Legislature(2017 - 2018)CAPITOL 106

01/23/2018 03:00 PM HEALTH & SOCIAL SERVICES

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Audio Topic
03:04:32 PM Start
03:05:40 PM Presentation: Role of Contraceptive Coercion in Domestic Violence
03:35:45 PM HB162
04:05:55 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentation: Invited Testimony Relating to TELECONFERENCED
HB 25 by:
- Rep. Claman, Sponsor
- Michelle Overstreet, Founder & Exec. Dir., My
House, Wasilla
- Ginny Walsh, Program Coordinator, Arctic Women
in Crisis, Utqiagvik
- Danielle Campoamor, New York City, NY
-- Testimony <Invitation Only> --
*+ HB 162 DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        January 23, 2018                                                                                        
                           3:04 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative David Eastman                                                                                                    
Representative Jennifer Johnston                                                                                                
Representative Matt Claman (alternate)                                                                                          
Representative Dan Saddler (alternate)                                                                                          
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION: ROLE OF CONTRACEPTIVE COERCION IN DOMESTIC                                                                        
VIOLENCE                                                                                                                        
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
HOUSE BILL NO. 162                                                                                                              
"An Act relating  to criminal and civil  history requirements and                                                               
a registry  regarding certain licenses,  certifications, appeals,                                                               
and  authorizations  by  the  Department  of  Health  and  Social                                                               
Services; and providing for an effective date."                                                                                 
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 162                                                                                                                  
SHORT TITLE: DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK                                                                          
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
03/08/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/08/17       (H)       HSS, JUD                                                                                               
01/23/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
DANIELLE CAMPOAMOR                                                                                                              
Brooklyn, New York                                                                                                              
POSITION STATEMENT:  Testified during  a presentation on the role                                                             
of contraceptive coercion in domestic violence.                                                                                 
                                                                                                                                
GINNY WALSH, Program Coordinator                                                                                                
Arctic Women in Crisis                                                                                                          
Utqiagvik, Alaska                                                                                                               
POSITION STATEMENT:  Testified during  a presentation on the role                                                             
of contraceptive coercion in domestic violence.                                                                                 
                                                                                                                                
STACIE KRALY, Chief Assistant Attorney General                                                                                  
Statewide Section Supervisor                                                                                                    
Human Services Section                                                                                                          
Civil Division (Juneau)                                                                                                         
Department of Law                                                                                                               
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Presented HB  162 on  behalf of  the Rules                                                             
Committee at the request of the Governor.                                                                                       
                                                                                                                                
MARGARET BRODIE, Director                                                                                                       
Director's Office                                                                                                               
Division of Health Care Services                                                                                                
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:   Answered questions during  discussion of HB                                                             
162.                                                                                                                            
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:04:32 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:04   p.m.                                                               
Representatives  Spohnholz, Tarr,  Claman (alternate),  Johnston,                                                               
Saddler  (alternate), Eastman,  and  Edgmon were  present at  the                                                               
call to  order.  Representative  Kito arrived as the  meeting was                                                               
in progress.                                                                                                                    
                                                                                                                                
^PRESENTATION:  ROLE   OF  CONTRACEPTIVE  COERCION   IN  DOMESTIC                                                             
VIOLENCE                                                                                                                      
          PRESENTATION: ROLE OF CONTRACEPTIVE COERCION                                                                      
                      IN DOMESTIC VIOLENCE                                                                                  
                                                                                                                                
3:05:40 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  first order of business would                                                               
be  a  presentation on  the  role  of contraceptive  coercion  in                                                               
domestic violence.  She said  that Representative Claman, sponsor                                                               
of HB  25 which  related to  contraceptives, would  introduce the                                                               
topic and then the committee would listen to invited testimony.                                                                 
                                                                                                                                
