Legislature(2021 - 2022)DAVIS 106
05/13/2021 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB89 | |
| HB106 | |
| HB153 | |
| HB139 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 139 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | SB 89 | TELECONFERENCED | |
| += | HB 153 | TELECONFERENCED | |
| += | HB 106 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 13, 2021
3:27 p.m.
DRAFT
MEMBERS PRESENT
Representative Liz Snyder, Co-Chair
Representative Tiffany Zulkosky, Co-Chair
Representative Ivy Spohnholz
Representative Zack Fields
Representative Ken McCarty
Representative Mike Prax
Representative Christopher Kurka
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR SENATE BILL NO. 89(FIN)
"An Act relating to house rules for assisted living homes."
- MOVED HCS CSSB 89(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 106
"An Act relating to missing persons under 21 years of age."
- MOVED HB 106 OUT OF COMMITTEE
HOUSE BILL NO. 153
"An Act relating to the identification, location, and
notification of specified family members of a child who is in
state custody."
- HEARD & HELD
HOUSE BILL NO. 139
"An Act relating to guardians, guardianships, successor
guardians, incapacitated guardians, incapacitated individuals,
and testamentary appointments of guardians; and relating to
withholding or withdrawing life-sustaining procedures."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 89
SHORT TITLE: ASSISTED LIVING HOMES: HOUSE RULES
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/22/21 (S) READ THE FIRST TIME - REFERRALS
02/22/21 (S) HSS, FIN
03/18/21 (S) HSS AT 1:30 PM BUTROVICH 205
03/18/21 (S) Heard & Held
03/18/21 (S) MINUTE(HSS)
03/30/21 (S) HSS AT 1:30 PM BUTROVICH 205
03/30/21 (S) Moved SB 89 Out of Committee
03/30/21 (S) MINUTE(HSS)
03/31/21 (S) HSS RPT 4DP 1NR
03/31/21 (S) DP: WILSON, BEGICH, COSTELLO, HUGHES
03/31/21 (S) NR: REINBOLD
04/07/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/07/21 (S) Heard & Held
04/07/21 (S) MINUTE(FIN)
04/12/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/12/21 (S) <Bill Hearing Rescheduled to 4/14/21>
04/14/21 (S) FIN RPT CS 6DP 1NR SAME TITLE
04/14/21 (S) DP: STEDMAN, BISHOP, HOFFMAN, WILSON,
WIELECHOWSKI, VON IMHOF
04/14/21 (S) NR: OLSON
04/14/21 (S) FIN AT 9:00 AM SENATE FINANCE 532
04/14/21 (S) Moved CSSB 89(FIN) Out of Committee
04/14/21 (S) MINUTE(FIN)
04/26/21 (S) TRANSMITTED TO (H)
04/26/21 (S) VERSION: CSSB 89(FIN)
04/28/21 (H) READ THE FIRST TIME - REFERRALS
04/28/21 (H) HSS
04/29/21 (H) HSS AT 3:00 PM DAVIS 106
04/29/21 (H) -- MEETING CANCELED --
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
05/04/21 (H) Heard & Held
05/04/21 (H) MINUTE(HSS)
05/11/21 (H) HSS AT 3:00 PM DAVIS 106
05/11/21 (H) -- MEETING CANCELED --
05/13/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 106
SHORT TITLE: MISSING PERSONS UNDER 21 YEARS OLD
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR
02/19/21 (H) READ THE FIRST TIME - REFERRALS
02/19/21 (H) STA, HSS
03/11/21 (H) STA AT 3:00 PM GRUENBERG 120
03/11/21 (H) Scheduled but Not Heard
03/16/21 (H) STA AT 3:00 PM GRUENBERG 120
03/16/21 (H) Heard & Held
03/16/21 (H) MINUTE(STA)
03/25/21 (H) STA AT 3:00 PM GRUENBERG 120
03/25/21 (H) -- MEETING CANCELED --
04/01/21 (H) STA AT 3:00 PM GRUENBERG 120
04/01/21 (H) Heard & Held
04/01/21 (H) MINUTE(STA)
04/08/21 (H) STA AT 3:00 PM GRUENBERG 120
04/08/21 (H) Moved HB 106 Out of Committee
04/08/21 (H) MINUTE(STA)
04/09/21 (H) STA RPT 5DP 2NR
04/09/21 (H) DP: CLAMAN, STORY, VANCE, TARR, KREISS-
TOMKINS
04/09/21 (H) NR: EASTMAN, KAUFMAN
04/22/21 (H) HSS AT 3:00 PM DAVIS 106
04/22/21 (H) Heard & Held
04/22/21 (H) MINUTE(HSS)
04/27/21 (H) HSS AT 3:00 PM DAVIS 106
04/27/21 (H) Heard & Held
04/27/21 (H) MINUTE(HSS)
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
05/04/21 (H) <Bill Hearing Canceled>
05/11/21 (H) HSS AT 3:00 PM DAVIS 106
05/11/21 (H) -- MEETING CANCELED --
05/13/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 153
SHORT TITLE: CHILD IN NEED OF AID; NOTICE OF PLACEMENT
SPONSOR(s): CRONK
03/26/21 (H) READ THE FIRST TIME - REFERRALS
03/26/21 (H) HSS, JUD
04/20/21 (H) HSS AT 3:00 PM DAVIS 106
04/20/21 (H) Heard & Held
04/20/21 (H) MINUTE(HSS)
05/04/21 (H) HSS AT 3:00 PM DAVIS 106
05/04/21 (H) <Bill Hearing Canceled>
05/11/21 (H) HSS AT 3:00 PM DAVIS 106
05/11/21 (H) -- MEETING CANCELED --
05/13/21 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 139
SHORT TITLE: GUARDIANS; LIFE-SUSTAINING PROCEDURES
SPONSOR(s): HANNAN
03/17/21 (H) READ THE FIRST TIME - REFERRALS
03/17/21 (H) HSS, JUD
05/13/21 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
CRAIG BAXTER, Program Manager
Residential Licensing Section
Division of Health Care Services
Department of Health and Social Services (DHSS)
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on
CSSB 89(FIN).
