Legislature(2015 - 2016)CAPITOL 106

03/22/2016 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 315 ELECTRONIC VISIT VERIFICATION: MEDICAID TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 334 CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE TELECONFERENCED
Heard & Held
-- Public Testimony --
*+ HB 328 REGULATION OF SMOKING TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         March 22, 2016                                                                                         
                           3:12 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Paul Seaton, Chair                                                                                               
Representative Liz Vazquez, Vice Chair                                                                                          
Representative Neal Foster                                                                                                      
Representative Louise Stutes                                                                                                    
Representative Geran Tarr                                                                                                       
Representative Adam Wool                                                                                                        
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative David Talerico                                                                                                   
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 315                                                                                                              
"An Act relating to an electronic visit verification system for                                                                 
providers of certain medical assistance services."                                                                              
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 334                                                                                                              
"An Act relating to visitation and child custody."                                                                              
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 328                                                                                                              
"An Act prohibiting smoking in certain places; relating to                                                                      
education on the smoking prohibition; and providing for an                                                                      
effective date."                                                                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 315                                                                                                                  
SHORT TITLE: ELECTRONIC VISIT VERIFICATION: MEDICAID                                                                            
SPONSOR(s): REPRESENTATIVE(s) VAZQUEZ                                                                                           
                                                                                                                                
02/17/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/17/16       (H)       HSS                                                                                                    
03/22/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 334                                                                                                                  
SHORT TITLE: CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE                                                                            
SPONSOR(s): REPRESENTATIVE(s) MUNOZ                                                                                             
                                                                                                                                
02/22/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/22/16       (H)       HSS, JUD                                                                                               
03/22/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 328                                                                                                                  
SHORT TITLE: REGULATION OF SMOKING                                                                                              
SPONSOR(s): REPRESENTATIVE(s) TALERICO                                                                                          
                                                                                                                                
02/22/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/22/16       (H)       HSS, JUD, FIN                                                                                          
03/22/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ANITA HALTERMAN, Staff                                                                                                          
Representative Liz Vazquez                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 315 for the bill sponsor,                                                                   
Representative Vazquez.                                                                                                         
                                                                                                                                
ALLISON LEE, State Director; Chair                                                                                              
Rescare Alaska                                                                                                                  
Alaska PCA Providers Association                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 315.                                                                   
                                                                                                                                
DENISE TOCCO                                                                                                                    
Sandata Technologies                                                                                                            
Port Washington, New York                                                                                                       
POSITION STATEMENT:  Testified in support of HB 315.                                                                          
                                                                                                                                
GREY MITCHELL, Director                                                                                                         
Division of Labor Standards & Safety                                                                                            
Department of Labor & Workforce Development                                                                                     
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
315.                                                                                                                            
                                                                                                                                
CONNIE SIPE, Executive Director; Co-Chair                                                                                       
Center for Community                                                                                                            
Alaska PCA Providers Association                                                                                                
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 315.                                                                   
                                                                                                                                
REPRESENTATIVE CATHY MUNOZ                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 334 as the sponsor of the                                                                   
bill.                                                                                                                           
                                                                                                                                
AL LEVY, Chair                                                                                                                  
Board of Psychologist and Psychological Associate Examiners                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 334.                                                                   
                                                                                                                                
DEBBIE HOLBROOK, Attorney                                                                                                       
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during discussion of HB 334.                                                                   
                                                                                                                                
ANDY HARRINGTON                                                                                                                 
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 334.                                                                   
                                                                                                                                
JOHN HOAG, Attorney                                                                                                             
Petersburg, Alaska                                                                                                              
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
KATHRYN SODEN, Senior Staff Attorney                                                                                            
Legal Program                                                                                                                   
Alaska Network of Domestic Violence and Sexual Assault (ANDVSA)                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
SARALYN TABACHNICK, Executive Director                                                                                          
AWARE                                                                                                                           
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
KIRSTEN SWANSON, Attorney                                                                                                       
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during discussion of HB 334.                                                                   
                                                                                                                                
FRED VALDEZ, Attorney                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
JOSEPH COULTER-KHAN                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
CATHY COULTER-KHAN                                                                                                              
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 334.                                                                       
                                                                                                                                
JOSHUA BANKS, Staff                                                                                                             
Representative Dave Talerico                                                                                                    
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 328 on behalf of the bill                                                                   
sponsor, Representative Talerico.                                                                                               
                                                                                                                                
MICHAEL PATTERSON                                                                                                               
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 328.                                                                          
                                                                                                                                
DALE FOX, President/CEO                                                                                                         
Alaska CHARR                                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in opposition to HB 328.                                                                       
                                                                                                                                
KAREN PERDUE                                                                                                                    
American Cancer Society                                                                                                         
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 328.                                                                          
                                                                                                                                
EDY RODEWALD                                                                                                                    
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 328.                                                                          
                                                                                                                                
EMILY NENON, Alaska Government Relations Director                                                                               
American Cancer Society                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 328.                                                                   
                                                                                                                                
GARY FERGUSON, M.D.                                                                                                             
Senior Director of Community Health Services                                                                                    
Alaska Native Tribal Health Consortium                                                                                          
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 328.                                                                          
                                                                                                                                
ALEX MCDONALD, Owner                                                                                                            
Ice Fog Vapor                                                                                                                   
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in opposition to HB 328.                                                                       
                                                                                                                                
SHARON WOLKOFF                                                                                                                  
Kodiak Area Native Association                                                                                                  
Kodiak, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 328.                                                                          
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:12:55 PM                                                                                                                    
                                                                                                                                
CHAIR PAUL  SEATON called  the House  Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    3:12   p.m.                                                               
Representatives Seaton,  Stutes, Vazquez,  Foster, and  Wool were                                                               
present at  the call  to order.   Representative Tarr  arrived as                                                               
the meeting was in progress.                                                                                                    
                                                                                                                                
[Chair Seaton passed the gavel to Vice Chair Vazquez.]                                                                          
                                                                                                                                
         HB 315-ELECTRONIC VISIT VERIFICATION: MEDICAID                                                                     
                                                                                                                                
3:14:18 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR  LIZ  VAZQUEZ  announced  that  the  first  order  of                                                               
business would  be HOUSE  BILL NO.  315, "An  Act relating  to an                                                               
electronic  visit verification  system for  providers of  certain                                                               
medical assistance services."                                                                                                   
                                                                                                                                
3:14:37 PM                                                                                                                    
                                                                                                                                
ANITA HALTERMAN, Staff, Representative  Liz Vazquez, Alaska State                                                               
Legislature, paraphrased from the  Sponsor Statement [included in                                                               
members' packets], which read, in part:                                                                                         
                                                                                                                                
     This bill  requires the implementation  and use  of EVV                                                                    
     systems  for PCA  services in  Alaska. The  EVV systems                                                                    
     monitor and  verify home  health services  delivered by                                                                    
     PCAs by  tracking whether home visits  occurred and the                                                                    
     time spent in  the home. The EVV system  will verify in                                                                    
     real time  the physical location of  the provider (PCA)                                                                    
     and the recipient  after they both "sign  in" and "sign                                                                    
     out" of  the EVV system.  The "sign in" and  "sign out"                                                                    
     is  usually done  by land-line  or cell  phone and  the                                                                    
     location is verified by the  EVV program. Thus, the EVV                                                                    
     system reduces waste, abuse and  fraud by capturing and                                                                    
     reporting actual  time worked by  the PCA or  home care                                                                    
     provider. The  goal of  HB 315 is  to ensure  the State                                                                    
     only pays  providers for approved services  rendered by                                                                    
     appropriate home  health agency personnel  while within                                                                    
     the recipients' home or  other authorized setting. This                                                                    
     ensures  that Medicaid  recipients receive  services as                                                                    
     authorized.  It  is  anticipated that  billing  errors,                                                                    
     fraud, and abuse will  be reduced significantly through                                                                    
     verification of home visits through these efforts.                                                                         
                                                                                                                                
     As  Alaska's population  is aging,  the demand  for PCA                                                                    
     and home  care services will increase.  Accordingly, it                                                                    
     is will  become increasingly  more important  to ensure                                                                    
     that home care is  delivered properly and that publicly                                                                    
     funded   resources   are   being  managed   and   spent                                                                    
     appropriately. It  is anticipated  that Alaska  has the                                                                    
     potential  to realize  savings of  between $15  million                                                                    
     and $37 million dollar.                                                                                                    
                                                                                                                                
MS.  HALTERMAN relayed  that some  of the  major benefits  of the                                                               
proposed HB  315 included that  the technology  could potentially                                                               
provide early identification for  adult protective service issues                                                               
by identifying  neglect situations  and triggering alerts  to the                                                               
agencies when  a care giver  did not show  up at the  home, which                                                               
would also realize  savings for reducing payment  of services not                                                               
rendered.   She directed attention to  supportive documents which                                                               
addressed  the   return  on  investment  [included   in  members'                                                               
packets].                                                                                                                       
                                                                                                                                
                                                                                                                              
3:17:02                                                                                                                         
                                                                                                                                
MS. HALTERMAN  paraphrased from  some proposed  changes [included                                                               
in  members'  packets]  from  the  original bill  to  a  not  yet                                                               
introduced  committee substitute  (CS)  for HB  315, labeled  29-                                                               
LS1287\W, Glover,  2/18/16 [included in members'  packets], which                                                               
read:                                                                                                                           
                                                                                                                                
     Upon reviewing  the bill  as it  had been  written, I'd                                                                    
     realized  that home  and community  based and  personal                                                                    
     care attendant services are NOT  always provided in the                                                                    
     home  but that  sometimes  they are  provided in  other                                                                    
     settings. The  language change  on version  W addresses                                                                    
     the  need   for  more  flexibility  with   language  to                                                                    
     accommodate the various settings  where services may be                                                                    
     provided. The addition of language  to allow for "other                                                                    
     approved settings" addressed that issue.                                                                                   
                                                                                                                                
                                                                                                                              
3:17:50                                                                                                                         
                                                                                                                                
MS. HALTERMAN  moved on to paraphrase  proposed changes [included                                                               
in members' packets]  from the not yet introduced Version  W to a                                                               
not yet introduced committee substitute  (CS) for HB 315, labeled                                                               
29-LS1287\E,  Glover,  3/21/16  [included in  members'  packets],                                                               
which read:                                                                                                                     
                                                                                                                                