3:05:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  CLAMAN,  as  sponsor  of  HB  25,  explained  the                                                               
relationships of the proposed bill  to the presentation, pointing                                                               
out  that the  bill expanded  access to  birth control  by giving                                                               
women full  access to birth  control methods without  barriers on                                                               
cost or availability.   The proposed bill would  also allow women                                                               
to have a  one-year supply of contraceptives.   He reported that,                                                               
since  then,  there  was  an  increased  national  and  statewide                                                               
awareness on domestic violence and  sexual assault.  He explained                                                               
that contraceptive coercion was a  form of domestic violence that                                                               
was perpetuated  by abusers,  as abusers  could dictate  when and                                                               
how  contraceptives can  and cannot  be  accessed as  a means  of                                                               
gaining power  and control.   He  listed hiding,  withholding, or                                                               
destroying the birth control to  deliberately cause pregnancy, as                                                               
well as lying about having had  a vasectomy, forcing a partner to                                                               
forego birth control, or forcing  a partner to become pregnant or                                                               
end a pregnancy against her will.   He declared that this blatant                                                               
disregard  for  women's  health,   women's  rights,  and  women's                                                               
autonomy was inexcusable.  He  stated that the presentation would                                                               
further  educate about  issues  such  as contraceptive  coercion,                                                               
stressing that  this was a  serious form  of domestic abuse.   He                                                               
emphasized  that  contraceptive  coercion  was  a  public  health                                                               
issue,  as well  as  a public  safety issue.    He declared  that                                                               
access  to  affordable  and  reliable  contraception  would  help                                                               
current and potential victims of abuse.                                                                                         
                                                                                                                                
3:10:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER  (alternate)  asked how,  if  an  abusive                                                               
partner kept oral contraception away  from their partner for one,                                                               
two, or  three months, did extending  that for one year  make any                                                               
qualitative difference in the level of abuse.                                                                                   
                                                                                                                                
3:11:02 PM                                                                                                                    
                                                                                                                                
DANIELLE CAMPOAMOR  stated that she  had been born and  raised in                                                               
Eagle River,  Alaska, and was  currently living in  Brooklyn, New                                                               
York.   She shared  her background,  that she grew  up in  a home                                                               
with  a physically,  verbally,  and  financially abusive  father.                                                               
When her  mother became  pregnant, she had  been forced  to leave                                                               
her work, and  subsequently she was financially  dependent on her                                                               
husband, Ms.  Campoamor's father.   She reflected that  her first                                                               
memories were  of extreme physical  violence, and that,  when she                                                               
was about 15 years of age,  she experienced extreme pain when she                                                               
started her period.  She later  found out that this was caused by                                                               
endometriosis.   Her mother  was aware  that birth  control could                                                               
mitigate  some  of the  side  effects  of endometriosis,  so  she                                                               
broached  the topic  with her  father, only  to be  beaten as  he                                                               
believed that birth control had one  purpose and would give her a                                                               
freedom that  he did not  want to allow.   As she and  her mother                                                               
were financially  dependent on  her abusive  father, they  had no                                                               
idea  what to  do  until  they were  made  aware  of the  Planned                                                               
Parenthood Clinic  in Anchorage,  Alaska.  She  was able  to save                                                               
money  and  buy her  own  birth  control  which helped  with  the                                                               
effects  of the  endometriosis and  allowed her  to not  miss any                                                               
more school.   She reported that  she was only able  to get three                                                               
months of birth  control at a time, which made  it more difficult                                                               
to navigate the complexities of  procurement without her father's                                                               
knowledge.   She  pointed out  how  scary it  was to  live in  an                                                               
abusive home  where her life was  controlled by the abuser.   She                                                               
declared that "every part of your  day is riddled with fear.  You                                                               
have no  idea what will  set them off and  you have no  idea what                                                               
kind of  person you're  going to  be having to  deal with  day to                                                               
day."  She shared that she had  no idea how she would continue to                                                               
access the birth control, and that,  when she was caught, she did                                                               
suffer.    She  emphasized  that  she had  seen  the  effects  of                                                               
domestic violence and  that the ability to  procure birth control                                                               
allowed a  victim, whether  a child  or an adult,  a tiny  bit of                                                               
control and freedom over her own life.                                                                                          
                                                                                                                                
3:15:56 PM                                                                                                                    
                                                                                                                                
CHAIR  SPOHNHOLZ asked  how a  12-month  supply of  contraception                                                               
would help someone experiencing contraceptive coercion.                                                                         
                                                                                                                                
MS. CAMPOAMOR allowed that, although  a 3-month supply sounded so                                                               
easy for  someone not in  an abusive situation,  consistent trips                                                               
to a  pharmacy or place you  don't want the abuser  to know about                                                               
was "extremely difficult  and extremely scary."   When women were                                                               
able to make one trip for  an entire year supply, this would keep                                                               
women  safer  and would  hopefully  offer  the next  step  toward                                                               
leaving the abusive and dangerous situation.                                                                                    
                                                                                                                                
3:17:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER (alternate)  acknowledged  the pain  from                                                               
endometriosis  and asked  how  many women  in  Alaska used  birth                                                               
control for medical purposes versus contraception.                                                                              
                                                                                                                                