LYNNE KEILMAN-CRUZ, Chief of Quality
Division of Seniors and Disabilities
Department of Health and Social Services (DHSS)
POSITION STATEMENT: Answered questions during the hearing on
CSSB 89(FIN).
LISA PURINTON, Chief
Criminal Records and Identification Bureau
Division of Statewide Services
Department of Public Safety (DPS)
Anchorage, Alaska
POSITION STATEMENT: During the hearing on HB 106, provided a
summary of the bill on behalf of the administration.
SUE STANCLIFF, Staff
Representative Mike Cronk
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: During the hearing on HB 153, discussed the
bill on behalf of Representative Cronk, prime sponsor.
REPRESENTATIVE SARA HANNAN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 139.
TIMOTHY CLARK, Staff
Representative Sara Hannan
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Provided a sectional analysis of HB 139 on
behalf of Representative Hannan, prime sponsor.
PAUL DOUGLAS
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 139.
ACTION NARRATIVE
3:27:26 PM
CO-CHAIR LIZ SNYDER called the House Health and Social Services
Standing Committee meeting to order at 3:27 p.m.
Representatives Spohnholz, Prax, Kurka, Zulkosky, and Snyder
were present at the call to order. Representatives McCarty and
Fields arrived as the meeting was in progress.
SB 89-ASSISTED LIVING HOMES: HOUSE RULES
3:28:56 PM
CO-CHAIR SNYDER announced that the first order of business would
be CS FOR SENATE BILL NO. 89(FIN), "An Act relating to house
rules for assisted living homes."
CO-CHAIR SNYDER reminded members that this bill, by request of
the governor, is the companion bill to HB 103, which the
committee heard on 4/13/21 and for which public testimony was
taken. She further reminded members that the committee first
heard CSSB 89(FIN) on [5/4/21], at which time amendments were
offered and the bill was held over for further discussion and
the amendment deadline extended. She explained that after
Amendment 2 was adopted it became clear during testimony by Mr.
Craig Baxter that the amendment needed to be changed. She said
the amendment's sponsor, Representative Spohnholz, would
therefore like to withdraw Amendment 2 and offer a revised
version to be responsive to the needs of the Department of
Health and Social Services (DHSS). She invited Representative
Spohnholz to provide background information.
3:31:32 PM
REPRESENTATIVE SPOHNHOLZ stated that in working with Mr. Baxter
and Suzanne Cunningham [Department of Health and Social Services
(DHSS)], and Stephanie Wheeler, State Long Term Care Ombudsman,
it was decided to rescind action on Amendment 2 and adopt a new
amendment that is clearer and will not require as detailed of a
regulation package. Amendment 3, she continued, is therefore an
update to the three changes put into the bill at the request of
the long term care ombudsman [via adoption of Amendment 2],
which are updated Internet access, quality of care, and
protection against retaliation.
3:32:59 PM
The committee took an at-ease from 3:33 p.m. to 3:35 p.m.
3:35:29 PM
CO-CHAIR ZULKOSKY moved to rescind the adoption of Amendment 2
to CSSB 89(FIN). There being no objection, the adoption of
Amendment 2 was rescinded.
REPRESENTATIVE SPOHNHOLZ withdrew Amendment 2 to CSSB 89(FIN).
There being no objection, it was so ordered.
3:35:56 PM
REPRESENTATIVE SPOHNHOLZ moved to adopt Amendment 3 to CSSB
89(FIN), labeled 32-GS1675\B.1, Dunmire, 5/12/21, which read:
Page 2, line 1, following "environment":
Insert "free from abuse and discrimination"
Page 2, line 16:
Delete "and"
Insert "[AND]"
Page 2, line 18, following "AS 47.33.060":
Insert "; and
(D) having access to the Internet provided
by the home, subject to availability in the community,
and having a private device to access the Internet at
the resident's own expense"
Page 3, line 5, following "with":
Insert "cultural preferences and"
Page 3, line 11, following "home":
Insert "without fear of reprisal or retaliation"
Page 3, line 18:
Delete "and"
Insert "[AND]"
Page 3, line 20, following "home":
Insert ";
(20) receive information in a language the
resident understands; and
(21) receive quality care; in this
paragraph, "quality care" means care of a resident in
accordance with the resident's assisted living plan,
plan of care, personal preferences, and health care
providers' recommendations"
Page 3, following line 20:
Insert a new bill section to read:
"* Sec. 4. AS 47.33.990 is amended by adding new
paragraphs to read:
(20) "retaliation" means an adverse action
taken, or threatened, by an assisted living home or an
agent of an assisted living home against a resident in
response to a complaint made to, or about, the home."
CO-CHAIR ZULKOSKY objected for the purpose of discussion.
REPRESENTATIVE SPOHNHOLZ explained that Amendment 3 is the
[proposed] new compromise language from working with Mr. Baxter
and [Ms.] Wheeler, and that the language would continue to
provide protection from abuse and discrimination. She specified
that the language for updating the Internet access provision now
states, "having access to the Internet provided by the home,
subject to availability in the community, and having a private
device to access the Internet at the resident's own expense".
So, she explained, it is saying that the resident must provide
his or her own device and that to the extent Internet is
available in the community, the home should provide it.
Representative Spohnholz conveyed that the language for quality
care now states, "means care of a resident in accordance with
the resident's assisted living plan, plan of care, personal
preferences, and health care providers' recommendations". She
noted that this definition is consistent with the intent of a
home and community-based waiver services final rule, given the
purpose of the bill is to get Alaska in compliance with that.
Lastly, she said, Amendment 3 would add a definition to
retaliation under AS 47.33.990, which is not currently defined
in the assisted living homes chapter. This new language states
that retaliation "means an adverse action taken, or threatened,
by an assisted living home or an agent of an assisted living
home against a resident in response to a complaint made to, or
about, the home." She pointed out that this language is more
specific so that a perception of a threat does not qualify.