     Version E keeps  the change made in version  W and adds                                                                    
     a few others as follows:                                                                                                   
                                                                                                                                
     1. Prior  to requesting a  hearing over this  bill, SDS                                                                    
     inquired  of our  office about  the development  of the                                                                    
     new system  they appear  to have  thought they  were to                                                                    
     develop in light  of language used in versions  A and W                                                                    
     of this  bill. The changes  to version H make  it clear                                                                    
     that the  Department shall procure an  electronic visit                                                                    
     verification system  and not develop one  of their own.                                                                    
     The development  of a  system would  be costly  and the                                                                    
     Department alerted me on March  16, 2016 that this bill                                                                    
     would  likely have  a $5  million  dollar fiscal  note,                                                                    
     this  lead   us  to  understand   that  they   had  not                                                                    
     understood the  intent of this  bill. In  addition, the                                                                    
     changes in  version H also  add a stipulation  that the                                                                    
     system must allow  providers to electronically document                                                                    
     the service  in near real-time where  it is technically                                                                    
     feasible. This  will allow us to  address allowing more                                                                    
     flexibility  in remote  areas with  no telephone,  cell                                                                    
     phone or  computer access. It has  been discovered that                                                                    
     vendors  appear to  offer  another  solution for  those                                                                    
     settings  that  actually  is entered  after  the  visit                                                                    
     occurs. These  vendors offer a unique  number to assure                                                                    
     that  the above  information  is  collected and  stored                                                                    
     when technology  solutions are  not feasible.  The bill                                                                    
     ensures  that any  vendor must  be  capable of  meeting                                                                    
     these requirements.                                                                                                        
                                                                                                                                
     2. The  PCA providers have  raised issues with  a third                                                                    
     party  employment relationship  concern  that has  been                                                                    
     addressed by  the Federal Department  of Labor  and our                                                                    
     office felt  the need to  place assurances in  the bill                                                                    
     that address  this issue. We  do not intend  to replace                                                                    
     the  role of  the PCA  provider or  Home and  Community                                                                    
     based  provider agencies  in the  role of  employer. In                                                                    
     order to address that concern,  we changed the language                                                                    
     of  the bill  in order  to ensure  the providers  still                                                                    
     have the  ability to be  alerted to concerns  that need                                                                    
     to  be  managed  by  the  agency.  Therefore  it  seems                                                                    
     advisable to  add language that requires  the vendor to                                                                    
     alert  the  provider  agency  of  any  gaps  or  missed                                                                    
     appointments in order for them  to remediate the issue.                                                                    
     The state also should have  the option to receive these                                                                    
     alerts and the new CS addresses that issue.                                                                                
                                                                                                                                
     3.  The  final  change addresses  integration  concerns                                                                    
     that agencies  raised. Some  claim to  have proprietary                                                                    
     systems that they feel will  no longer be usable with a                                                                    
     vendor based  EVV system.  The final  version E  adds a                                                                    
     new  section  that  addresses  this  by  requiring  the                                                                    
     vendor to  integrate any existing EVV  systems into the                                                                    
     vendor solution.                                                                                                           
                                                                                                                                
     4. We  had leg  legal define "real  time" as  "within a                                                                    
     couple of minutes of the  occurrence". This was done in                                                                    
     order  to identify  any  gaps in  service  or to  allow                                                                    
     adult  protective service  issues to  be identified  as                                                                    
     early   as    possible   for   the    most   vulnerable                                                                    
     beneficiaries.                                                                                                             
                                                                                                                                
3:21:34 PM                                                                                                                    
                                                                                                                                
MS.  HALTERMAN summarized  that  the  bill "is  easy  to use,  it                                                               
doesn't require  hardware or  software, and  it does  assure that                                                               
the services that  are paid for by state  government are actually                                                               
being rendered within those homes."                                                                                             
                                                                                                                                
3:21:50 PM                                                                                                                    
                                                                                                                                
VICE CHAIR VAZQUEZ opened public testimony.                                                                                     
                                                                                                                                
3:22:15 PM                                                                                                                    
                                                                                                                                
ALLISON LEE,  State Director; Chair,  Rescare Alaska,  Alaska PCA                                                               
Providers  Association,  stated   support  for  electronic  visit                                                               
verification  (EVV) systems  for  PCA  (personal care  attendant)                                                               
services, and  pointed to some  issues with the not  yet proposed                                                               
committee substitute.   She directed  attention to a  white paper                                                               
stating  general  support  for  the proposed  bill  [included  in                                                               
members' packets],  and she noted  that the Department  of Health                                                               
and Social  Services had the authority  to establish requirements                                                               
for EVV without any legislation.                                                                                                
                                                                                                                                
3:23:55 PM                                                                                                                    
                                                                                                                                
DENISE TOCCO,  Sandata Technologies, stated support  for proposed                                                               
HB  315, and  reported  that Sandata  Technologies  was a  vendor                                                               
currently  which offered  EVV systems  in seven  states, and  had                                                               
been providing  this EVV technology  to payers and  providers for                                                               
the past  36 years.  She  stated that the EVV  systems had proven                                                               
to remove fraud and improve  quality by ensuring that only visits                                                               
that  were properly  verified  were allowed  to  be submitted  as                                                               
claims.  She  declared that the third party  outcomes showed that                                                               
EVV programs could  reduce claims costs by as much  as 50 percent                                                               
without changing  the benefit structure  or care  delivery model,                                                               
as  the savings  were a  result  of the  removal of  fraud.   She                                                               
estimated  that  EVV  systems could  provide  a  "minimum  claims                                                               
reduction  of  5 percent,"  which  represented  an estimated  $50                                                             
million savings  in the first  year prior to any  Federal Medical                                                             
Assistance  Percentages (FMAP).    She relayed  that Centers  for                                                               
Medicare  &   Medicaid  Services  (CMS)  had   recently  approved                                                               
enhanced  FMAP rates  at  90 percent  for one  time  fees and  75                                                               
percent  for recurring  fees for  two states  with EVV  programs.                                                               
She declared  that proposed  HB 315 was  an important  first step                                                               
toward improving  efficiency and  insuring care, after  which the                                                               
Department  of  Health and  Social  Services  could evaluate  and                                                               
procure  an  EVV  solution  that  works best  for  Alaska.    She                                                               
suggested that  Sandata Technologies recommended a  single vendor                                                               
solution  in  order to  maximize  program  savings, and  increase                                                               
quality of care with consistent  monitoring and alerts.  She also                                                               
recommended that  an EVV solution  be required to  integrate with                                                               
existing  provider   software  systems,  to  help   maintain  the                                                               
investments  made  by  local  providers.   She  shared  that  the                                                               
majority of  home care providers in  most states had not  made an                                                               
investment  in technology  and would  welcome  solutions to  help                                                               
automate their businesses.  She  reported that EVV solutions were                                                               
sold as a  software service, and that there was  not any software                                                               
or hardware to buy.   She relayed that it would  take four to six                                                               
months to implement a statewide  program.  She reiterated support                                                               
for the proposed HB 315.                                                                                                        
                                                                                                                                
3:26:32 PM                                                                                                                    
                                                                                                                                
MS. TOCCO, in response to  Representative Tarr, said that she was                                                               
affiliated  with Sandata  Technologies,  a  vendor providing  EVV                                                               
software to state programs.                                                                                                     
                                                                                                                                
REPRESENTATIVE TARR  asked if Sandata anticipated  an interest in                                                               
providing the services, should the proposed bill pass.                                                                          
                                                                                                                                
MS. TOCCO  replied that Sandata would  like to bid on  any public                                                               
procurement as a result of the proposed bill.                                                                                   
                                                                                                                                
3:28:52 PM                                                                                                                    
                                                                                                                                
GREY MITCHELL,  Director, Division  of Labor Standards  & Safety,                                                               
Department  of  Labor &  Workforce  Development,  in response  to                                                               
Representative Tarr, explained that he  did not have any specific                                                               
information about  the services, as  his involvement was  for the                                                               
potential impacts  on labor laws  and any EVV  requirement issues                                                               
that may impact the state.                                                                                                      
                                                                                                                                
3:29:42 PM                                                                                                                    
                                                                                                                                
MS.  TOCCO,  in  response  to  Representative  Tarr,  offered  an                                                               
explanation  as an  industry vendor,  and not  specifically as  a                                                               
representative from  her company.   She explained  that non-urban                                                               
visits could  be verified  through a  variety of  ways, including                                                               
telephonic verification of visits,  cellular GPS solutions, home-                                                               
based device  solutions, and she acknowledged  that the geography                                                               
of Alaska  offered some unique  challenges.  She shared  that her                                                               
company  had operated  in  many large  states  with rural  areas,                                                               
where connectivity  could be  a challenge,  and the  company, and                                                               
other vendors,  had found multiple solutions  for verification of                                                               
visits.                                                                                                                         
                                                                                                                                
3:30:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  asked about  the changes in  technology over                                                               
the  past  36  years  that   Sandata  Technologies  had  been  in                                                               
business.                                                                                                                       
                                                                                                                                
MS. TOCCO replied  that her company had used  telephones, and had                                                               
held the original patents on  electronic visit verification (EVV)                                                               
although that had since expired.                                                                                                
                                                                                                                                