MS. CAMPOAMOR said that she was  unable to answer the question as                                                               
she was not  privy to the medical history.   She declared that 59                                                               
percent of  adult women in  Alaska experienced  partner violence,                                                               
and that  30 percent of Alaskans  were not able to  access victim                                                               
services  or encourage  others to  do so  because there  were not                                                               
services available locally.  She  reported that the reasons women                                                               
procure  birth  control ran  "the  gamut  from endometriosis  to"                                                               
painful cramps to a wide variety of reasons.                                                                                    
                                                                                                                                
3:18:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER (alternate)  asked whether  this was  her                                                               
personal  story or  whether  she was  an expert  in  the area  of                                                               
public health.                                                                                                                  
                                                                                                                                
3:19:10 PM                                                                                                                    
                                                                                                                                
MS.  CAMPOAMOR replied  that  this was  her  personal story,  and                                                               
that, even  though she lived in  New York, she still  cared about                                                               
Alaska.   She reported that  she was an  editor in New  York, had                                                               
been able to attend college  and leave the abusive situation, and                                                               
that  she   volunteered  for   many  domestic   violence  related                                                               
organizations trying to combat systemic sexual violence.                                                                        
                                                                                                                                
CHAIR  SPOHNHOLZ asked  if she  believed long  acting, reversible                                                               
contraceptives  could  aid  those  suffering  from  contraceptive                                                               
coercion.                                                                                                                       
                                                                                                                                
3:20:14 PM                                                                                                                    
                                                                                                                                
MS. CAMPOAMOR  replied, "I do."   She offered her belief  that it                                                               
was important  for all forms  of birth control to  be considered,                                                               
as those  were easier  to conceal  from the abuser.   As  she had                                                               
been  beaten when  caught  with birth  control,  she offered  her                                                               
assumption that there  were "plenty of other women  in Alaska who                                                               
have faced similar situations and circumstances."                                                                               
                                                                                                                                
CHAIR SPOHNHOLZ  asked for any recommendations  for consideration                                                               
to prevent contraceptive coercion.                                                                                              
                                                                                                                                
MS. CAMPOAMOR  replied that  this was the  first step,  that open                                                               
dialogue  and, as  Alaska had  a horrific  domestic violence  and                                                               
sexual assault problem, affordable access  to birth control was a                                                               
big part.                                                                                                                       
                                                                                                                                
3:22:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR spoke  on the power individuals  had over the                                                               
ability to manage reproductive health care needs.                                                                               
                                                                                                                                
3:22:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  (alternate) asked to what  degree were we                                                               
trying to  solve the  problems of  domestic violence  and abusive                                                               
parents,  as   opposed  to   the  limitations   on  contraceptive                                                               
prescriptions.                                                                                                                  
                                                                                                                                
3:23:25 PM                                                                                                                    
                                                                                                                                
MS. CAMPOAMOR opined that "they go  hand and hand."  She declared                                                               
that domestic violence was insidious  and the ways an abuser will                                                               
try  to control  their victim  were multiple.   She  acknowledged                                                               
that, although it  seemed that birth control was a  minor part of                                                               
a  women's life,  it was  not.   This was  a way  for a  woman to                                                               
protect herself  from future abuse,  as the majority of  women in                                                               
abusive situations  were also  raped.   Birth control  could help                                                               
ensure that a woman did not have  more children to keep her in an                                                               
abusive situation.   She declared that birth control  was a vital                                                               
part of a  woman taking that first step.   She offered her belief                                                               
that  if  there was  a  desire  to  combat domestic  violence  in                                                               
Alaska,  it was  necessary to  investigate all  avenues in  which                                                               
domestic violence was able to run rampant.                                                                                      
                                                                                                                                
REPRESENTATIVE SADDLER  (alternate) suggested that  public health                                                               
experts should  testify and  to not limit  testimony to  a single                                                               
person's experience.                                                                                                            
                                                                                                                                
3:25:38 PM                                                                                                                    
                                                                                                                                
GINNY WALSH, Program Coordinator,  Arctic Women in Crisis, stated                                                               
her support  for HB 25,  as contraceptive coercion was,  in part,                                                               
about  victims not  having the  understanding that  this form  of                                                               
coercion counted  as an abuse  tactic in  the cycle of  power and                                                               
control.   She  said that  contraceptive coercion  was especially                                                               
dangerous because  it often built on  mental, economic, physical,                                                               
and  sexual abuse.   She  reported  on stories  from her  shelter                                                               
about the sabotage of birth  control and the threats from violent                                                               
partners.   She declared that  education, medical  screening, and                                                               
other prevention  tools were  urgently needed.   She  stated that                                                               
comprehensive  insurance   coverage  of   contraceptives  offered                                                               
victims a  great variety  of options, including  access to  a 12-                                                               
month supply  of contraceptives  for use  in safety  planning and                                                               
healthy  relationships.   Harm  reduction  intervention for  this                                                               
group of women  needed to include steps  which ensured affordable                                                               
access  to emergency  contraception  and  forms of  contraception                                                               
that  were less  susceptible  to detection  and  tampering.   She                                                               
declared that  access to affordable  birth control  and avoidance                                                               
of pregnancy were steps toward freedom and safety.                                                                              
                                                                                                                                