3:38:20 PM
REPRESENTATIVE KURKA said his concern is whether this language
would prohibit the home from expelling a resident who is hostile
and making it a bad experience for everyone.
REPRESENTATIVE SPOHNHOLZ replied that Amendment 3 is drafted in
a way so it would not create the scenario where assisted living
homes are forced to have hostile residents living there. She
deferred to DHSS to address the process for evicting someone who
is hostile.
3:40:26 PM
CRAIG BAXTER, Program Manager, Residential Licensing Section,
Division of Health Care Services, Department of Health and
Social Services (DHSS), responded that there are six different
reasons under which an assisted living home can evict a
resident, of which one is documented disruptive behavior that
puts the resident, staff, or other residents in the home at
risk. If the facility meets proof that the resident's behaviors
are putting others at risk, [the facility] can terminate its
contract with the resident. He said DHSS would not look at it
as retaliation if the resident involved was threatening others,
harming others, harming themselves, or harming staff.
3:41:15 PM
REPRESENTATIVE KURKA said he is concerned about the practicality
of the language in Amendment 3 regarding Internet availability
in the community. For example, he pointed out, Wasilla has good
Internet service in general but certain spots within the
community have poor service, which is the case for his business
location. He said it makes sense that the device for accessing
the Internet be at the resident's own expense, but he is
concerned about having the requirement as a right.
REPRESENTATIVE MCCARTY offered his belief that the amendment's
language, "subject to availability in the community," does
address the concern because it would fit the scenario of
availability in one spot in the community but no availability
across the street from that spot.
REPRESENTATIVE KURKA argued that the language is the same
community not a different community, and "community" is broader
than the language [in Amendment 2] which specifically stated
available to the "home". So, he maintained, if a certain level
of service is available in the community, the home would have to
provide that level of service even if the Internet provider was
unable to provide that same level of access to the home.
REPRESENTATIVE MCCARTY said he is not concerned with the use of
community nor the device being at the resident's own expense.
REPRESENTATIVE KURKA suggested a conceptual amendment that would
replace "in the community" with "to the home".
REPRESENTATIVE SPOHNHOLZ suggested "in the community to the
home,".
CO-CHAIR SNYDER suggested "availability to the home in the
community,".
3:46:33 PM
REPRESENTATIVE SPOHNHOLZ moved Conceptual Amendment 1 to
Amendment 3: after "availability" insert "to the home". Thus
page 1, line 11, would read, "subject to availability to the
home in the community, and having a private device to". There
being no objection, Conceptual Amendment 1 to Amendment 3 was
adopted.
3:47:56 PM
The committee took a brief at-ease.
3:48:34 PM
CO-CHAIR ZULKOSKY asked whether it is clear within this language
that there are exceptions for facilities located within
communities that don't have unencumbered access to the Internet.
MR. BAXTER responded that he believes the language as crafted
would cover DHSS for ensuring that exemptions could be carved
out for communities and individual facilities that have
difficulty accessing the Internet or high-speed Internet.
3:51:03 PM
REPRESENTATIVE KURKA noted the inequality of Internet pricing
across the state. He pointed out that the further away from
urban areas the higher the cost for the same level of service
costs. He said he is concerned about putting this cost burden
on the assisted living homes unless it is something the homes
already have. He said he is going to oppose Amendment 3 rather
than offer an amendment to shift this cost burden from the home
to the resident.
CO-CHAIR ZULKOSKY removed her objection to the motion to adopt
Amendment 3 [as amended] to CSSB 89(FIN).
REPRESENTATIVE KURKA objected to Amendment 3, as amended.
A roll call vote was taken. Representatives McCarty, Spohnholz,
Fields, Zulkosky, and Snyder voted in favor of Amendment 3, as
amended. Representatives Prax and Kurka voted against it.
Amendment 3, as amended, was therefore adopted by a vote of 5-2.
3:54:21 PM
REPRESENTATIVE KURKA moved to adopt Amendment 4 to CSSB 89(FIN),
labeled 32-GS1675\B.2, Dunmire, 5/13/21, which read:
Page 1, lines 4 - 5:
Delete ". The house rules must be consistent with
42 C.F.R. 441.301(c)(4) and [,]"
Insert ","
Page 1, line 6, following "chapter.":
Insert "An assisted living home that receives
federal funds shall adopt rules consistent with 42
C.F.R. 441.301(c)(4)."
Page 1, line 12, following "42 C.F.R.
441.301(c)(4)(vi)(D)":
Insert "if the provider receives federal funds"
CO-CHAIR SNYDER objected for the purpose of discussion.
REPRESENTATIVE KURKA spoke to Amendment 4. He allowed it is
important to protect residents in [assisted living] homes in
statute, but said he is concerned that the bill cites federal
laws and regulations that the homes must comply with. That is
appropriate for homes which are receiving federal funds, he
stated, but it would be unjust and inviting federal overreach to
require homes which do not receive federal funds to comply with
federal regulations. He said Amendment 4 would therefore limit
the scope of this to those homes that receive federal.
CO-CHAIR SNYDER requested Ms. Lynne Keilman-Cruz to speak to the
concern that Amendment 4 would address.
3:56:11 PM
LYNNE KEILMAN-CRUZ, Chief of Quality, Division of Seniors and
Disabilities, related that [DHSS] had considered that language
in the bill but didn't see how a system could be established
where private-pay individuals who could potentially pay more
would have less rights than those receiving support under the
Medicaid waivers. It would be a double standard, she stated, so
for consistency [DHSS] made it apply to all providers regardless
of the funding type. She said [DHSS] believes this is minimally
burdensome as currently written without Amendment 4 and there is
no indication that providers would not currently meet those
minimal standards. She further noted that there are very few
providers not receiving Medicaid or not certified Medicaid
providers, so the language in the bill is minimally burdensome
to the department.