3:31:16 PM                                                                                                                    
                                                                                                                                
CONNIE SIPE, Executive Director;  Co-Chair, Center for Community,                                                               
Alaska  PCA  Providers  Association,  reported  that  Alaska  PCA                                                               
Providers Association represented  the largest provider companies                                                               
in Alaska.  She stated support  of the proposed bill, in concept,                                                               
and  directed   attention  to  the  aforementioned   white  paper                                                               
[included in members' packets].   She expressed desire to work on                                                               
the not yet  introduced committee substitutes.   She relayed that                                                               
the  Medicaid expenditures  for PCAs  in the  last year  had been                                                               
about  $89 million  in  Alaska, pointing  out  that the  provider                                                               
agencies  were  "economic engines  in  the  communities where  we                                                               
provide many,  many hours of jobs  and work."  She  reported that                                                               
the  white paper  had urged  a  standards based  method, used  by                                                               
Washington and  other states,  which had set  a standard  for the                                                               
kind of EVV  systems to be used statewide, so  that the providers                                                               
could  use an  integrated software  system.   She noted  that the                                                               
State of Alaska was still  requiring hard copy time sheets signed                                                               
by  the worker  and  the client.   She  offered  belief that  one                                                               
uniform  state system  could be  very inefficient  as there  were                                                               
large  providers from  multiple  states  with different  systems.                                                               
She expressed  concern with a real  time window as it  imposed an                                                               
implied monitoring  obligation that could be  difficult to staff.                                                               
She  relayed information  from a  CMS seminar  during which  some                                                               
states  had been  told they  were "joint  employers" of  personal                                                               
care attendants,  as indicated  by an EVV  system with  real time                                                               
access by  the state.   She  stated that, as  there were  not any                                                               
clear   federal  regulations,   this  was   currently  based   on                                                               
interpretation by  the U.S. Department  of Justice.   She pointed                                                               
out that  this could  affect the  state's liability  for overtime                                                               
pay  to  a  personal  care  attendant.   She  pointed  out  that,                                                               
although the  aggregate cost of  Medicaid spent on  personal care                                                               
attendants seemed  large, this was  so much less per  client than                                                               
the cost of  nursing homes.  She reported that  the personal care                                                               
attendants were  the lowest paid  per unit service in  the Alaska                                                               
Medicaid system.                                                                                                                
                                                                                                                                
3:37:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  relayed that  this issue  had arisen  in the                                                               
past, as there had been a  re-evaluation of the time allotted for                                                               
personal care  services (PCAs).   She relayed that  some services                                                               
had  been  re-scheduled  into 15  minute  increments,  which  she                                                               
opined had scaled back the  amount of time allocated to patients.                                                               
She asked if  this was putting a  lot of strain on  the system to                                                               
provide the  services in the  allotted time, and  possibly taking                                                               
away from provider time with the client.                                                                                        
                                                                                                                                
MS. SIPE reported that Medicaid costs  for the PCAs had come down                                                               
from over  $100 million annually,  partially as an effort  by the                                                               
Department  of   Health  and  Social  Services   to  become  more                                                               
prescriptive about  the amount  of time and  service.   She noted                                                               
that,  in other  states, many  consumers did  not have  land line                                                               
phones, and  not all PCAs had  a cell phone or  availability of a                                                               
land  line.    She  expressed  concern  for  this,  sharing  that                                                               
sometimes workers were  met by a crisis  immediately upon arrival                                                               
at a job, and were not able  to sign-in right away.  She reminded                                                               
that the agencies were in a  constant back and forth with workers                                                               
and clients, so  were much more aware of the  goings-on, and that                                                               
this provider  information and  data were  kept available  to the                                                               
state upon request.                                                                                                             
                                                                                                                                
3:41:01 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR asked  how  frequently  the association  was                                                               
audited.                                                                                                                        
                                                                                                                                
MS. SIPE relayed that the state  would draw 50 of the higher risk                                                               
service providers each year, of  which a number were PCA agencies                                                               
and  home and  community based  providers.   She shared  that her                                                               
agency included  10 providers and  had been audited  three times,                                                               
although never  found to have any  problems.  She noted  that, as                                                               
they  were  subject to  audit  for  seven  years, they  kept  the                                                               
records for that far back.                                                                                                      
                                                                                                                                
3:42:30 PM                                                                                                                    
                                                                                                                                
VICE CHAIR VAZQUEZ asked about the  periods of time for the three                                                               
audits.                                                                                                                         
                                                                                                                                
MS.  SIPE offered  her  belief  that the  state  audits were  for                                                               
service in 2006, then again for services in 2010 and in 2011.                                                                   
                                                                                                                                
VICE  CHAIR VAZQUEZ  asked about  the compensation  received from                                                               
the  Department  of  Health  and Social  Services  for  every  15                                                               
minutes of service.                                                                                                             
                                                                                                                                
MS. SIPE stated that the Medicaid  base rate for personal care in                                                               
Anchorage, although there were  some regional adjustments because                                                               
of cost,  was $6.10 for each  15 minute unit.   She reported that                                                               
many  PCAs in  this area  had Certified  Nursing Assistant  (CNA)                                                               
certificates,  and asked  to be  paid $15  - $16  per hour.   She                                                               
added that all  the unpaid costs, support  costs, and supervisory                                                               
costs were  also paid out  of this, as  they only billed  for the                                                               
actual services delivered.  She  pointed out that the agency paid                                                               
the travel time, as it was not billed to Medicaid.                                                                              
                                                                                                                                
MS.  SIPE, in  response  to  Vice Chair  Vazquez,  said that  the                                                               
regional cost in SE Alaska was  9 percent higher, adding about $2                                                               
per  hour.   She  relayed  that the  PCAs  started  at $14.58  or                                                               
$15.02, and,  dependent on prior experience,  could start higher,                                                               
up to $16 per  hour.  She said that it was  difficult to pay less                                                               
than $16 per  hour in Anchorage, although  in smaller communities                                                               
in SE Alaska PCAs were sometimes paid $14.50 - $15 per hour.                                                                    
                                                                                                                                
VICE CHAIR VAZQUEZ asked if the agency offered health insurance.                                                                
                                                                                                                                
MS.  SIPE replied  that the  agency would  be obligated  to start                                                               
providing  health  insurance  for  people  with  variable  hours,                                                               
fluctuating around  30 hours  per week,  on July  1.   She stated                                                               
that it  was likely they would  not be able to  provide this, and                                                               
would then  also have to  drop the  health insurance for  40 hour                                                               
per  week workers  as  the agency  could not  afford  to pay  the                                                               
insurance premiums.   She acknowledged that this  would result in                                                               
the  payment  of  penalties.    She  reported  that  the  monthly                                                               
insurance premium  for a worker  with no dependents was  $950 per                                                               
month, with  a fairly high  deductible.   She stated that  it was                                                               
not  possible to  pay these  premiums for  those only  working 30                                                               
hours per week.  She shared  that the agency was looking at lower                                                               
cost policies with  higher deductibles that would  still meet the                                                               
Patient Protection and Affordable  Care Act (PPACA) requirements.                                                               
She said  that part time  workers received the  required benefits                                                               
of  unemployment  insurance,  a  small Christmas  bonus,  and  an                                                               
occasional  paid  holiday  each  year.   She  reported  that  the                                                               
[profit] margin was very low as there  was a lot of paid time for                                                               
training,  no-shows,  supervisors,   billing  clerks,  compliance                                                               
staff, and "other things."                                                                                                      
                                                                                                                                
[HB 315 was held over.]                                                                                                         
                                                                                                                                
         HB 334-CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE                                                                     
                                                                                                                                
3:47:10 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR VAZQUEZ  announced that  the next  order of  business                                                               
would be HOUSE  BILL NO. 334, "An Act relating  to visitation and                                                               
child custody."                                                                                                                 
                                                                                                                                
3:47:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CATHY  MUNOZ, Alaska State  Legislature, explained                                                               
that she  had given  a lot  of thought to  AS 25.24.150,  and its                                                               
judgements for  custody.   She relayed that  she had  met several                                                               
individuals   who    had   experienced    significantly   damaged                                                               
relationships with their children due  to the application of this                                                               
law.  She paraphrased from the Sponsor Statement, which read:                                                                   
                                                                                                                                
     HB 334  was introduced  to give judges  more discretion                                                                    
     in  determining  the  best interest  of  the  child  in                                                                    
     custody  cases.  Currently,  AS  25.24.150  includes  a                                                                    
     provision  that  if  a  parent   has  been  accused  of                                                                    
     domestic violence  that parent may not  be awarded sole                                                                    
     or  joint  physical  or legal  custody  of  the  child.                                                                    
     Although there is a rebuttable  presumption in place to                                                                    
     overcome  this  provision,  it  is  a  lengthy  process                                                                    
     involving  the  requirement  to  complete  a  one  year                                                                    
     batterer's intervention  program. Domestic  violence is                                                                    
     broadly  defined   to  include  an   ex-parte  domestic                                                                    
     violence order,  a violation  of an  order, misdemeanor                                                                    
     assault, or allegations  of abuse. In 2004,  HB 385 was                                                                    
     signed  into  law   which  established  the  rebuttable                                                                    
     presumption.  The intent  of  this  legislation was  to                                                                    
     ensure  those  with  a  criminal  history  of  domestic                                                                    
     violence were  held accountable  for their  actions and                                                                    
     that the children in question  were protected. At times                                                                    
     the provisions  of AS 25.24.150 are  used for custodial                                                                    
     advantage. In  these instances,  the discretion  of the                                                                    
     court is limited and the  best interest of the child is                                                                    
     affected.  The  U.S.  Department of  Health  and  Human                                                                    
     Services   states,  "Fatherless   children  are   at  a                                                                    
     dramatically greater  risk of drug and  alcohol abuse."                                                                    
     Additionally,  they state  "Fatherless children  living                                                                    
     in homes  without contact with their  biological father                                                                    
     are  twice as  likely to  drop out  of school."  HB 334                                                                    
     seeks to give flexibility  to judges, while maintaining                                                                    
     the  presumption  for   those  with  criminal  domestic                                                                    
     violence  convictions  while  ensuring that  the  well-                                                                    
     being of children remains our primary priority.                                                                            
                                                                                                                                
REP. MUNOZ read from the proposed bill, page 4, line 29:                                                                        
                                                                                                                                
     The  willingness   and  ability   of  each   parent  to                                                                    
     facilitate  and   encourage  a  close   and  continuing                                                                    
     relationship  between the  other parent  and the  child                                                                    
     except   that  the   court   may   not  consider   this                                                                    
     willingness and  ability if one  parent shows  that the                                                                    
     other  parent  has  sexually assaulted  or  engaged  in                                                                    
     domestic violence...                                                                                                       
                                                                                                                                