3:27:53 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  acknowledged   the  concerns  expressed  by                                                               
Representative  Saddler that  much  of this  would be  considered                                                               
anecdotal unless a university researcher  had collected the data.                                                               
She asked about the frequency  for hearing these concerns as part                                                               
of the cycle of abuse being personally experienced.                                                                             
                                                                                                                                
3:28:40 PM                                                                                                                    
                                                                                                                                
MS.  WALSH reported  that she  could not  give exact  statistics.                                                               
She shared  a conversation with a  young woman who was  forced to                                                               
continue with  a pregnancy  which she  did not  want, as  she was                                                               
afraid of  an escalation  of violence in  the relationship.   She                                                               
opined that once  a month someone spoke with her  about access to                                                               
birth  control and  a desire  to either  terminate or  continue a                                                               
pregnancy from which they did not feel self-determination.                                                                      
                                                                                                                                
3:29:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  mused that  the  people  working with  this                                                               
every day  could give better  information, and that  she believed                                                               
this  was a  regular occurrence  with  all types  of abuse  being                                                               
under reported.                                                                                                                 
                                                                                                                                
MS.  WALSH expressed  her agreement  that  it was  underreported,                                                               
noting that it took a long  time to create a relationship whereby                                                               
someone would feel comfortable with sharing.                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER (alternate)  expressed caution  that this                                                               
was an  important issue and it  was important to ensure  that the                                                               
committee was informed by evidence  and defensible statistics and                                                               
sampling, and "not driven or guided by hand chosen assumptions."                                                                
                                                                                                                                
CHAIR   SPOHNHOLZ  asked   whether  Representative   Saddler  was                                                               
suggesting that these experiences were not valid.                                                                               
                                                                                                                                
REPRESENTATIVE  SADDLER  (alternate)  replied  that  he  was  not                                                               
saying that.                                                                                                                    
                                                                                                                                
3:31:06 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ asked  if she was familiar with the  HB 25, which                                                               
was being considered by the legislature.                                                                                        
                                                                                                                                
MS. WALSH said that she was.                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ asked  how this proposed bill  would affect women                                                               
who experienced domestic violence, and  how would it empower them                                                               
to respond to contraceptive coercion.                                                                                           
                                                                                                                                
MS. WALSH offered some  examples of self-determination, including                                                               
access  to emergency  contraception  and  forms of  contraception                                                               
which  were less  susceptible to  detection and  tampering.   She                                                               
declared that  this offered  more freedom  and many  more options                                                               
for choice about pregnancy.                                                                                                     
                                                                                                                                
3:32:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR  shared  her   personal  experience  as  the                                                               
director  of  group  that  helped women  access  services.    She                                                               
suggested that it  was good to remember that many  of these women                                                               
already  had children  and  wanted  to keep  them  safe in  these                                                               
abusive  situations.   She  opined  that  this  was part  of  the                                                               
conversation  to give  women more  ability to  leave the  abusive                                                               
situation, as well as protect the children.                                                                                     
                                                                                                                                
3:34:02 PM                                                                                                                    
                                                                                                                                
MS. WALSH shared  a story from a participant who  was forced into                                                               
a pregnancy that impacted her  health and family.  She reiterated                                                               
the  importance for  women to  have options  and access  to birth                                                               
control.                                                                                                                        
                                                                                                                                
3:34:45 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:35:34 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ brought the committee back to order.                                                                            
                                                                                                                                
        HB 162-DHSS CENT. REGISTRY;LICENSE;BCKGROUND CHK                                                                    
                                                                                                                                
3:35:45 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that the  final order of business would                                                               
be HOUSE  BILL NO. 162,  "An Act  relating to criminal  and civil                                                               
history requirements  and a registry regarding  certain licenses,                                                               
certifications, appeals, and authorizations  by the Department of                                                               
Health  and  Social  Services; and  providing  for  an  effective                                                               
date."                                                                                                                          
                                                                                                                                