MR. BAXTER agreed. He stated that if this right is going to be
afforded to residents in some assisted living homes it should be
afforded in all assisted living homes. For residents' rights,
he said, it must be remembered that these are the residents'
homes, not institutions, so this is something that should be
supported across all facilities, not as certain ones that are
dependent on Medicaid dollars. He said residents and their
families would find it difficult to comprehend if a resident was
to move from one home to another and the rules on their rights
suddenly change because that home doesn't accept Medicaid home
and community-based waiver service. He maintained that
residents should be afforded the right regardless of which
assisted living home they are residing in and should be able to
have visitors of their choosing at the time of their choice,
just as would anyone else living in their own personal home.
4:00:01 PM
REPRESENTATIVE PRAX said he doesn't understand how anybody would
be forced to live in any given home, so he questions why the
homes should be required to do something. If a person wants a
service that is not offered, he continued, then that person has
the right to not purchase that assisted living home.
CO-CHAIR SNYDER responded that sometimes by virtue of limited
availability a person's options are restricted, and therefore
someone requiring the services of an assisted living home is
forced into that option.
REPRESENTATIVE SPOHNHOLZ noted 42 CFR 441.301(c)(4) includes an
individual's rights to privacy, dignity, respect, and freedom
from coercion and restraint. She stated that folks should be
able to have the things listed here as rights regardless of
whether they are being paid for by the resident or by Medicaid.
These are people's homes, places where three or more people
live, she continued, and people should be able to live in
dignity and free from interference, so they have the liberty to
live their best lives.
REPRESENTATIVE PRAX concurred, but said the simple solution is
that someone can move if they don't like where they are living.
He said he questions how often people are forced to live in a
given home situation.
REPRESENTATIVE SPOHNHOLZ answered that these are people who
cannot live by themselves autonomously. She stated that in some
communities there may not be multiple assisted living homes and
therefore few choices. She further stated that at a little over
700 assisted living homes in Alaska there aren't enough to meet
the need and it is difficult to find a home. It needs to be
ensured that everybody can have the rights of dignity and
liberty, she said, regardless of how it is being paid for.
4:03:47 PM
REPRESENTATIVE KURKA stated that Amendment 4 would not change
the nearly three pages of statute that do guarantee the rights
of residents. He said his objection and the thrust of the
amendment is not that onerous things are being added to this
law, but that federal statute is being cited, which is subject
to change and not governed by the Alaska State Legislature. If
it is thought that those federal rules are good, he continued,
then they should be put into state statute instead of citing the
federal code number and saying a home must comply with federal
rules and state rules. There are two standards, he stated, and
the issue is saying that a home must comply with the federal
rules even if not receiving federal monies.
CO-CHAIR SNYDER stated she sees the logic, but noted it isn't
unusual to reference federal rules and regulations in Alaska
statute and therefore it isn't something that makes this unique
to some other aspects of Alaska's statutes. She said there is
opportunity moving forward if Representative Kurka wants to
pursue being more specific with state protections and
integrating that into state statute, but that it gives her pause
to remove these protections before being prepared to insert
state level protections.
CO-CHAIR ZULKOSKY asked whether she is correct in understanding
that the department's position is that adopting Amendment 4
could make enforcement of this legislation complicated and
potentially burdensome for DHSS.
MR. BAXTER replied that having two different standards would
make it difficult for DHSS to apply them and people would
struggle when trying to transition between the facility types
with different standards. He advised that having the same
standard across the board for all facilities and all residents
is ideal, especially since it is a resident's right.
4:08:35 PM
REPRESENTATIVE KURKA submitted that citing federal [law and
regulation] in Alaska statutes is part of the problem the
state is held by federal strings that may or may not be in the
best interest of the state and its communities. He said he
isn't saying there is anything objectionable in this specific
federal statute, rather he is objecting to applying federal
strings to [assisted living] homes that are not taking federal
money. Regarding the department's concerns about enforcement,
he argued that DHSS has two separate standards that are being
added here and it's not a matter that these rights are being
deprived but that new federal requirements are being referenced
in addition to the state's requirements. He said homes will
have to comply with nearly three pages of rights and regulations
and it's a matter of whether to comply with federal statute or
code when a home is not receiving federal money.
CO-CHAIR SNYDER maintained her objection.
A roll call vote was taken. Representative Kurka voted in favor
of Amendment 4. Representatives Fields, McCarty, Spohnholz,
Prax, Zulkosky, and Snyder voted against it. Therefore,
Amendment 4 failed to be adopted by a vote of 1-6.
4:11:35 PM
CO-CHAIR ZULKOSKY moved to report CSSB 89(FIN), as amended, out
of committee with individual recommendations and the
accompanying fiscal notes, and to give Legislative Legal
Services the authority to make technical and conforming changes.
4:12:09 PM
The committee took a brief at-ease.
4:12:42 PM
REPRESENTATIVE KURKA objected.
A roll call vote was taken. Representatives Spohnholz, Fields,
McCarty, Prax, Zulkosky, and Snyder voted in favor of moving
CSSB 89(FIN), as amended, out of committee. Representative
Kurka voted against it. Therefore, HCS CSSB 89 (HSS) was moved
out of the House Health and Social Services Standing Committee
by a vote of 6-1.
4:13:38 PM
The committee took an at-ease from 4:13 p.m. to 4:16 p.m.
HB 106-MISSING PERSONS UNDER 21 YEARS OLD
4:16:56 PM
CO-CHAIR SNYDER announced that the next order of business would
be HOUSE BILL NO. 106, "An Act relating to missing persons under
21 years of age."
CO-CHAIR SNYDER noted that HB 106 is by request of the governor.
She asked the Department of Public Safety to provide a recap of
the bill.
4:17:29 PM
LISA PURINTON, Chief, Criminal Records and Identification
Bureau, Division of Statewide Services, Department of Public
Safety (DPS), provided a summary of HB 106 on behalf of the
administration. She explained that HB 106 would align state law
with federal requirements as it relates to missing persons under
the age 21. She said current state law requires law enforcement
agencies to report information for missing individuals under the
age of 18 to the state and national databases for missing
juveniles, and to the Missing Persons Clearinghouse, and this
information must be reported within 24 hours of learning the
person has been reported missing. She explained that HB 106
would increase the age from 18 years to individuals under 21
years to address that vulnerable population, usually college age
population, that are often away from the home for the first
time. As well, HB 106 would change the 24-hour timeframe to
within 2 hours of receiving notification for agencies to report
that information to the state and national databases. She
further specified that HB 106 would address changes to AS
18.65.620 and AS 47.10.141.