REP. MUNOZ  expressed her concern  with the "engaged  in domestic                                                               
violence" language.   She  declared that  there was  a rebuttable                                                               
presumption  in  which  the  parents   accused  or  convicted  of                                                               
domestic violence on  one or more occasions could  complete a one                                                               
year  batters' intervention  program, although  the parent  could                                                               
only see the child under  supervised conditions on a very limited                                                               
basis during  this year.   She reported  that Alaska had  some of                                                               
the toughest domestic violence laws in  the U.S.  She stated that                                                               
the changes proposed  in the bill would not weaken  the laws, and                                                               
the domestic violence orders or  the process for filing would not                                                               
change.   She shared that the  proposed changes to the  law would                                                               
require a  conviction of domestic  violence for  those provisions                                                               
of  AS  25.24.150 to  apply  in  custodial decisions,  and  would                                                               
result in more equity, due process,  and the best interest of the                                                               
child  to   be  the  first  priority   in  determining  custodial                                                               
arrangements.  She  shared an anecdote for the  problems with the                                                               
statute.                                                                                                                        
                                                                                                                                
3:54:43 PM                                                                                                                    
                                                                                                                                
[Vice Chair Vazquez returned the gavel to Chair Seaton]                                                                         
                                                                                                                                
REPRESENTATIVE  MUNOZ,   in  response  to   Representative  Tarr,                                                               
explained  that  the current  law  could  be used  for  custodial                                                               
advantage, as  it was  as ex-parte filing  which did  not require                                                               
both parties to  be present.  She shared that  any contact during                                                               
this time could result in a  violation of the ex-parte order, and                                                               
be considered a domestic violence incident.                                                                                     
                                                                                                                                
3:56:35 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON opened public testimony.                                                                                           
                                                                                                                                
3:56:47 PM                                                                                                                    
                                                                                                                                
AL  LEVY,   Chair,  Board   of  Psychologist   and  Psychological                                                               
Associate Examiners, stated that  he was representing himself and                                                               
the interests  of his clients.   He declared that he  was opposed                                                               
to  HB  334.   He  shared  that he  was  a  therapist in  private                                                               
practice in Anchorage, he worked  with children and families many                                                               
of which  were families  going through divorce,  and that  he had                                                               
been addressing domestic  violence and its effects  for almost 30                                                               
years.   He  emphasized that  passage  of proposed  HB 334  would                                                               
"roll back  the clock  30 years in  terms of  protecting children                                                               
and victim parents  to a time when there was  little recourse for                                                               
victims  and children."   He  declared that  children and  victim                                                               
parents had  the right to  live free of  abuse and the  threat of                                                               
violence,  they deserved  safety.   He stated  that the  proposed                                                               
bill would  cost too much  money at a  time when the  state could                                                               
least afford it,  as it would dramatically increase  costs to the                                                               
State  of Alaska.    He explained  that raising  the  bar from  a                                                               
finding of domestic violence by  the preponderance of evidence to                                                               
the conviction of a crime  of domestic violence, which was beyond                                                               
a reasonable doubt, would lead  to increased demands on the state                                                               
attorney general,  as well as municipal  prosecutors to prosecute                                                               
every  case of  domestic violence.   He  stated that  there would                                                               
also  be   increased  demands  on  the   state  troopers,  police                                                               
departments, the  public defender's office, the  Office of Public                                                               
Advocacy, the courts, and the  Office of Children's Services.  He                                                               
emphasized that  the rebuttable  presumption worked,  it required                                                               
the judge to find the domestic  violence, and the current law did                                                               
a  good job  protecting vulnerable  children and  victim parents.                                                               
He acknowledged  that errors for  finding domestic  violence when                                                               
none had  occurred could  happen, although  these cases  were the                                                               
exception,  and not  the  rule.   He  declared  that due  process                                                               
rights were currently observed,  as parents facing accusations of                                                               
domestic  violence were  afforded the  opportunity to  face their                                                               
accuser,  hear  and  see  the evidence,  and  offer  evidence  in                                                               
return.   He stressed  that the proposed  bill was  not restoring                                                               
any lost  rights to  accused parents,  but was,  instead, denying                                                               
the right to  safety for vulnerable children  and victim parents.                                                               
He declared  that raising the  standard to a  criminal conviction                                                               
beyond  a reasonable  doubt was  unreasonable and  unrealistic to                                                               
the victims  of domestic  violence.  He  said that  education and                                                               
better  training for  judges,  custody investigators,  attorneys,                                                               
and social workers was needed,  as this would increase knowledge,                                                               
accuracy, and understanding about  domestic violence.  He relayed                                                               
that safety was the highest priority, not parents' rights.                                                                      
                                                                                                                                
4:04:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR mused  that  the challenge  was that  "human                                                               
relationships are so  complex."  She pointed to  the potential to                                                               
behave  in   damaging  ways  during   custody  battles   and  the                                                               
dissolving of  relationships.  She  asked if  there was a  way to                                                               
address these circumstances for who was telling the truth.                                                                      
                                                                                                                                
MR. LEVY offered his belief that  the primary need was for better                                                               
training in education,  as every dollar invested  would bring ten                                                               
times the  return in  dividends for  savings in  cost, heartache,                                                               
and damage  to people.   He suggested to  not cut the  budget for                                                               
the Alaska  Network on Domestic  Violence and Sexual  Assault and                                                               
instead,  to provide  the resources  necessary for  education and                                                               
training.   He suggested required  training on  domestic violence                                                               
to  police  officers,  social  workers,  judges,  and  other  key                                                               
players.   He  relayed that  10  percent of  divorce and  custody                                                               
cases take  up 90  percent of  the court  time.   He acknowledged                                                               
that these  cases typically involved  serious questions  of harm,                                                               
substance  abuse,  and  domestic  violence,  and  required  close                                                               
scrutiny  by trained  experts  who knew  what to  look  for.   He                                                               
suggested  that  more  resources  be provided  to  state  custody                                                               
investigators,  as currently  there was  an income  cut-off which                                                               
made  it  difficult  for  many people,  with  income  above  that                                                               
amount, to  afford a private  custody investigator.   He reminded                                                               
the committee that  every dollar spent on  prevention would "reap                                                               
huge benefits down the road."                                                                                                   
                                                                                                                                
4:08:15 PM                                                                                                                    
                                                                                                                                
DEBBIE  HOLBROOK,  Attorney,  relayed   that  she  had  practiced                                                               
domestic relations and family law, as  well as civil law over the                                                               
past 40 years.   She shared that she had been  a mediator for the                                                               
court system,  as well as a  guardian ad litem, and  that she was                                                               
aware  that all  the sociological  studies on  the adjustment  of                                                               
children after  divorce was  to make sure  that the  children had                                                               
frequent and open access to both  parents.  She reported that the                                                               
changes  in   the  custody  statute   since  2004   had  included                                                               
references  to   domestic  violence  which  did   not  require  a                                                               
conviction, so  consequently there were now  attempts to litigate                                                               
domestic  violence crime  in  the midst  of  civil divorce  cases                                                               
without affording the accused any  of the criminal safeguards and                                                               
protections afforded someone  if they were charged  with a crime.                                                               
She opined that this had led  to serious problems, and she stated                                                               
her support  of the proposed bill.   She offered her  belief that                                                               
"the pendulum has  swung too far on this  domestic violence issue                                                               
at least  with regards  to private  custody cases.   I  have seen                                                               
that allegations alone have become  a bludgeon to be used against                                                               
fathers in custody  cases."  She stated that  once the allegation                                                               
was made  there was no  longer a  presumption of innocence.   She                                                               
explained that the issuance of  an ex parte restraining order was                                                               
the start of  the difficulties for fathers, as  this could result                                                               
in no contact  or only supervised visits with the  children.  She                                                               
offered her belief  that young fathers were not  in the financial                                                               
position to  afford an  attorney and were  often quite  naïve and                                                               
unaware about  the custody statutes,  the repercussions,  and the                                                               
breadth of  the definition  for domestic  violence.   She relayed                                                               
that her experience indicated that  many women were encouraged to                                                               
use this as  a "weapon."  She said that  many judges were worried                                                               
about looking  soft on  domestic violence,  and often  cited that                                                               
their  hands were  tied by  the statute.   She  opined that  most                                                               
people  were not  aware  of  how very  broad  the definition  for                                                               
domestic  violence had  become,  and could  now include  texting,                                                               
yelling, and telephone conversations.   She declared that she was                                                               
not trying  to minimize domestic  violence, but  that requirement                                                               
of conviction  allowed the accused some  protections when accused                                                               
of  something this  serious.   She  opined  that the  legislature                                                               
needed to  be aware  when removing  obstacles, and  that children                                                               
needed access to both parents.                                                                                                  
                                                                                                                                
4:16:02 PM                                                                                                                    
                                                                                                                                
ANDY HARRINGTON  said that  he had  done a lot  of pro  bono work                                                               
over  the   years.    He   offered  six  points   supporting  his                                                               
understanding that  the approach of  the proposed bill was  not a                                                               
good  idea.   He  offered his  first point  that  the history  of                                                               
domestic  violence  proven by  a  preponderance  of the  evidence                                                               
before  a civil  court  was  an appropriate  basis  to apply  the                                                               
presumption that  was currently in  the statute.  He  stated that                                                               
the requirement for  a conviction proved before  another court by                                                               
a reasonable  doubt would  run the  risk of  erasing some  of the                                                               
progress that  had been made over  the last several years  on the                                                               
overwhelming  domestic  violence  problem.   He  noted  that  the                                                               
Alaska   Supreme  Court   had  already   given  the   statute  an                                                               
appropriately  narrowed interpretation  which  prevented it  from                                                               
being  abused  and misused  in  many  situations, and  that  this                                                               
should be  taken into  account.  He  suggested that  the proposed                                                               
bill could expand application of  the presumption, as the history                                                               
of domestic violence  meant two incidences, or  one incident that                                                               
caused serious physical injury.   He offered his belief that this                                                               
needed  to  be  thought  through quite  carefully,  as  it  could                                                               
broaden the application.                                                                                                        
                                                                                                                                
4:17:46 PM                                                                                                                    
                                                                                                                                
[Chair Seaton passed the gavel to Vice Chair Vazquez]                                                                           
                                                                                                                                