3:36:09 PM                                                                                                                    
                                                                                                                                
STACIE  KRALY,   Chief  Assistant  Attorney   General,  Statewide                                                               
Section  Supervisor,  Human   Services  Section,  Civil  Division                                                               
(Juneau), Department of Law, offered  a brief overview of HB 162.                                                               
She noted  that participation  in many  federal programs  such as                                                               
Medicaid and  foster care required  that states  conduct criminal                                                               
background  checks  before  licensure or  payment  for  services.                                                               
Department  of   Health  and  Social  Services   has  been  doing                                                               
background checks for  many years, and, in  2005, the Legislature                                                               
passed a bill  which codified a background check  process for all                                                               
persons who were  paid for in-whole or in-part  by the Department                                                               
of Health and  Social Services, as noted in AS  47.05.300.  Since                                                               
then, the background check was conducted  in two parts:  first, a                                                               
fingerprint  based  criminal  history  check for  all  state  and                                                               
federal  criminal  offenses; second,  a  civil  history check  of                                                               
various  data bases,  some  federal  and some  state.   This  was                                                               
required for anyone applying to be  a foster parent or a personal                                                               
care attendant,  among others.   She reported that  several gaps,                                                               
overlaps, and  inconsistencies had been identified  and addressed                                                               
through the  regulatory process.   The remainder of  these issues                                                               
needed to be fixed in statute.                                                                                                  
                                                                                                                                
3:38:44 PM                                                                                                                    
                                                                                                                                
MS.  KRALY explained  that  the proposed  bill  clarified that  a                                                               
civil history check  was a check of  already existing registries,                                                               
and  that  a  stand-alone  registry or  database  was  not  being                                                               
created as  it was  not operationally or  fiscally feasible.   It                                                               
also clarified  that background checks were  required of licensed                                                               
entities, as well  as the owners and the workers.   She said that                                                               
the proposed  bill further renamed  the two  existing registries,                                                               
one of  which was currently  called the central registry  and the                                                               
other was called the centralized  registry.  These two registries                                                               
would  be renamed  the civil  registry and  the child  protection                                                               
registry.   She added that  the proposed bill made  amendments to                                                               
AS 47.32,  the licensing provisions  of the Department  of Health                                                               
and Social Services.   She explained that  this allowed licensing                                                               
investigators   to  share   licensing  investigations   with  law                                                               
enforcement  when  there  were concurrent  investigations.    She                                                               
added  that  another  change  would  allow  the  three  licensing                                                               
divisions to share information.                                                                                                 
                                                                                                                                
3:41:28 PM                                                                                                                    
                                                                                                                                
MS.  KRALY  stated   that  this  would  allow   the  division  to                                                               
investigate individuals who were  accused of abusing, neglecting,                                                               
or exploiting an individual in care.                                                                                            
                                                                                                                                
3:42:46 PM                                                                                                                    
                                                                                                                                
MS. KRALY  paraphrased from the  Sectional Analysis  [Included in                                                               
members' packets], which read:                                                                                                  
                                                                                                                                
     Section 1. This section  would make conforming edits to                                                                  
     rename the  centralized registry to the  civil registry                                                                    
     to  avoid  confusion under  the  current  law with  the                                                                    
     centralized  registry (AS  47.05.330)  and the  central                                                                    
     registry in AS 47.17.040 (see section 14).                                                                                 
                                                                                                                                
     Sections  2  and  3.  These  sections  would  amend  AS                                                                  
     47.05.310(d) and  47.32.310(d) to clarify  that barrier                                                                    
     crimes apply to individuals as well as entities.                                                                           
                                                                                                                                
     Section 4. This section  would amend AS 47.53.310(e) to                                                                  
     allow an  individual to seek a  background check; under                                                                    
     the  current law  only entities  can seek  a background                                                                    
     check. This  section would also remove,  at the request                                                                    
     of the Department of Public  Safety, the designation of                                                                    
     the Department of Health and  Social Services (DHSS) as                                                                    
     a   criminal  justice   agency  for   purpose  of   the                                                                    
     background check program.                                                                                                  
                                                                                                                                
     Section 5.  This section would  amend AS  47.05. 310(f)                                                                  
     to  make it  clear that  the DHSS  may, in  addition to                                                                    
     exceptions to  the barrier crime provisions,  approve a                                                                    
     variance for a barrier crime.                                                                                              
                                                                                                                                
     Section 6. This section  would amend AS 47.05.310(h) to                                                                  
     address  how   a  non-licensed  provider,  such   as  a                                                                    
     relative  who is  receiving payment  by  the Office  of                                                                    
     Children's  Services,  is  treated under  the  statute.                                                                    
     This   amendment  would   make  it   clear  that   such                                                                    
     providers,  while not  being paid  by  DHSS, are  still                                                                    
     subject to background checks prior to placement.                                                                           
                                                                                                                                