REPRESENTATIVE KURKA asked whether these are already things the
state is generally doing, and it is just a matter of codifying
the practice.
MS. PURINTON confirmed that this is correct. She said most of
the law enforcement agencies are aware of this difference
between state law and federal requirements and most do their
best to comply with the federal requirement to get the data
entered within two hours of receipt of the information. She
stated that right now the department conducts training with law
enforcement and trains them to the more restrictive federal
requirement. But, she continued, there is no state requirement
for them to do that; the bill addresses that gap so there is
conforming language on both sides.
4:21:58 PM
REPRESENTATIVE PRAX requested confirmation that this proposed
change is to align Alaska statute with federal requirements,
nothing more, nothing less.
MS. PURINTON responded that that is correct. She said there are
no major changes other than to increase the reporting
requirement to age 21 and to more timely enter this information
into the database, which is to align state requirements with
federal law.
4:22:40 PM
CO-CHAIR ZULKOSKY moved to report HB 106 out of committee with
individual recommendations and the accompanying zero fiscal
note.
4:23:11 PM
The committee took a brief at-ease at 4:23 p.m.
4:23:18 PM
CO-CHAIR SNYDER, after confirming there was no objection,
announced that HB 106 was moved out of the House Health and
Social Services Standing Committee.
4:24:11 PM
The committee took an at-ease from 4:24 p.m. to 4:30 p.m.
HB 153-CHILD IN NEED OF AID; NOTICE OF PLACEMENT
4:30:49 PM
CO-CHAIR SNYDER announced that the next order of business would
be HOUSE BILL NO. 153, "An Act relating to the identification,
location, and notification of specified family members of a
child who is in state custody."
4:31:07 PM
SUE STANCLIFF, Staff, Representative Mike Cronk, Alaska State
Legislature, on behalf of Representative Cronk, prime sponsor,
stated that HB 153 would ensure extended family members or close
family friends are contacted as potential foster parents. She
said the bill's main provision would make sure that a supervisor
signs off that the required due diligence search for family
members has occurred. If not, she continued, the social worker
is directed to complete that search to the supervisor's
satisfaction in as a timely manner as possible. The further
noted that the bill requires the search to be completed within a
30-day time limit, but also recognizes that Alaska is an
expansive state so an extensive search may require additional
time. The bill allows for that levity, she added, but requires
a supervisor to verify the progress.
MS. STANCLIFF stated that HB 153 would put this additional
protection into statute since it is not currently addressed by
the Office of Children's Service's (OCS). She said the policy
is warranted due to the continuous high social worker turnover
rate - some social workers are very new and may not continue
beyond one or two years. Having a supervisor sign off that a
family search has been thoroughly conducted will ensure that
children are protected and in the best foster home possible.
When good family placement is available, she added, keeping a
child with his or her family or as close to home as possible is
often the placement of the child's best interest, which is the
bill's intent.
4:33:21 PM
REPRESENTATIVE MCCARTY offered his support for HB 153. He asked
whether OCS has had any disagreements with the proposed
legislation.
MS. STANCLIFF responded that the sponsor's understanding is that
OCS is already doing this to the best of its ability and putting
this into statute will codify that OCS is to do this. If OCS is
not able to do it, then the supervisor would provide a written
progress statement.
4:35:21 PM
REPRESENTATIVE KURKA said he likes the direction of the bill but
questions whether it needs to be strengthened or cleaned up. He
pointed out that for a child the 30-day requirement, which could
be extended with a supervisor's approval, represents a long
time. He drew attention to the term "due diligence" on page 1,
line 13, and asked whether there is a standard or definition for
the term. He stated he doesn't want to pass a bill full of good
intent but without enough teeth to meaningfully achieve its
objective.
MS. STANCLIFF replied that she doesn't have a definitive answer
or response to the comments, but said the department tries to
adhere to the timeframe. She specified that this is carryover
from previous legislation and the sponsor took the 30 days
directly from that previous work. Regarding page 1, lines 12-
14, she stated that if the department is not able to complete
the search within the 30 days, the supervisor must notify that
DHSS has done its best to find the relatives within that 30-day
period. She noted that completing the search isn't as difficult
in Bush villages where everybody knows everybody and knows the
families, but it can become very challenging in a different
setting or if there is no living relative.
4:39:31 PM
REPRESENTATIVE KURKA stated he would like to receive background
information on the previous legislative history as well as on
the standard for due diligence. He referred to page 1, line 9,
regarding notifying ["adult family members of the child"] and
asked how family is defined.
MS. STANCLIFF answered that it is defined in statute.
4:40:52 PM
CO-CHAIR ZULKOSKY asked whether the sponsor has reached out to
child welfare advocates or folks in the field who have assessed
this legislation.
MS. STANCLIFF replied that the sponsor felt this was a very
simple bill and has not heard from [child welfare advocates] or
reached out to foster care but has spoken with the department.
CO-CHAIR ZULKOSKY noted that in 2018 Alaska was the third lowest
in non-relative placement, although it may have improved with
the Tribal Child Welfare Compact. She said she is interested in
a future discussion with the department about where that is at
in context with HB 153.
4:42:39 PM
REPRESENTATIVE FIELDS asked whether the sponsor has coordinated
with Facing Foster Care, an advocacy group for foster families
in Anchorage.
MS. STANCLIFF responded no but said the sponsor would do that
with invited testimony.