4:18:06 PM                                                                                                                    
                                                                                                                                
MR.  HARRINGTON stated  that there  many reasons  why there  were                                                               
more incidents of domestic violence  than there were convictions,                                                               
including under  reporting, lack  of law enforcement,  and courts                                                               
that needed  to decrease  hours.  He  suggested that,  should the                                                               
legislature  couple this  change with  a significant  increase in                                                               
law enforcement,  prosecutors, public  defenders, and  courts, it                                                               
might  then make  some sense.   He  stated his  concern with  the                                                               
disparate  impact on  rural and  urban  areas, as  there was  "an                                                               
unfortunate reality  that criminal  law enforcement cannot  be as                                                               
responsive to Alaska's  rural areas as it is in  urban areas.  We                                                               
can't afford  to achieve that  equality."  He offered  his belief                                                               
that  this  was   another  reason  why  the   requirement  for  a                                                               
conviction before the presumption of  guilt was applied was not a                                                               
good  idea.   He asked  that the  legislators not  make up  their                                                               
minds based  on hearing one side  of an anecdote that  may or may                                                               
not be representative of what was happening on a larger scale.                                                                  
                                                                                                                                
VICE  CHAIR VAZQUEZ  asked  for  him to  cite  the Supreme  Court                                                               
decision regarding this statute.                                                                                                
                                                                                                                                
MR.  HARRINGTON,  in response,  relayed  that,  in 270  P.3d  737                                                               
(2012),  the  court had  held  that  completion of  a  batterer's                                                               
intervention  program  was   not  the  only  way   to  rebut  the                                                               
presumption, and that  the Superior Court was  not prevented from                                                               
completing a best interest analysis.                                                                                            
                                                                                                                                
REPRESENTATIVE  WOOL  asked  about  earlier  testimony  that  the                                                               
definition of domestic violence  had expanded to include texting,                                                               
phone  calls, and  yelling, and  whether this  broader definition                                                               
had  now included  more people  "under the  umbrella of  domestic                                                               
violence."  He  asked if this could preclude  someone from having                                                               
any visitation with their child.                                                                                                
                                                                                                                                
MR. HARRINGTON opined that these  and similar incidences could be                                                               
a  violation of  the domestic  violence statute  if committed  in                                                               
violation  of  an  existing  protective   order.    He  expressed                                                               
agreement that  it was  appropriate to be  held accountable.   He                                                               
shared  that,  if the  point  was  made  that the  definition  of                                                               
domestic  violence  was too  broad,  then  perhaps it  should  be                                                               
reviewed  to determine  if it  encompasses items  that it  should                                                               
not, and then adjust the definition.   He offered his belief that                                                               
the approach of  the proposed bill was not the  right solution to                                                               
that particular problem.                                                                                                        
                                                                                                                                
REPRESENTATIVE WOOL  suggested that  this may be  a case  by case                                                               
situation.                                                                                                                      
                                                                                                                                
4:23:13 PM                                                                                                                    
                                                                                                                                
JOHN HOAG, Attorney, said that  he had sent in comments [included                                                               
in members'  packets].  He  reported that he had  volunteered and                                                               
handled about 90  domestic violence cases pro bono  over the past                                                               
9 years.   He  stated that  rarely had  he seen  a case  with one                                                               
incident  of domestic  violence, as  most cases  had patterns  of                                                               
domestic violence that usually occurred  over time.  He expressed                                                               
agreement  with  earlier testimony  that  it  was "the  most  un-                                                               
reported  crime probably  there is."   He  said that  requiring a                                                               
conviction  was  a  bad  idea,   and  he  testified  against  the                                                               
amendments.   He  clarified that  attorneys were  appointed if  a                                                               
person could not afford them in  a custody case if there had been                                                               
issues of domestic violence.   He offered his opinion that judges                                                               
were very reluctant  to order supervised visitation,  and that it                                                               
was usually arranged through family or  friends, and it was not a                                                               
cost  factor.   He reported  that  the Supreme  Court had  deemed                                                               
there must be  a pathway for unsupervised visitation.   He stated                                                               
that  the cases  where this  supervision remained  in place  were                                                               
most often  when the party  did not follow the  court directives.                                                               
He  urged the  committee not  to pass  this bill,  as it  was his                                                               
experience that  most women  did not  use this as  a weapon.   He                                                               
suggested that  the definition of  domestic violence  be expanded                                                               
to  cover  abusive  relationships  and  the  terrible  effect  on                                                               
children.                                                                                                                       
                                                                                                                                
4:27:01 PM                                                                                                                    
                                                                                                                                
KATHRYN  SODEN,  Senior  Staff Attorney,  Legal  Program,  Alaska                                                               
Network of Domestic Violence and  Sexual Assault (ANDVSA), stated                                                               
that she  was speaking  in opposition  to proposed  HB 334.   She                                                               
shared that she had worked with  ANDVSA for more than five years,                                                               
and had  represented men and  women who had  experienced domestic                                                               
violence in  family law  cases.  She  expressed her  concern that                                                               
there were  many reasons  for a lack  of criminal  conviction for                                                               
domestic violence,  although the  victims and the  children still                                                               
needed the protections of the law.   She said that the rebuttable                                                               
presumption law had protected children  in many cases where there                                                               
were not  any criminal  convictions.   She shared  two anecdotes,                                                               
the first  of which  included four to  five criminal  charges for                                                               
domestic  violence being  filed against  the abusive  mother, but                                                               
subsequently  being dismissed.    She relayed  that the  domestic                                                               
violence  rebuttable presumption  had then  been applied  and the                                                               
custody of  the children was awarded  to the father.   She stated                                                               
that  this made  the children  safer.   In the  second case,  the                                                               
mother had endured years of abuse  from the father, but had never                                                               
sought help  from the  police because she  did not  speak English                                                               
and was  isolated within  an ethnic  community.   Again, although                                                               
there were no  convictions against the father,  the court applied                                                               
the  rebuttable  presumption  law  and  awarded  custody  of  the                                                               
children to the mother.  She  stated that in both cases, when the                                                               
presumption was  applied, the abusive  parent still  had frequent                                                               
regular and open contact with  the children while that parent was                                                               
required to  get services to  address the problem.   She declared                                                               
that the rebuttable  presumption law was working as  it should to                                                               
keep Alaskan  kids safe.   She reiterated  her opposition  to the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
MS. SODEN, in response to  Representative Tarr, said that, in her                                                               
experience,  an   ex  parte  protective   order  alone   was  not                                                               
considered as an incident of  domestic violence, in order for the                                                               
court  to  apply  the  presumption   law.    She  said  that  the                                                               
presumption law  required a preponderance of  evidence, which was                                                               
not  the standard  for an  ex  parte that  domestic violence  had                                                               
occurred.  She relayed that the  system could make the finding of                                                               
domestic  violence upon  further litigation,  as then  both sides                                                               
would have  the opportunity to  be heard.   She said that  it was                                                               
not her experience that the courts  would cut off kids from their                                                               
parents for  a year, and  that the  courts were very  hesitant to                                                               
take away visitation  even in extremely abusive  situations.  She                                                               
declared that  it was  important to keep  the presumption  law in                                                               
its current  state as it  allowed the victim's parent  the safety                                                               
of  having sole  legal  and primary  physical  custody until  the                                                               
abuser gets treatment for the issues.   She stated that it was an                                                               
extremely rare circumstance for the  court to cut off all contact                                                               
with the children.                                                                                                              
                                                                                                                                
4:33:18 PM                                                                                                                    
                                                                                                                                
SARALYN TABACHNICK,  Executive Director,  AWARE, stated  that the                                                               
proposed bill  was going  in the  wrong direction  for supporting                                                               
victims  of  domestic  violence,   particularly  children.    She                                                               
pointed  out that  not  every victim  of  domestic violence  even                                                               
reported to law  enforcement.  She shared that  her experience at                                                               
AWARE was  for children who had  been ordered by courts  to spend                                                               
unsupervised  time with  an  abusive parent,  one  that had  been                                                               
hurtful to  their mother,  a parent  they were  afraid of,  and a                                                               
parent who  may be directly abusive  to the child, as  well.  She                                                               
stated that  much more  often at  AWARE it  was mothers  who were                                                               
trying to protect their children.                                                                                               
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
4:35:55 PM                                                                                                                    
                                                                                                                                
MS. TABACHNICK  continued her testimony,  stating that  often the                                                               
children were sent  to be with a parent who  terrified them.  She                                                               
reported that often  this was a regular repetitive  pattern.  She                                                               
pointed  out  that  unless  a child  could  articulate  what  was                                                               
terrifying for them,  there was not any protection  for them, and                                                               
that they  could not tell  until they  felt safe.   She continued                                                               
and stated that children will not  feel safe until they were free                                                               
from harm and fear.  She  relayed that children were being raised                                                               
learning  that their  needs and  feelings did  not matter,  their                                                               
boundaries  were not  respected or  important, and  they did  not                                                               
have rights  to boundaries.   She stressed  that this set  up the                                                               
most vulnerable  children to  be harmed.   She declared  that she                                                               
found proposed HB 334 "to be  one of the most disheartening bills                                                               
I've  ever  spoken  to in  my  nearly  30  years  at AWARE.    If                                                               
anything, we  need laws that  further protect children;  not laws                                                               
that make  it more difficult  to keep  them safe."   She reported                                                               
that research  had indicated that  children were most  helped and                                                               
healed after divorce when both  parents got along.  She addressed                                                               
the  fear induced  by  domestic violence,  and  pointed out  that                                                               
texting  and  telephone  calls  by a  person  who  has  committed                                                               
domestic violence were  another source of fear.   She stated that                                                               
"we  all deserve  to live  without fear  and without  concern for                                                               
fear particularly  in our intimate  partner relationships  and in                                                               
our parenting relationships."                                                                                                   
                                                                                                                                
4:38:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  relayed that  there  could  be hundreds  of                                                               
phone  calls and  texts harassing  an individual  and creating  a                                                               
feeling of being in real danger.                                                                                                
                                                                                                                                
MS. TABACHNICK stated  that these were power  and control tactics                                                               
which  was  what domestic  violence  was  about, the  control  of                                                               
another person by keeping them in fear.                                                                                         
                                                                                                                                
4:39:30 PM                                                                                                                    
                                                                                                                                
KIRSTEN  SWANSON, Attorney,  paraphrased  from a  letter she  had                                                               
submitted to  the committee, which  read:  [included  in members'                                                               
packets.]                                                                                                                       
                                                                                                                                