     Section 7.  This section would  make a  conforming edit                                                                  
     to AS  47.05.310(i) to rename the  centralized registry                                                                    
     to the civil registry (similar to section 1).                                                                              
                                                                                                                                
     Section 8. This  section would add a new  section to AS                                                                  
     47.05.310 to  address immunity  from civil  or criminal                                                                    
     liability  for reporting  during  the background  check                                                                    
     process.                                                                                                                   
                                                                                                                                
     Section  9.  This  section   would  provide  a  similar                                                                  
     framework for  the civil registry checks  as background                                                                    
     checks  (see AS  47.05.310). This  means that  the same                                                                    
     process  applies to  a person  who is  found to  have a                                                                    
     barring criminal conviction under  AS 47.05.310 as well                                                                    
     as a barring civil finding under AS 47.05.330.                                                                             
                                                                                                                                
     Section  10.   This  section  would  be   repealed  and                                                                  
     reenacted  to outline  how the  department will  review                                                                    
     existing  registries, rather  than  create yet  another                                                                    
     separate  database. This  section  would also  identify                                                                    
     what  DHSS  will  be  looking for  in  terms  of  civil                                                                    
     findings  that  are   inconsistent  with  licensure  or                                                                    
     payment (e.g., CINA findings,  terminated from DHSS for                                                                    
     assaultive/neglectful   or    exploitative   behavior).                                                                    
     Information  contained  or  obtained via  the  registry                                                                    
     would  be  confidential and  not  subject  to a  public                                                                    
     records request.                                                                                                           
                                                                                                                                
     Section  11.  This  would amend  the  current  immunity                                                                  
     section to  reflect the change  to civil  registry from                                                                    
     centralized registry.                                                                                                      
                                                                                                                                
     Section  12.  This would  establish  a  new section  to                                                                  
     address the ability to seek  a variance for any finding                                                                    
     under this chapter and how  to appeal a decision if you                                                                    
     disagree with any decision made by DHSS.                                                                                   
                                                                                                                                
     Section 13.  This section  would amend  AS 47.05.390(6)                                                                  
     to  expand  the  definition  of entity  to  include  an                                                                    
     individual service provider.                                                                                               
                                                                                                                                
     Section  14.  This  section would  rename  the  central                                                                  
     registry  maintained   by  the  Office   of  Children's                                                                    
     Services  to the  child  protection  registry to  avoid                                                                    
     confusion.  It also  clarifies  what  is maintained  on                                                                    
     this registry,  including substantiated  findings under                                                                    
     AS 47.10 or AS 47.17.                                                                                                      
                                                                                                                                
     Section  15. This  new  subsection  would clarify  that                                                                  
     before  a substantiated  finding can  be placed  on the                                                                    
     child  protection registry  the person  must have  been                                                                    
     afforded notice  of the finding and  the opportunity to                                                                    
     challenge the finding.                                                                                                     
                                                                                                                                
     Section 16.  This section would make  a conforming edit                                                                  
     to AS 47.32.010(c)  replacing centralized registry with                                                                    
     civil registry (similar to section 1).                                                                                     
                                                                                                                                
     Section  17.  This  section would  amend  AS  47.32  to                                                                  
     provide authority  for DHSS  to consider  prior adverse                                                                    
     licensing findings  in determining whether to  grant or                                                                    
     deny a  license or  whether to place  a condition  on a                                                                    
     license.                                                                                                                   
                                                                                                                                
     Section 18.  This would  add a new  section to  make it                                                                  
     clear  that  when  there  is   an  allegation  that  an                                                                    
     employee  or  individual  affiliated  with  a  licensed                                                                    
     entity is alleged to have  engaged in any behavior that                                                                    
     would impact the  safety or welfare of  a resident, the                                                                    
     department may investigate that  individual and issue a                                                                    
     report  on the  findings  of  that investigation.  This                                                                    
     section  would further  provide  that if  a finding  of                                                                    
     abuse  or neglect  is substantiated  then that  finding                                                                    
     will  be part  of the  civil registry  process and  may                                                                    
     result in a person  being prohibited from employment or                                                                    
     licensure in  the future. This section  would also make                                                                    
     it clear  that before such  a finding can be  used, due                                                                    
     process must be afforded.                                                                                                  
                                                                                                                                