REPRESENTATIVE SPOHNHOLZ recounted that in 2018 House Bill 151
was enacted, which required that supervisors document in writing
in the case file whether a search had been conducted for an
appropriate placement with an adult family member or a family
friend. She offered her understanding that federal law requires
the 30-day timeframe, which is why it wasn't put into House Bill
151 at that time. She encouraged the sponsor to reach out to
former Representative Les Gara and Amanda Metivier with Facing
Foster Care in Alaska given they are experts in child welfare
law and the history of reform over the last decade and could
help in the crafting and understanding the background.
MS. STANCLIFF expressed her thanks for this information. She
stated that AS 47.10.990 defines adult family members.
CO-CHAIR SNYDER stated that HB 153 was held over and that
invited testimony would be heard at the bill's next hearing.
HB 139-GUARDIANS; LIFE-SUSTAINING PROCEDURES
4:45:18 PM
CO-CHAIR SNYDER announced that the final order of business would
be HOUSE BILL NO. 139, "An Act relating to guardians,
guardianships, successor guardians, incapacitated guardians,
incapacitated individuals, and testamentary appointments of
guardians; and relating to withholding or withdrawing life-
sustaining procedures."
4:46:01 PM
CO-CHAIR ZULKOSKY moved to adopt the proposed committee
substitute (CS) for HB 139, Version LS0036\G, Bannister,
5/10/21, as the working document. There being no objection,
Version G was before the committee.
4:46:31 PM
REPRESENTATIVE SARA HANNAN, Alaska State Legislature, as prime
sponsor, presented HB 139. She explained that the bill comes
from constituents and would resolve a very real issue that they
are facing. She said HB 139 would do three things. First, it
would give legal guardians of incapacitated adult wards the
authority to consent on behalf of that ward to cease or withhold
lifesaving medical measures when those procedures would only
prolong the dying process or offer no reasonable expectation of
cure or relief for the illness that the ward is being treated
for. Second, it would allow the guardian of an incapacitated
ward to make a testamentary (by will) appointment of a
subsequent guardian for the ward should the current guardian
die. Third, it would allow a guardian to name a successor
guardian of his or her ward should the guardian become
incapacitated. She noted that these provisions are all legal,
that guardianships vary from state to state, and that the
circumstances being looked at in HB 139 are narrow in the
statutory areas of Alaska law.
REPRESENTATIVE HANNAN related that Paul Douglas, the constituent
who brought this issue to her, is an older man who is faced with
having an incapacitated [adult] child with a disease. The
family fears that, once they have passed, the decisions they've
made for their son for the last 60 years will not be able to be
carried out. She noted that a group within the court system,
the American Association of Retired Persons (AARP), and the
legal community called [Working Interdisciplinary Networks of
Guardianship Stakeholder (WINGS)], are looking at several
aspects of guardianship law in Alaska that they believe are not
adequate to deal with all circumstances. But, she continued,
she has not yet engaged with those groups on this one very
narrow piece that her constituent asked her to investigate.
4:49:56 PM
TIMOTHY CLARK, Staff, Representative Sara Hannan, Alaska State
Legislature, provided a sectional analysis of HB 139 on behalf
of Representative Hannan, prime sponsor. He stated that the
foundation of the bill is best interest of the ward. Under
existing Alaska law, he explained, the authority of guardians is
limited in end-of-life circumstances, which does not work in the
best interest of the wards. There are examples within the
Journal of the American Medical Association, he continued, of
when a guardian cannot ascertain a patient's preferences and
faces the ethical challenges involved in assessing a person's
best interest. Guardians may be reluctant to give orders
limiting treatment, he related, and reports have long suggested
that they choose instead the safer path of aggressive care by
default or defer to a cumbersome judicial process. That "safer
path" can result in prolonging the dying process and suffering
of the ward under the most extreme end of life circumstance.
MR. CLARK informed the committee that most states do not have
very clear guidance for guardians in statute. That lack of
clarity, he said, can lead to these inadvertent circumstances
where suffering is often prolonged needlessly. Besides the
specific circumstances of the sponsor's constituent, he noted,
there are also more general circumstances in terms of the
wellbeing of incapacitated wards under these end-of-life
situations.
MR. CLARK noted that in granting guardians this authority the
guardian is still not alone in this decision-making process. It
is required, he pointed out, that the incapacitated ward not
have on record anything written or known otherwise in terms of
what his or her end-of-life choices may be. Secondly, the ward
would have to suffer from what is known in law as a qualifying
condition, which is essentially a terminal illness or permanent
unconsciousness. The determination of that condition must be
made by the ward's personal physician and another doctor if
available, and when it comes to permanent unconsciousness a
neurologist also must agree.
MR. CLARK addressed the provisions of HB 139. He explained that
the sections in the bill dealing with a guardian's ability to
name a successor guardian in a will in case of the guardian's
death, or to nominate a successor in case of the guardian's own
incapacity [in the future], is a peace of mind issue for someone
devoted to their adult incapacitated ward. With these
mechanisms, he continued, a guardian can have the peace of mind
that their ward will be looked after by someone who shares their
concern for their ward's wellbeing.
4:56:05 PM
MR. CLARK provided the sectional analysis for HB 139. He said
Section 1 would amend AS 13.26.211 by adding a new subsection
that allows the guardian of an incapacitated person to appoint
by will a person to act as guardian for the ward if the current
guardian dies. This new subsection also states that the
appointment of the new guardian takes effect when the appointee
has given notice to the persons and in one of the manners
described in AS 13.26.296 and files acceptance of the
appointment in the court in which the will is probated. He
noted that AS 13.26.296 has to do with notification of the ward,
the ward's relatives if they can be found, or other interested
parties. He stated that in a future hearing the attorneys
consulted by the sponsor can describe this provision further in
that the court would still have authority to make a final
judgement on the successor guardian's nomination.
REPRESENTATIVE HANNAN, responding to Co-Chair Snyder, noted that
Mr. Paul Douglas, a constituent of hers, is committed to this
issue and has illuminating insights.