     I am  writing this  letter in support  of HB  334. This                                                                    
     bill will  address some of the  unintended consequences                                                                    
     in  the domestic  violence statutes.  No one  should be                                                                    
     the  victim of  violence from  a domestic  partner, but                                                                    
     the  current   statutes  are   encouraging  unnecessary                                                                    
     litigation  and  hurting  children.  Domestic  violence                                                                    
     restraining orders are civil  cases, not criminal cases                                                                    
     so the burden  of proof is minimal. This  makes it much                                                                    
     easier for  someone to  now use the  court system  as a                                                                    
     weapon  against the  other  parent. Frequently,  people                                                                    
     will  file a  restraining  order before  they file  for                                                                    
     divorce or  custody of their children.  This allows the                                                                    
     person  who  makes the  allegation  to  kick the  other                                                                    
     parent  out of  the home,  restrict all  access to  the                                                                    
     children,  freeze  the  bank accounts  and  change  the                                                                    
     locks.  Once the  parties are  involved in  the custody                                                                    
     case  any  allegations  of  domestic  violence  have  a                                                                    
     tendency  to  severely  curtail access  of  the  parent                                                                    
     being  accused  of abuse  to  their  children. It  also                                                                    
     makes the  case more litigious  and hostile so  that it                                                                    
     is unlikely  that the parents  will be able  to mediate                                                                    
     their  differences  and  successfully  co-parent  their                                                                    
     children. The presumption in custody  cases is that the                                                                    
     non-abuser is  the better  parent. Therefore,  a person                                                                    
     who can  convince the  court that  they are  victims of                                                                    
     past  domestic violence  will get  full custody  of the                                                                    
     children. Unfortunately, the  presumption advantage has                                                                    
     encouraged people to exaggerate  and make up stories to                                                                    
     get  the  other  parent  labeled as  a  perpetrator  of                                                                    
     domestic  violence.  Even   if  the  domestic  violence                                                                    
     allegation is more  than ten years ago,  has nothing to                                                                    
     do  with the  children, does  not include  violence and                                                                    
     was never previously reported  to anyone the allegation                                                                    
     is  enough  to immediately  deny  access  of the  other                                                                    
     parent  to   the  children.  Children  are   then  left                                                                    
     confused  and hurt  as to  why a  parent they  love has                                                                    
     suddenly  and without  warning  disappeared from  their                                                                    
     life.  The increase  in  domestic violence  restraining                                                                    
     order  hearings and  domestic  violence allegations  in                                                                    
     custody cases  clogs the court system  with unnecessary                                                                    
     litigation.  It  costs  the judicial  system  resources                                                                    
     better used  in prosecuting criminal cases  of domestic                                                                    
     violence.   It  encourages   custody  hearings   to  be                                                                    
     contentious,  winner  take  all affairs  that  make  it                                                                    
     difficult for  parents to put aside  their differences,                                                                    
     put  the best  interests  of their  children first  and                                                                    
     learn  to   co-parent  their  children.  HB   334  will                                                                    
     actually  protect  victims  of  domestic  violence  and                                                                    
     children in  custody cases by removing  the impetus for                                                                    
     exaggerating  and  lying   about  prior  arguments  and                                                                    
     disagreements. When the court  system is inundated with                                                                    
     questionable  claims of  domestic  violence  it has  an                                                                    
     impact of  making domestic violence seem  less serious.                                                                    
     This  hurts people  who truly  are victims  in need  of                                                                    
     help  as  their   cases  end  up  delayed   due  to  an                                                                    
     overburdened court system.                                                                                                 
                                                                                                                                
4:44:17 PM                                                                                                                    
                                                                                                                                
FRED  VALDEZ, Attorney,  stated that  he had  primarily practiced                                                               
family law  for the past 35  years, and had been  a prosecutor of                                                               
domestic violence  for 1.5 years.   He  said that he  was against                                                               
the proposed bill.  He reported  that the crime being charged was                                                               
often not  the first instance  of domestic violence, as  often it                                                               
was  not until  after many  incidences that  the victim  took the                                                               
initiative and called for help.   Hence, a standard of conviction                                                               
of a domestic violence crime was  not a good standard for change.                                                               
He suggested other  changes to guard against the  use of domestic                                                               
violence as a tool to gain  advantage in the battle over custody.                                                               
He  stated that  the  judges  had a  very  good  grasp for  these                                                               
situations.   He shared court  room presentations of  some texts,                                                               
stating  that  they  were  "too  vile  to  even  repeat  in  this                                                               
testimony.  They  threaten, they coerce, they call  names..."  He                                                               
expressed  agreement  that  these  texts  were  about  power  and                                                               
control,  emphasizing  that,  as   Alaska  had  a  huge  domestic                                                               
violence problem, the proposed bill was a step backwards.                                                                       
                                                                                                                                
4:47:12 PM                                                                                                                    
                                                                                                                                
JOSEPH COULTER-KHAN read from a prepared statement, which read:                                                                 
                                                                                                                                
     My  name is  Joseph Coulter-Khan.  I am  fourteen years                                                                    
     old. I  am here  to tell you  why I think  HB 334  is a                                                                    
     step in  the wrong  direction. My  father has  not been                                                                    
     convicted of  domestic violence, but I  am legitimately                                                                    
     terrified  of him.  When I  lived with  him, I  saw him                                                                    
     yell constantly. I saw him  beat up my sister and shove                                                                    
     her down the  stairs. I saw him  constantly threaten my                                                                    
     mother,  my  sisters,  and me.  He  embarrasses  me  in                                                                    
     public with his yelling and  anger. I'm afraid of being                                                                    
     with  him. Every  time I  get a  phone call  my stomach                                                                    
     drops, I start to sweat, to  panic, pace, and go into a                                                                    
     whole  anxiety  attack.  I  start  hyperventilating.  I                                                                    
     don't  want to  live  with that  kind  of pressure  and                                                                    
     anxiety. It is a negative  energy and distracts me from                                                                    
     my schoolwork  and from doing  the things that  I love.                                                                    
     Because my  father has not  been convicted  of domestic                                                                    
     violence,  if HB  334 passes  I would  have to  go with                                                                    
     someone who has  abused me for 10-12  years. Why should                                                                    
     I be with him? Why should  he have the right to me when                                                                    
     he  is the  one  who abused  me?  If he  has  a say  in                                                                    
     everything I  do, he  may make  decisions that  are not                                                                    
     the  best for  me.  He told  me that  if  he gets  full                                                                    
     custody  he will  take me  to  Arizona and  not let  me                                                                    
     contact  my mother  at all.  He says  bad things  to me                                                                    
     about my  mother. Some mothers  are too afraid  to call                                                                    
     the police because they are  afraid of what the abusers                                                                    
     will do  to them when they  get out. So then  there are                                                                    
     abusers  who  get  custody  because  they  aren't  held                                                                    
     accountable  for   their  abuse.    My   childhood  was                                                                    
     stressful  and now  that I'm  away from  my father  I'm                                                                    
     feeling better. If I have  to spend more time with him,                                                                    
     it will waste the rest of  the childhood that I have. I                                                                    
     won't  have  a regular  childhood.  You  don't know  my                                                                    
     father. You don't know what  he's done. But there is no                                                                    
     conviction  of domestic  violence. HB  334 violates  my                                                                    
     rights as a minor to safety from my abusive father.                                                                        
                                                                                                                                
4:50:54 PM                                                                                                                    
                                                                                                                                
CATHY COULTER-KHAN  said that she  was also a victim  of domestic                                                               
violence, and  shared her educational background,  including that                                                               
she was a Fulbright  Scholar and a PhD.  She  stated that she had                                                               
spent more than 20 years in  an abusive marriage in which she was                                                               
physically and  emotionally abused.   She  shared an  incident of                                                               
violence in  which her  husband was  subsequently arrested.   She                                                               
stated that  she did not  leave simply  because she did  not have                                                               
the means to  leave and she could  not see an escape  route.  She                                                               
did  not know  where  she  would go  and  how  would she  support                                                               
herself and  her children.   As a  result, she  denied everything                                                               
and the charges were dropped, and  there was not a conviction for                                                               
domestic violence.  She pointed  out that the proposed bill would                                                               
not  have  allowed  that  instance of  domestic  violence  to  be                                                               
consequential in a current hearing,  as it had happened more than                                                               
five  years prior.   She  explained that  abusers would  isolate,                                                               
denigrate,  and  cut  their  victims   off  from  any  source  of                                                               
independence.   Life  was  a  series of  crises  and  day to  day                                                               
survival.   She relayed  instances of  abuse, shame,  and mockery                                                               
her  husband  had  heaped  on  her  children  until  one  of  her                                                               
daughters had  entered the crisis  center during her  junior year                                                               
in high  school.   She pointed  out that there  had never  been a                                                               
conviction of  domestic violence.   She reported that it  was not                                                               
until after  more than  20 years  of abuse that  she was  able to                                                               
leave, because she had a job  that would support her, and she had                                                               
family and friends  who supported her.  She stated  that this was                                                               
her fourth year  of divorce litigation, and that  her husband had                                                               
not paid  any child support  for almost  three years, even  as he                                                               
left her with marital debt and  froze their assets.  She declared                                                               
that  he was  using  the  legal system  to  perpetuate power  and                                                               
control, and  that custody of the  children was a means  to exert                                                               
control.   She  acknowledged  that her  evidence  was flimsy,  as                                                               
there  were not  any convictions,  and  it was  difficult to  put                                                               
together sufficient evidence to protect  her children.  She asked                                                               
how women  without an education,  a job,  or a family  to support                                                               
them  could get  a conviction.    She stated  that requiring  the                                                               
conviction was to support the  abusers, perpetuate the abuse, and                                                               
endanger  the  children.    She  stated  her  opposition  to  the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
VICE CHAIR  VAZQUEZ noted the  committee was running out  of time                                                               
and "we're going to have to  cut off testimony on this particular                                                               
bill.  I apologize."                                                                                                            
                                                                                                                                
[HB 334 was held over.]                                                                                                         
                                                                                                                                
