proposed study would clarify many questions. She spoke
about the confusion for children when watching their parents
being touched at the airport screenings "in the very way their
parents told them not to let anybody touch them." She declared
that Alaska already had to spend a large amount of money on
mental and physical health issues, and that airport screenings
brought up many of these issues. She described a physical
contact during an airport screening that was a health concern.
She offered her belief that the study [described in proposed HB
319] was necessary.
3:58:05 PM
REPRESENTATIVE DICK asked about her discussions with DHSS and if
there was a fiscal note for the proposed bill.
REPRESENTATIVE CISSNA directed attention to the attached fiscal
note [Included in members' packets]. She agreed that although
it was not a small amount, DHSS had forecast the need for three
studies.
3:59:15 PM
REPRESENTATIVE SEATON pointed out that the fiscal note was for
$640,000 in each of FY13 and FY 14.
REPRESENTATIVE CISSNA said that the proposed bill would also
address some of the governor's concerns. She shared that when
she had asked TSA for a study, they had instead responded to the
governor with an "outline [of] the job they're doing, but with
no numbers or any real study."
4:00:25 PM
REPRESENTATIVE DICK asked if there had been a nationwide study.
REPRESENTATIVE CISSNA, in response, said that she had not found
any of this information. She declared that there was no
oversight on TSA, and that states did not have the power to
change TSA, as it was a federal entity. She expressed her
concern that the State of Alaska would be financially
accountable for the outcome of these airport screenings,
especially for any problems related to re-traumatization.
4:02:13 PM
REPRESENTATIVE SEATON asked whether the proposed study should
concentrate on the newer screening systems, instead of including
the older systems.
REPRESENTATIVE CISSNA suggested that there would be different
effects from each type of technology, and she questioned the
safety and consequences from each type. She shared the TSA
claim that the scanner was safer than the flight, and she
reported that her next study would be on the dangers of flight.
She offered her belief that the new scanners were more X-ray
like, and could be more damaging to anyone with potential
cancers on body surfaces. She expressed her desire to find that
other studies were available. She opined that studies were not
conducted because of "what feels like political issues."
4:06:31 PM
REPRESENTATIVE SEATON, directing attention to page 1, line 7, of
the proposed bill, asked to clarify the intent of the study;
whether the bill was attempting to establish a percentage of
traumatized people, or to find out if these traumas did exist.
REPRESENTATIVE CISSNA replied that she wanted to ensure that
Alaska airports were given the freedom to change the security
process which was "inflicted on our passengers," so that
passengers were touched in ways that were respectful and safe.
She declared that the State of Alaska needed to be responsible
for the money spent on health care, "to fight to make sure that
we bring the cost down," and to demand to be reimbursed for the
costs that arise from federal decisions.
4:10:10 PM
REPRESENTATIVE KERTTULA, offering her belief that the federal
government should do this study, opined that the proposed fiscal
note would not allow the proposed bill to pass. She suggested
inserting "(E) post-traumatic stress disorder" on page 1, after
line 13.
4:11:37 PM
MARILYN GUTTENBERG declared that there was physical and
psychological harm from repeated use of the screening machines,
as the machines were not calibrated. She described a personal
experience.
DIANE SCHENKER, Co-Director, Alaskans' Freedom to Travel USA,
said that she had spent at least one day each week at the
Anchorage Airport interviewing travelers since the scanners were
installed in December 2011. She declared that the scanners had
many false alarms; hence, the screeners would pat down and touch
the passengers. She relayed some of the passenger stories of
invasive pat downs by screeners. She commented on the possible
health consequences from searches of luggage, as passengers no
longer had any control over their luggage. She stated that, as
some people would no longer travel by plane, there were
unintended health consequences.
4:18:49 PM
PATRICIA ANDERSON, Co-Director, Alaskans' Freedom to Travel USA,
stated that she had been groped 5 times in the last 16 months,
and she had cancelled two other flights because she did not want
to be touched again. She declared that she now refused to go
through the scanners, as she was not assured to the safety of
these scanners. She discussed some of her personal experiences
with TSA and her concerns with her perceived lack of sanitation
by TSA, revealing that she did want to do anything that could
compromise her well-being. She stated that flying was very
stressful. She expressed her concern for the well-being of her
daughter, and that she had attempted to limit both of their
exposures to x-rays. She declared the need for an immediate,
independent, published study.
4:23:17 PM
JOE MCLAUGHLIN, MD, MPH, Chief and State Epidemiologist, Section
of Epidemiology, Division of Public Health, Department of Health
and Social Services, stated that the administration had no
position on the proposed bill. He declared that proposed HB 319
would require DHSS to investigate the varied health effects of
airport screening in general. He noted that it would be
necessary to evaluate the potential for psychological trauma and
physical effect from airport screening to travelers. He
declared that passage of HB 319 would necessitate that DHSS
contract with one or more outside agencies to perform the
studies. He offered his belief that this would require several
separate studies, including behavioral health, radiologic, and
toxicologic studies. Each of these studies would require the
development of a study protocol, review by an institutional
review board, and two years for the implementation and write up.
He declared that the studies would be very expensive, a
challenge to successfully implement, and a substantial increase
to the current DHSS workload.
4:25:54 PM
CHAIR KELLER closed public testimony.
4:26:20 PM
REPRESENTATIVE DICK asked Representative Cissna if the proposed
bill would be a good investment of the funds and effective in
repealing the actions of TSA.
4:27:18 PM
REPRESENTATIVE CISSNA offered her belief that many actions had
occurred without a full study to the consequences. She opined
that the screenings at airports would change our culture. She
shared that officials from TSA had suggested a curricula for
children to better understand the pat downs at airports. She
declared that federal and state constitutional rights had been
lost. She suggested that the federal government should be sued.
She declared that proposed HB 319 was an effort to gather the
information.
4:31:36 PM
CHAIR KELLER declared that HB 319 would be held over.
4:32:10 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:32 p.m.