Legislature(2011 - 2012)CAPITOL 106

03/10/2011 03:00 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HCR 3 SENIOR CITIZEN PROTECTIONS TELECONFERENCED
Moved CSHCR 3(HSS) Out of Committee
*+ HCR 1 PANCREATIC CANCER AWARENESS MONTH TELECONFERENCED
Moved CSHCR 1(HSS) Out of Committee
*+ HCR 5 VITAMIN D SUPPLEMENTS TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled 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.                                                                                                          

Document Name Date/Time Subjects
Sponsor Statement PC.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 - Pancreatic Awareness Fiscal note.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 Support.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 Support 2.pdf HHSS 3/10/2011 3:00:00 PM
HCR3 Promoting Safety for Older Alaskans.pdf HHSS 3/10/2011 3:00:00 PM
HCR3 Sponsor Statement 2 15 11.pdf HHSS 3/10/2011 3:00:00 PM
HCR 3 Support Letter from AK Commission on Aging 3 1 11.pdf HHSS 3/10/2011 3:00:00 PM
HCR3 Support Ltr from Long Term Care Ombudsman .pdf HHSS 3/10/2011 3:00:00 PM
HCR3.AK Commission on Aging Press Release.Senior Growth.2.17.09.pdf HHSS 3/10/2011 3:00:00 PM
HCR 3 - Safety Protection of Older Alaskans fiscal note.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 McFadden Letter support 3.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 McFadden Obituary support 4.pdf HHSS 3/10/2011 3:00:00 PM
HCR 1 PANCAN endorsement letter support 5.pdf HHSS 3/10/2011 3:00:00 PM
HCR3.Senior & Disabilities Services Fact Sheet.2.14.11.pdf HHSS 3/10/2011 3:00:00 PM
HCR3.State of Alaska.Adult Protecttve Services brochure.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Sponsor Statement.pdf HHSS 3/10/2011 3:00:00 PM
HCR5.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 1.pdf HHSS 3/10/2011 3:00:00 PM
HCR 5 - Disease Prevention Vitamin D Fiscal note.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 2.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 3.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 4.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 5.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 6.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 7.pdf HHSS 3/10/2011 3:00:00 PM
AARP letter of support.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 8.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Backup 9.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Letter of Support 1.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Letter of Support 2.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Letter of Support 3.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Cancer Whereas Clarification.pdf HHSS 3/10/2011 3:00:00 PM
HCR5 Critical Responses to the IOM Report.pdf HHSS 3/10/2011 3:00:00 PM
Dr Peter Ehrnstrom Response to HCR 5_3-9-11_Keller.pdf HHSS 3/10/2011 3:00:00 PM