4:59:09 PM
PAUL DOUGLAS testified in support of HB 139. He stated he is
the father and legal guardian of his son who has been
incapacitated since birth. He explained that several years ago,
while exploring advance directives and end of life issues, he
came to the realization that after more than 50 years of caring
for, overseeing, and participating in the development,
education, and overall wellbeing of his son, Alaska's statutes
preclude him from participating in all lifesaving decisions
regarding medical procedures related to his son's quality of
life and end of life care. After several years of seeking
support from his local legislators to modify the existing
statutes, he continued, Representative Hannan and her staff
accepted the challenge.
MR. DOUGLAS stated that this issue is very real to him because
in September 2020 his son was diagnosed with stage five advanced
kidney disease with a projected life expectancy of six to twelve
months. He said he agrees with the medical community's
advisement that his son is not a candidate for dialysis and that
the only solution is to focus on quality-of-life issues.
However, he pointed out, current state statute does not allow
him to make those decisions on behalf of his incapacitated son.
MR. DOUGLAS asked committee members to consider the plight of
hundreds of other Alaska families as they face these same heart-
rending decisions. He said his intent today is to focus not
only on his own personal dilemma but to in a small way represent
the grave issues facing many other Alaska families caring for
incapacitated wards. He urged the committee to support HB 139.
REPRESENTATIVE SPOHNHOLZ requested Mr. Douglas to describe what
he means by "quality of life" decisions.
MR. DOUGLAS replied that providing life sustaining medical
procedures just to keep someone alive when it is known for what
purposes? He said his son is wheelchair bound after spinal
surgery in 2016 and is now suffering from untreatable advanced
kidney disease, so his lifetime is short and doing anything to
prolong that doesn't make sense. After discussions with his
[son's] personal care physician and other physicians, he stated,
the consensus is that that is the appropriate way to go. But,
he continued, according to statute he cannot make that decision
and tell the doctors this is what he wants to do.
5:03:23 PM
MR. CLARK resumed the sectional analysis. He explained that
Section 2 would amend 13.26.281(a), which refers to the
termination of guardianships, to add that the subsection is
subject to subsection (c) in the same section.
MR. CLARK stated that Section 3 would amend AS 13.26.281 by
adding a new subsection (c) that would allow a guardian of an
incapacitated person, while having capacity, to name a person to
become a successor guardian for the incapacitated person if the
guardian becomes incapacitated. He said this subsection also
notes that the person named by the guardian has priority as
successor, despite the categories of priority described in AS
13.26.311. He noted that this subsection further states that
the appointment of the successor guardian takes effect when the
appointee has given notice to the persons and in one of the
manners described in AS 13.26.296 and has accepted the
appointment.
MR. CLARK stated that Section 4 relates to the authority of a
guardian to decide on behalf of an incapacitated ward when it
comes to end of life decisions. He said Section 4 would amend
AS 13.26.316(c) which has to do with the general powers and
duties of guardians in two ways. The first is mainly
housekeeping and would substitute the word ["ensure" for
"assure"] in four places where it appears in the section. The
second is the addition of a new [paragraph] (8), which states
that a guardian may make the decision to withdraw or withhold
life-sustaining procedures from the ward if doing so is in the
best interest of the ward. Any such decision must be made
according to AS 13.52.045, which is addressed in Section 5 of
the bill.
MR. CLARK explained that Section 5 would amend AS 13.52.045,
which pertains to the conditions under which life-sustaining
procedures may be withdrawn or withheld, including that the ward
must have a qualifying condition as determined by the ward's
primary physician and at least one other physician if another is
available. A determination of permanent unconsciousness must
include a consultation with a neurologist. He further explained
that in this section "a guardian of an incapacitated person
under AS 13.26" is added to those persons who may determine that
life-sustaining procedures may be withheld or withdrawn from a
patient if doing so would be consistent with the patient's best
interests.
MR. CLARK concluded the sectional analysis by pointing out that
Section 6 would repeal AS 13.26.316(e)(3), which in current
statute prohibits a guardian from consenting to the withholding
of lifesaving procedures on behalf of their ward.
5:09:05 PM
REPRESENTATIVE MCCARTY asked whether a guardian wishing to
appoint [a successor] guardian via a will would be appointed in
a proactive manner. In response to Mr. Clark, he noted that
Section 1 refers to appointment [of a successor guardian] by
will and that Section 3 refers to naming a successor guardian in
case the guardian becomes incapacitated. He asked whether one
person would be the "runner up" in the flow.
MR. CLARK replied that in the case of a testamentary appointment
of a surrogate in case the current guardian dies, he assumes the
current guardian could take that step at any time during his or
her guardianship while still living. He said the naming a
successor guardian should the current guardian become
incapacitated must take place while the current guardian still
has capacity.
REPRESENTATIVE MCCARTY surmised that these provisions are not
asking for that to be done in advance.
MR. CLARK answered that these provisions would be completely
voluntary on the part of any guardian.
REPRESENTATIVE HANNAN responded that it must be done in advance.
For example, she said, the will of [the current guardian] would
have to include the testamentary selection. Or, if Mr. Douglas
decided he needed to have a guardian lined up in case he had a
stroke, that would have to be done now while Mr. Douglas has
full capacity to decide to choose someone to become the guardian
for his son. So, she added, they both would have to be done
prior to the event where they would be needed.
REPRESENTATIVE MCCARTY posed a scenario in which Mr. Douglas is
the guardian for Representative McCarty who is incapacitated.
He inquired whether Mr. Douglas must have a backup guardian in
case something happens to Mr. Douglas unexpectedly.
MR. CLARK replied that these provisions are something a guardian
may choose to do, not anything that a guardian would be required
to do. If a guardian did choose to appoint a successor guardian
by will, a testamentary procedure, then the guardian would have
to be alive to create that will and provision in that will.
Also, he continued, it is clear in the bill that the current
guardian must have capacity at the time of appointing a
successor guardian in the event of the current guardian's future
incapacity.
REPRESENTATIVE MCCARTY surmised that if something happened to
the guardian the courts become the guardian of the ward.
MR. CLARK deferred the question into the future when there is an
attorney available to answer it.