                  HB 328-REGULATION OF SMOKING                                                                              
                                                                                                                                
4:57:40 PM                                                                                                                    
                                                                                                                                
VICE  CHAIR VAZQUEZ  announced that  the next  order of  business                                                               
would  be HOUSE  BILL NO.  328,  "An Act  prohibiting smoking  in                                                               
certain   places;   relating   to  education   on   the   smoking                                                               
prohibition; and providing for an effective date."                                                                              
                                                                                                                                
4:58:21 PM                                                                                                                    
                                                                                                                                
JOSHUA BANKS,  Staff, Representative Dave Talerico,  Alaska State                                                               
Legislature,  said  that they  had  a  committee substitute  that                                                               
mirrored  the   Senate  version  of   the  proposed  bill.     He                                                               
paraphrased  from the  Sponsor  Statement  [included in  members'                                                               
packets], which read:                                                                                                           
                                                                                                                                
     Current Alaska  law prohibits smoking in  many areas of                                                                    
     the  state, including  healthcare facilities,  schools,                                                                    
     childcare  facilities,  and  public  meeting  rooms  in                                                                    
     government buildings.  Many communities  and businesses                                                                    
     have   voluntarily    created   smoke-free   workplaces                                                                    
     allowing over one-half of Alaskans  to live and work in                                                                    
     smoke-free   buildings.   There    are   however   many                                                                    
     businesses  and  smaller  communities who  have  chosen                                                                    
     not, or  are not able  to take similar action  in their                                                                    
     buildings,  leading to  exposure  to second-hand  smoke                                                                    
     and the  resulting negative health effects.  House Bill                                                                    
     328  seeks  to  safeguard working  Alaskans  and  their                                                                    
     children from  the adverse effects of  secondhand smoke                                                                    
     by providing  a statewide smoke-free workplace  law for                                                                    
     businesses   and  public   places.  Certain   boroughs,                                                                    
     cities,  and the  unorganized borough  who do  not have                                                                    
     the ability to create  and enforce smoke-free workplace                                                                    
     laws  will  be  covered   under  HB  328.  State  level                                                                    
     Medicaid  expenditures   that  can  be   attributed  to                                                                    
     smoking is  about $67  Million per  year, which  can be                                                                    
     reduced as  we limit  unwanted exposure  to second-hand                                                                    
     smoke. HB 328 does not  make smoking in Alaska illegal,                                                                    
     but  rather  puts   reasonable  limitations  for  where                                                                    
     someone can smoke. This bill  does not prohibit outdoor                                                                    
     smoking,  except  within  certain areas  near  building                                                                    
     entrances/exits,  air intakes,  and other  specifically                                                                    
     designated  public   gathering  places.  It   does  not                                                                    
     legislate  who a  business can  hire and  free standing                                                                    
       tobacco and e-cigarette shops are excluded from HB                                                                       
     328.                                                                                                                       
                                                                                                                                
5:01:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  STUTES asked  about the  reasonable standards  he                                                               
referenced,  and questioned  where  smoking would  be allowed  in                                                               
Alaska if the proposed bill passed.                                                                                             
                                                                                                                                
MR. BANKS  replied that smoking  would be allowable in  your home                                                               
and outside  as long as it  was not within a  certain distance to                                                               
buildings.                                                                                                                      
                                                                                                                                
REPRESENTATIVE STUTES  asked where  currently it was  possible to                                                               
smoke in the State of Alaska.                                                                                                   
                                                                                                                                
MR. BANKS offered to list the places.                                                                                           
                                                                                                                                
5:04:11 PM                                                                                                                    
                                                                                                                                
MICHAEL PATTERSON  offered his  personal experience  with smoking                                                               
and breathing  in various  areas around  the state,  depending on                                                               
local rules  for smoking in public  places.  He declared  that he                                                               
did not  have the  right to put  his smoke on  other people.   He                                                               
shared  that  he  had  COPD,  and that  second  hand  smoke  from                                                               
tobacco, as  well as  dust and  chemicals could set  it off.   He                                                               
said that  e-cigarettes had carcinogens,  and that they  were not                                                               
safe, comparing  them to "a  biological weapon" because  of their                                                               
particle size  and its  ability to  travel through  most objects.                                                               
He stated  that he would be  exposed and have no  warning because                                                               
the smell  was like many other  things.  He testified  in support                                                               
of the proposed bill.                                                                                                           
                                                                                                                                
5:09:00 PM                                                                                                                    
                                                                                                                                
DALE  FOX, President  and CEO,  Alaska CHARR,  stated that  CHARR                                                               
opposed smoking bans  in bars, as the proposed  bill expanded the                                                               
smoking  ban in  bars  across  Alaska.   He  declared that  CHARR                                                               
supported freedom of  choice.  He said that  every community with                                                               
this freedom of  choice had many smoking  and non-smoking venues.                                                               
He stated  that the  public allowed freedom  of choice,  and that                                                               
this proposed  bill would invalidate  the actions of  these local                                                               
communities.   He  challenged the  concept that  this action  was                                                               
good for business, reporting that  many businesses experienced 30                                                               
percent  loss  of  business  the   first  year,  with  subsequent                                                               
declines in  business until  the fourth  year, when  business was                                                               
back to even.   He stated that  the average bar was  not happy to                                                               
lose money.   He declared that the anti-smoking  league would not                                                               
stop with this message to  take smoking outside, but would return                                                               
with  bans  in other  places  such  as sidewalks,  docks,  parks,                                                               
wilderness trails, and  other places.  He said that  it was up to                                                               
the elected officials to decide  the amount of freedom allowed in                                                               
America.                                                                                                                        
                                                                                                                                
REPRESENTATIVE  TARR  asked  about  those members  of  CHARR  who                                                               
advocated opposite positions.                                                                                                   
                                                                                                                                
MR.  FOX  replied  that  the board  and  the  government  affairs                                                               
committee  had  taken  a  unanimous  position  in  opposition  to                                                               
government edicts  on smoking.   He said that many  businesses in                                                               
the  industry  had  gone  smoke free  whether  for  economics  or                                                               
personal choice.                                                                                                                
                                                                                                                                
5:13:24 PM                                                                                                                    
                                                                                                                                
KAREN PERDUE,  American Cancer Society, shared  her background in                                                               
public health and tobacco control  policy, which included 8 years                                                               
as the  Commissioner and 10  years as the Deputy  Commissioner of                                                               
the Department of Health and  Social Services.  She reported that                                                               
she  had also  been the  CEO and  President of  the Alaska  State                                                               
Hospital and Nursing Home Association,  and that virtually all of                                                               
the  hospitals  in  the  state,  as well  as  the  employees  and                                                               
patients,  were tobacco-free.   She  explained that  the proposed                                                               
bill simply  asked people  to take smoking  outside.   She stated                                                               
that  the culture  expectation set  by the  hospitals was  for an                                                               
understanding of  the importance  of public  health intervention.                                                               
She  declared that  second hand  smoke was  real and  documented,                                                               
sharing  that all  the women  in  her family  had been  medically                                                               
compromised  from smoking,  even  though some  had never  smoked.                                                               
There was a  higher correlated risk from exposure  to second hand                                                               
smoke.  She  shared that the Fairbanks Borough had  not passed an                                                               
ordinance similar  to Anchorage  and Juneau,  as the  borough did                                                               
not have  health powers.   However, the proposed bill  would make                                                               
the regulation  of smoking  consistent between  the city  and the                                                               
borough.   She  shared that  the city  ordinance did  not include                                                               
private  facilities.    She expressed  her  concern  for  workers                                                               
exposed to  second hand smoke.   She supported that  the proposed                                                               
bill  included  e-cigarettes and,  as  the  science had  not  yet                                                               
caught  up with  the technology,  it could  not be  said that  e-                                                               
cigarettes were healthy.   She pointed out that it  was not often                                                               
that a  bill had no  cost to the state,  and yet saved  the state                                                               
money in health  costs.  She stated her support  for the proposed                                                               
bill.                                                                                                                           
                                                                                                                                
REPRESENTATIVE   WOOL  asked   where  someone   could  smoke   in                                                               
Fairbanks.                                                                                                                      
                                                                                                                                
MS. PERDUE  offered her  belief that the  city ordinance  did not                                                               
allow  smoking   in  private  businesses  except   for  bars  and                                                               
restaurants.    She opined  that  there  was not  any  regulation                                                               
beyond state law outside the city.                                                                                              
                                                                                                                                
VICE CHAIR VAZQUEZ  asked for clarification that  the borough did                                                               
not have any health authority.                                                                                                  
                                                                                                                                
MS. PERDUE said that the  borough had very limited health powers,                                                               
and that was also the case in other boroughs in Alaska.                                                                         
                                                                                                                                
5:19:10 PM                                                                                                                    
                                                                                                                                
EDY RODEWALD  stated that second  hand smoke was "the  cloud that                                                               
threatens the health and the  well-being of Alaskans," people who                                                               
have chosen  not to smoke  but cannot escape the  harmful effects                                                               
of smoke.  She shared that she had  worked in a bar as she worked                                                               
through college, and that her father,  a heavy smoker, died at 37                                                               
years  of   age  from  lung   cancer.    She  stated   that  this                                                               
differentially  impacted people  at  the  lower economic  levels,                                                               
reporting that Alaska  Natives smoked at twice the  rate and that                                                               
second  hand smoke  impacted children,  who had  no choice.   She                                                               
declared  that the  majority  of people  don't  smoke, and  don't                                                               
allow smoking in  their homes, but smoking was  allowed in public                                                               
places.  She opined that  smoking was reckless behavior, and that                                                               
most smokers agreed.   She said it was time  to remove smoke from                                                               
indoor  work places,  and declared  her support  of the  proposed                                                               
bill.                                                                                                                           
                                                                                                                                
5:21:09 PM                                                                                                                    
                                                                                                                                
EMILY  NENON,  Alaska  Government  Relations  Director,  American                                                               
Cancer Society, stated that she had  been working on the issue of                                                               
smoke free  workplaces in  Alaska for  the past  15 years  at the                                                               
local  level and  reported that  significant areas  of the  state                                                               
don't  have local  health  controls to  adopt  regulations.   She                                                               
pointed out  that there  were areas in  Fairbanks where  the city                                                               
ordinance did  not prohibit smoking  inside all workplaces.   She                                                               
maintained that  the organization's position was  to take smoking                                                               
outside and  to provide equal  protection for all workers  in the                                                               
workplace.                                                                                                                      
                                                                                                                                