     Section 19.  This is technical  fix that  would clarify                                                                  
     when formal  hearings are required when  an enforcement                                                                    
     action is taken after a licensing investigation.                                                                           
                                                                                                                                
     Section 20.  This would  add a  new section  to clarify                                                                  
     that  that  when  law enforcement  is  investigating  a                                                                    
     crime  that   is  also  the  subject   of  a  licensing                                                                    
     investigation,  the material  gathered by  DHSS may  be                                                                    
     shared with the law enforcement as a matter of law.                                                                        
                                                                                                                                
     Section  21.  This  section   would  clarify  that  all                                                                  
     divisions who implement AS  47.32 may share information                                                                    
     with each  other for the  purpose of  administering the                                                                    
     licensing programs at DHSS.                                                                                                
                                                                                                                                
     Section  22. This  section  would  repeal reference  to                                                                  
     provisions  of  the  current law  that  are  no  longer                                                                    
     necessary or  have been  determined to  be superfluous.                                                                    
     Specifically,  the section  would repeal  the reference                                                                    
     to the  civil registry  when doing a  background check,                                                                    
     references  to DHSS  as  criminal  justice agency,  and                                                                    
     statutes  stating  an  administrative  hearing  is  not                                                                    
     required when  the enforcement action sought  is a plan                                                                    
     of correction.                                                                                                             
                                                                                                                                
     Section  23.  This  is  an  applicability  section  for                                                                  
     purposes of applying the  criminal and civil background                                                                    
     checks before, on  or after the effective  date of this                                                                    
     act.                                                                                                                       
                                                                                                                                
     Section  24.  This  section would  advise  the  revisor                                                                  
     regarding title  changes to reflect amendments  in this                                                                    
     act, including the change to  include the civil history                                                                    
     registry.                                                                                                                  
                                                                                                                                
     Section 25.  This provides  for an  immediate effective                                                                  
     date.                                                                                                                      
                                                                                                                                
3:50:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE EASTMAN  directed attention  to Section 20  of the                                                               
Sectional  Analysis  and asked  how  it  would work  for  sharing                                                               
information between multiple investigations.                                                                                    
                                                                                                                                
MS. KRALY, in  response, said that the  most obvious circumstance                                                               
was a crime  committed at a licensed entity, such  as an assisted                                                               
living  home,  resulting in  an  immediate  response by  multiple                                                               
agencies and  a concurrent investigation.   Currently, in  such a                                                               
case, law enforcement would ask  for the licensing files although                                                               
the provisions  that were confidential  could not be  shared even                                                               
though there was an ongoing criminal investigation.                                                                             
                                                                                                                                
3:51:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO expressed his concern  for privacy.  He mused                                                               
that it  was necessary to attain  a formal legal document  to get                                                               
information,  and, as  this document  would  have provisions  for                                                               
accountability,  the individual  receiving  information would  be                                                               
aware of  the confidentiality and  privacy requirements  for this                                                               
information.    He  asked,  if   this  privacy  requirement  were                                                               
removed,  who   would  ensure  that  the   individual  requesting                                                               
information was accountable.                                                                                                    
                                                                                                                                
3:53:07 PM                                                                                                                    
                                                                                                                                
MS. KRALY,  in response, explained that  confidential information                                                               
existed throughout the Department  of Health and Social Services,                                                               
although she was not aware of how the DHSS dealt with this.                                                                     
                                                                                                                                
3:54:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO expressed  his  concern  that any  situation                                                               
which  authorized   "more  eyes  to  see   particular  pieces  of                                                               
information" was "making the opportunity  for the release of that                                                               
information increase."  He asked to  ensure that, as there was no                                                               
side  of   accountability  for   individuals  to   request  legal                                                               
documents,  there  were  provisions  in  place  to  maintain  the                                                               
privacy and confidentiality.                                                                                                    
                                                                                                                                
3:54:59 PM                                                                                                                    
                                                                                                                                
MARGARET BRODIE, Director, Director's  Office, Division of Health                                                               
Care Services,  Department of Health and  Social Services (DHSS),                                                               
explained  that  the  department  had  many  different  types  of                                                               
security, that the  background check was from  the Federal Bureau                                                               
of Investigation  (FBI), and this was  all contained in a  log to                                                               
ensure that "people  have only gone where they need  to go."  She                                                               
reported  that should  any  document be  missing,  this would  be                                                               
reported  to  the Office  of  the  Attorney  General and  to  the                                                               
Department   of  Public   Safety.     She  added   that  a   full                                                               
investigation  would be  conducted through  Department of  Health                                                               
and Social Services  and the "state's IT office," as  well as the                                                               
Department  of Public  Safety and  the FBI.   The  Office of  the                                                               
Attorney General would "wrap it all up."                                                                                        
                                                                                                                                