5:15:55 PM
CO-CHAIR ZULKOSKY stated she is interested in hearing from
invited testimony regarding the legal constructs around what
happens under current law in the absence of HB 139.
REPRESENTATIVE SPOHNHOLZ urged that the Office of Public
Advocacy be brought into this conversation since it handles
public guardianship for the State of Alaska and could help
unpack the legal framework for this in a constructive way. She
pointed out that there is familial guardianship and public
guardianship, and that care must be taken in crafting law to not
conflate the two. She inquired about the rationale in Section 4
for changing the word "assure" to "ensure" in multiple places.
MR. CLARK answered that according to the bill's drafting
attorney it is a style update that is legally preferred and
believed to be more explicit. Responding further to
Representative Spohnholz, he confirmed it is housekeeping and
not a policy call that is changing the meaning.
5:19:02 PM
REPRESENTATIVE KURKA asked whether the provision in Section 1
would cause problems with contingency appointees in a will and
other legal documents, or whether there is other statute that
would supersede these circumstances.
MR. CLARK replied that this provision is for the guardian of an
incapacitated ward to appoint, via the guardian's will, a
successor guardian for the ward should the guardian die.
REPRESENTATIVE KURKA posed a scenario in which he is the
guardian of a certain individual and via his will he has
appointed Representative McCarty as his replacement guardian.
The certain individual, he continued, has his own legal
statement that appoints Representative Kurka as guardian and
Representative Prax successor guardian. He asserted that the
certain individual's statement making Representative Prax the
successor would be a superseding document and that this
contingency is not in the bill's language.
MR. CLARK offered his assumption that if an incapacitated ward
had created a power of attorney or other document for health
care decisions while the ward had capacity, then that document
would supersede in healthcare decisions by the guardian. He
said this can be confirmed by attorneys during future hearings.
REPRESENTATIVE HANNAN pointed out that the difference in the
scenario that Representative Kurka is describing is someone who
has had capacity and made decisions. She said HB 139 addresses
the loophole of a person who has never had capacity to make
those decisions and documents. The concern here, she continued,
is the guardian who has always had that ability but loses it.
Currently, when the guardian dies, the courts make the decision
about who becomes the decider for that person. This family, she
continued, is asking for the ability to have the family
participate in that decision.
[HB 139 was held over.]
5:26:29 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:26 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 139 House HSS Hearing Request Memo 3.20.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 National Guardianship Association Standards of Practice 3.20.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Guardianship and End-of-Life Decision Making--Journal of the American Medical Association 3.20.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Sectional Summary 3.20.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Sponsor Statement 3.20.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Version I.PDF |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 153 FN- HSS.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| HB 139 DOA FN.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 153a Invited Testimony for 20 April 2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| HB0153A.PDF |
HHSS 4/20/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| HB153 - Sectional Analysis.pdf |
HHSS 4/20/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| HB153 - Sponsor Statement.pdf |
HHSS 4/20/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| HB 153 Supporting Documents and Education as of 04.19.2021.pdf |
HHSS 4/20/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 153 |
| SB 89 Fiscal Note 1 DHSS.PDF |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 Sectional Analysis Version GS 1675 A.pdf |
HHSS 5/13/2021 3:00:00 PM SFIN 4/7/2021 9:00:00 AM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 FAQ on Final Rule prepared by Coalition for Community Choice.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SFIN 4/7/2021 9:00:00 AM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 One Page Summary.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SFIN 4/7/2021 9:00:00 AM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 All Ways Caring Letter of Support.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 Commission on Aging Letter of Support.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 4/1/2021 1:30:00 PM |
SB 89 |
| SB 89 Letter of Support Colony Assisted Living Homes.pdf |
HHSS 5/13/2021 3:00:00 PM SHSS 4/1/2021 1:30:00 PM |
SB 89 |
| SB 89 Letter of Support Samash_Redacted.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SHSS 3/18/2021 1:30:00 PM |
SB 89 |
| SB 89 Settings Information webpage.pdf |
HHSS 5/13/2021 3:00:00 PM |
SB 89 |
| SB 89 Amendments.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
SB 89 |
| SB 89 Explanation of Changes ver. A to B 4.13.2021.pdf |
HHSS 4/29/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM SFIN 4/14/2021 9:00:00 AM |
SB 89 |
| SB 89 Amendments.pdf |
HHSS 5/4/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
SB 89 |
| HB 106 Sectional Analysis version A.pdf |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 Fiscal Note HSS PS.PDF |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 Fiscal Note DPS CJISP.PDF |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 DPS Prensentation 3.11.21 Distributed.pdf |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 Hearing Request 3.1.21.pdf |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 Sponsor Statement 2.18.21.pdf |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 version A.PDF |
HHSS 5/13/2021 3:00:00 PM HSTA 3/11/2021 3:00:00 PM |
HB 106 |
| HB 106 Additional Info - Missing Persons under 21 Statistics.pdf |
HHSS 5/13/2021 3:00:00 PM HSTA 3/16/2021 3:00:00 PM |
HB 106 |
| HB 106 Sectional Analysis 04.12.2021.pdf |
HHSS 4/22/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HB 106 Sponsor Statement 04.12.2021.pdf |
HHSS 4/22/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HHSS HB 106 DPS Presentation 04.12.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HB 106 DPS Fiscal Note 04.12.2021.pdf |
HHSS 4/22/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HB 106 HSS Fiscal Note 04.12.2021.pdf |
HHSS 4/22/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HHSS HB 106 DPS Presentation 04.22.2021.pdf |
HHSS 4/22/2021 3:00:00 PM HHSS 5/13/2021 3:00:00 PM |
HB 106 |
| HB 139 Explanation of Changes, Version I to Version G 5.10.21.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Blank CS Ver.G 5.10.21.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| HB 139 Version G Sectional Summary 5.12.2021.pdf |
HHSS 5/13/2021 3:00:00 PM |
HB 139 |
| SB 89 Amendments, 5.13 .pdf |
HHSS 5/13/2021 3:00:00 PM |
SB 89 |