5:23:13 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  asked if all the  municipalities with health                                                               
powers had enacted smoking bans.                                                                                                
                                                                                                                                
MS. NENON  replied "for the most  part, yes," and that  she would                                                               
provide the  list to  the committee.   She  relayed that  all the                                                               
major population  centers with  that power  at the  borough level                                                               
had already  taken action,  with Bethel being  the first  area to                                                               
pass this in 1998.                                                                                                              
                                                                                                                                
REPRESENTATIVE WOOL asked how many  of the major population areas                                                               
would be affected by the proposed bill.                                                                                         
                                                                                                                                
MS.  NENON   replied  that  this  proposed   bill  would  provide                                                               
protections for about  half of the state population  that was not                                                               
yet  covered.   She directed  attention  to a  chart listing  the                                                               
borough powers [included  in members' packets].   She stated that                                                               
public education  was a key  to the  ease of enforcement,  as the                                                               
laws were  largely self-enforcing.   She  opined that  Alaska was                                                               
ready to take the step to protect all workers.                                                                                  
                                                                                                                                
5:25:36 PM                                                                                                                    
                                                                                                                                
GARY  FERGUSON,   M.D.,  Senior  Director  of   Community  Health                                                               
Services, Alaska  Native Tribal Health Consortium,  reported that                                                               
there  was  strong  support  for  smoke-free  workplace  laws  in                                                               
Alaska, and he  offered an anecdote of a  restaurant in Unalaska.                                                               
He pointed  to a recent  poll which  reported that 69  percent of                                                               
Alaskans  across subgroups  including  geographic location,  age,                                                               
and political  party, strongly supported  the proposed bill.   He                                                               
shared that 72 percent of  Alaskans supported the inclusion of e-                                                               
cigarettes in a smoke-free workplace  law, and that a majority of                                                               
Alaska  Native   adults  supported  smoke-free   restaurants  and                                                               
believed  that smoking  should  not be  allowed  in in-door  work                                                               
areas.   He acknowledged  that tobacco use  was still  high among                                                               
Alaska Natives.   He stated that the proposed  bill would provide                                                               
comprehensive protection  from second-hand smoke  and e-cigarette                                                               
aerosol for employees and customers  in all workplaces and public                                                               
places.   He explained that  the proposed bill simply  asked that                                                               
those who choose to smoke or  use e-cigarettes to take it outside                                                               
in order to protect the health and safety of all Alaskans.                                                                      
                                                                                                                                
5:28:21 PM                                                                                                                    
                                                                                                                                
ALEX MCDONALD, Owner, Ice Fog  Vapor, stated his opposition to HB                                                               
328, as  he had many issues  with the bill as  currently written.                                                               
He  said it  was  "a huge  invasion in  the  privacy of  people's                                                               
homes."  He stated that many homes would have to become smoke-                                                                  
free places to allow health care  providers to come and help with                                                               
care.  He  declared that Alaska had a long  history of respecting                                                               
people's privacy, which the proposed  bill went against.  He said                                                               
that  the proposed  bill also  stripped a  business owner  of the                                                               
choice to  run the business as  they wished, and would  take away                                                               
local choice for  communities to regulate these  products as they                                                               
saw  fit.   He pointed  out  that, as  Alaska was  a huge  state,                                                               
something that  worked in one area  of the state may  not work in                                                               
another area.  He declared  that every other controlled substance                                                               
was given local option in Alaska.   He expressed concern with the                                                               
inclusion of vaporizers  in the proposed bill,  as these products                                                               
did not  produce combustion  or any  combustion by-products.   He                                                               
referenced  an  English  report   which  said  that  e-cigarettes                                                               
released negligible levels  of nicotine into ambient  air with no                                                               
identified  health risk  to  by-standers.   He  shared one  study                                                               
which concluded  that it could  be unhealthier to breathe  air in                                                               
big cities  compared to standing in  a room with someone  who was                                                               
vaping.  He said the technology  was being embraced in England to                                                               
help smokers stop the use  of tobacco products, and had concluded                                                               
that  e-cigarettes could  save lives  and long  term health  care                                                               
costs, and were not a gateway to smoking.                                                                                       
                                                                                                                                
5:31:08 PM                                                                                                                    
                                                                                                                                
SHARON WOLKOFF,  Kodiak Area Native Association,  stated that she                                                               
had done tobacco  cessation work, and was now  working in tobacco                                                               
prevention.   She  offered  anecdotes about  her  family and  its                                                               
history around smoking.   She testified in support  of smoke free                                                               
workplaces, so not to worry about  the health of loved ones.  She                                                               
expressed agreement  with the freedom  of choice for  everyone to                                                               
enjoy the establishments.                                                                                                       
                                                                                                                                
5:34:41 PM                                                                                                                    
                                                                                                                                
VICE CHAIR VAZQUEZ closed public testimony on HB 328.                                                                           
                                                                                                                                
[HB 328 was held over.]                                                                                                         
                                                                                                                                
5:35:02 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 5:35 p.m.                                                                                                          

Document Name Date/Time Subjects
HB315 version A.PDF HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 sponsors statement.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Hearing Request Memo.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_caring article-july-2011-evd-maximizes-service-effectiveness.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_PCA Association-EVV White Paper.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Experience_Outcomes_Sndata.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Five Facts about Electronic Visit Verification.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Florida Medicaid_DVM report_2011.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Fraud Brochure_Santrax_050715.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background _Alaska - EVV Overview with Pricing and ROI samples_Sandata.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Sandata EVV Presentation - 2015 12 17.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Care Embrace.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_AK article_State continues crackdown on Medicaid fraud.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_State of Alaska Department of Law Press Release Good Faith.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_State of Alaska Department of Law Press Release Fraud Charges Against 40 Individuals.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_State of Alaska Department of Law second Good Faith press release.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_TX_The Brownsville Herald article - State phases in new home health verification system.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_The Dallas Morning News article.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_United States Department of Labor Administrator's Interpretation No 2014-2.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_United States Department of Labor Fact Sheet.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_United States Department of Labor.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_How Will CareWatch Impact Your Agency.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_IL EVV One Page report_12.08.14.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_InformationWeek HealthCare article.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Medicaid Fraud Strike Force_Florida_2011 Annual Report.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_AK PCA overview 2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_ AK Personel Care Services flow chart.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Background_Santrax Payer Management.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 Fiscal Note DHSS-SDSA_3.18.16.pdf HHSS 3/22/2016 3:00:00 PM
HB 344 Testimony_Gerald Brown.pdf HHSS 3/22/2016 3:00:00 PM
HB 344
HB 344 proposed amendment_Seaton N.6.pdf HHSS 3/22/2016 3:00:00 PM
HB 344
HB 344 Proposed amendment Seaton N 5.pdf HHSS 3/22/2016 3:00:00 PM
HB 344
HB 344 Proposed amendemnt- SEaton N 3.pdf HHSS 3/22/2016 3:00:00 PM
HB 344
HB 334 Sectional.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 Letter of Support - Swanson.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 Letter of Support - Grant.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 Sponsor Statement.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 legislation_Ver H.PDF HHSS 3/22/2016 3:00:00 PM
HB 334
HB 328 - Legislation Ver. A.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Sectional Analysis.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Sponsor Statement.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-ACS CAN Alaska - Opinion Survey Results - Jan 29 2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-AK 2012 Public Opinion.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-AK 2015 Public Opinion.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-AS 44 29 020 Lethal effects of SHS.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-CDC Testimony on Secondhand Smoke and ENDS Aerosol Alaska February 2015.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-E-Cigarettes 2015.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-E-Cigarettes 2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-Legal Opinions.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-News Coverage.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-Research Source Docs.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-Smoke-Free Indoor Workplaces Supporters.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 - Supporting Document-SoA Impacts.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Fiscal Note DOA-FAC_03.18.16.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Fiscal Note DOT NRHA_3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note DHSS-CDPHP-03.18.16.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Fiscal Note DOT-IASO-3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note DOT-MVO_3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note DOT-SEF_3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note DOT-SRHA_3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note COT-CRHA_3.19.16.pdf HHSS 3/22/2016 3:00:00 PM
HB328 Fiscal Note DCCED-AMCO_03.18.16.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Fiscal Note DEC-FSS_03.18.16.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Suppport_email Jim Fassler.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Proposed CS_Ver W.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328( ) - Summary of Changes (Ver A to W).pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328( ) - Sectional Analysis Version w.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Proposed CS_Ver W.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Support_Written testimony_ Jean Tsigonis & AAFP.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Support - Various emails of support.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB315 Supporting Documents-Letter Maxim Supports Standards for Electric Visit Verification.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB315 proposed CS_ver E.pdf HHSS 3/22/2016 3:00:00 PM
HB 315
HB334 Opposition_Allison Mendel.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB334 written testimony_John Hoag.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 Letter of Opposition - Levy.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 334 Letter of Opposition - ANDVSA.pdf HHSS 3/22/2016 3:00:00 PM
HB 334
HB 328 Support Letter 3-16 John parker.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Support emails from 3.22.2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB328 Support letter_ Paul Ho, MD letter to AK House Health and Human Services Committee in support of House Bill 328.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
SB 1_HB328 Support_ testimony Rogers June.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
SB 1
SB 1_HB328 Support_ testimony Rogers June.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
SB 1
HB328 Support letter_ Paul Ho, MD letter to AK House Health and Human Services Committee in support of House Bill 328.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Opposition_Various emails and documents.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 opposition Allison amend for vape shops.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Support Letter 3-16 John parker.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Support emails from 3.22.2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Support emails_March 22 2016_22 emails.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
Hb 328 Support Testimony_ 3 persons_3.22.2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 opposition _ 17 emails_3.22.2016.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Opposition & docs_Alison Halpin.pdf HHSS 3/22/2016 3:00:00 PM
HB 328
HB 328 Opposition & documents_Angela Carrol.pdf HHSS 3/22/2016 3:00:00 PM
HB 328