REPRESENTATIVE  KITO  asked   if  the  individual  accountability                                                               
procedures were applicable  if "we remove the  firewall of having                                                               
to  request  information  from   another  silo  through  a  legal                                                               
process."                                                                                                                       
                                                                                                                                
MS. BRODIE  replied that there  were still the  same requirements                                                               
and accountability.                                                                                                             
                                                                                                                                
3:56:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  (alternate) asked,  "How many  bad apples                                                               
are  now  slipping through  the  cracks...  how many  people  are                                                               
getting  licensed  that  having  more  consistent,  broader,  and                                                               
efficiently  applied  licensing  background checks  is  going  to                                                               
fix."   He  requested a  description  of the  seriousness of  the                                                               
problem.                                                                                                                        
                                                                                                                                
MS. BRODIE, in response, explained  that if an individual had any                                                               
finding in  their background check,  they were  denied clearance.                                                               
She  noted that  they could  then go  through a  variance process                                                               
involving all the  divisions within the Department  of Health and                                                               
Social  Services to  show mitigating  circumstances and  to allow                                                               
explanations for  why this finding was  no longer an issue.   She                                                               
explained that  this explanation was  reviewed by a  committee, a                                                               
recommendation  was   made  to  the  division   director,  and  a                                                               
recommendation was then brought to the commissioner.                                                                            
                                                                                                                                
3:58:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER (alternate)  asked  Ms.  Kraley how  many                                                               
people this bill would catch.                                                                                                   
                                                                                                                                
MS. KRALY offered some individual  statistics for FY17, reporting                                                               
that 23,175 individuals submitted  information for the background                                                               
check  process  at  DHSS.    Of those,  about  3.2  percent,  556                                                               
individuals, had  barring conditions.  Of  these 556 individuals,                                                               
185  individuals  had  requested   variances  and  158  of  those                                                               
individuals had received approval for variance.                                                                                 
                                                                                                                                
REPRESENTATIVE SADDLER (alternate) asked  how big was the problem                                                               
that was being addressed by the proposed bill.                                                                                  
                                                                                                                                
MS.  KRALY acknowledged  that there  was not  a problem  for that                                                               
purpose, as  those with  criminal and  civil histories  that were                                                               
inconsistent with licensure and had  a predictive factor for use,                                                               
neglect, or exploitation were being  identified.  She opined that                                                               
the program, as it was  designed, worked exceptionally well.  She                                                               
declared that  the proposed  bill was designed  to clean  up some                                                               
language and  some confusion  within the  statute and  within the                                                               
process,  so this  was more  understandable  for the  applicants.                                                               
She  added  that  this  allowed   a  clean-up  for  language  and                                                               
identified  gaps.     She  noted  that  these   issues  had  been                                                               
identified many years earlier.                                                                                                  
                                                                                                                                
4:01:34 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER (alternate) pointed  out that this was not                                                               
a  huge problem  that  needed  to be  addressed  although it  was                                                               
making a system work better.                                                                                                    
                                                                                                                                
4:01:52 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  asked about the limitations  to the multiple                                                               
state data bases for integrated information sharing.                                                                            
                                                                                                                                
4:03:20 PM                                                                                                                    
                                                                                                                                
MS. KRALY said  that efficiency was a good topic  although it was                                                               
beyond the  scope of the proposed  bill.  She explained  that the                                                               
criminal  background checks  were performed  by stand-alone  data                                                               
bases, and she opined that these  were not integrated and did not                                                               
access each other.   She stated that the data  bases accessed for                                                               
civil  history  purposes  were civil  findings  unless  you  were                                                               
convicted  of  Medicaid fraud.    She  declared that  these  were                                                               
efficient registries although they were not interactive.                                                                        
                                                                                                                                
4:05:16 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ said that HB 162 would be held over.                                                                            
                                                                                                                                
4:05:55 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 4:05 p.m.                                                                                                          

Document Name Date/Time Subjects
HB 162 Fiscal Note DHSS-HCS 01.22.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162
HB162 Governor Transmittal Letter 1.22.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162
HB 162 Fiscal Note DPS-SS 01.22.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162
HB162 Sectional Analysis ver A 1.19.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162
HB162 Supporting Document-FAQs on Background Checks 1.19.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162
HB162 Supporting Documents-Proposed Background Check Process 1.22.18.pdf HHSS 1/23/2018 3:00:00 PM
HHSS 2/20/2018 3:00:00 PM
HB 162