Legislature(1995 - 1996)
02/10/1995 01:04 PM JUD
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HOUSE JUDICIARY STANDING COMMITTEE February 10, 1995 1:04 p.m. MEMBERS PRESENT Representative Brian Porter, Chairman Representative Joe Green, Vice Chairman Representative Con Bunde Representative Bettye Davis Representative Al Vezey Representative Cynthia Toohey Representative David Finkelstein MEMBERS ABSENT None COMMITTEE CALENDAR HB 39:"An Act relating to the authority of mobile intensive care paramedics, physician assistants, and emergency medical technicians to pronounce death under certain circumstances." PASSED OUT OF COMMITTEE HB 4:"An Act relating to absences from the state for purposes of determining residency under the permanent fund dividend program; and providing for an effective date." PASSED OUT OF COMMITTEE WITNESS REGISTER REPRESENTATIVE GENE THERRIAULT Alaska State Legislature State Capitol, Room 421 Juneau, AK 99801-1182 Telephone: (907) 465-4797 POSITION STATEMENT: Sponsor of CSHB 39 ANNE CARPENETI, Aide House Judiciary Committee State Capitol, Room 120 Juneau, AK 99801-1182 Telephone: (907) 465-4990 POSITION STATEMENT: Provided information on CSHB 39 MARK JOHNSON, Chief Emergency Medical Services Department of Health and Social Services P.O. Box 110616 Juneau, AK 99811-0616 Telephone: (907) 465-3027 POSITION STATEMENT: Testified in favor of HB 39 ROD MOURANT, Legislative Aide Representative Pete Kott Alaska State Legislature State Capitol, Room 432 Juneau, AK 99811-1182 Telephone: (907) 465-3777 POSITION STATEMENT: Presented the sponsor statement for CSHB 4 JUDY ERICKSON 4465 Mountainside Drive Juneau, AK 99801 Telephone: (907) 780-4995 POSITION STATEMENT: Testified in favor of CSHB 4 THOMAS C. WILLIAMS, Director Permanent Fund Dividend Division Department of Revenue P.O. Box 110460 Juneau, AK 99811-0460 Telephone: (907) 465-2323 POSITION STATEMENT: Testified in favor of CSHB 4 PREVIOUS ACTION BILL: HB 39 SHORT TITLE: AUTHORITY TO PRONOUNCE DEATH SPONSOR(S): REPRESENTATIVE(S) THERRIAULT,B.Davis,Bunde,G.Davis JRN-DATE JRN-PG ACTION 01/06/95 30 (H) PREFILE RELEASED 01/16/95 30 (H) READ THE FIRST TIME - REFERRAL(S) 01/16/95 31 (H) HES, JUD 01/19/95 90 (H) COSPONSOR(S): BUNDE 01/26/95 (H) HES AT 03:00 PM CAPITOL 106 01/26/95 (H) MINUTE(HES) 01/27/95 154 (H) HES RPT CS (HES) 7DP 01/27/95 154 (H) DP: ROKEBERG, G.DAVIS, BUNDE, TOOHEY 01/27/95 154 (H) DP: VEZEY, ROBINSON, BRICE 01/27/95 155 (H) ZERO FISCAL NOTE (DHSS) 1/27/95 01/27/95 161 (H) COSPONSOR(S): G.DAVIS 02/10/95 (H) JUD AT 01:00 PM CAPITOL 120 BILL: HB 4 SHORT TITLE: PERMANENT FUND DIVIDEND ELIGIBILITY SPONSOR(S): REPRESENTATIVE(S) KOTT JRN-DATE JRN-PG ACTION 01/06/95 21 (H) PREFILE RELEASED 01/16/95 21 (H) READ THE FIRST TIME - REFERRAL(S) 01/16/95 21 (H) STA, JUD, FIN 01/24/95 (H) STA AT 08:00 AM CAPITOL 102 01/24/95 (H) MINUTE(STA) 01/31/95 (H) MINUTE(STA) 02/01/95 190 (H) STA RPT 6DP 1NR 02/01/95 190 (H) DP: JAMES, PORTER, IVAN, ROBINSON 02/01/95 190 (H) DP: WILLIS, OGAN 02/01/95 190 (H) NR: GREEN 02/01/95 190 (H) ZERO FISCAL NOTE (REV) 2/1/95 02/10/95 (H) JUD AT 01:00 PM CAPITOL 120 ACTION NARRATIVE TAPE 95-10, SIDE A Number 000 The House Judiciary Standing Committee was called to order at 1:04 p.m. on Friday, February 10, 1995. A quorum was present. CHAIRMAN BRIAN PORTER stated the following bills would be heard: CSHB 39, and CSHB 4. He called Representative Therriault to come forward and introduce the committee substitute for HB 39(HES). HJUD - 2/10/95 HB 39 - AUTHORITY TO PRONOUNCE DEATH Number 020 REPRESENTATIVE GENE THERRIAULT, bill sponsor, introduced CSHB 39. He said the intent was in certain circumstances, to grant the power to those who do not normally have that authority, to declare someone deceased. In rural Alaska there are many instances where there is no doctor, so an emergency medical technician (EMT) or medical assistant has responded to an accident. Once they start cardiopulmonary resuscitation (CPR), they have a legal obligation to continue until somebody relieves them of that duty by either taking over for them, taking the patient to the emergency room, or by declaring death. He worked closely with Emergency Medical Services (EMS) providers to craft language that is fairly tight, so this power is only extended to EMTs and physician assistants in certain circumstances. Another consideration here in Alaska is that there are bodies of water so cold that you have hypothermia conditions, or cold water drowning. Special care needs to be taken in those instances. Two proposed amendments were included in the committee packets, which Representative Therriault supported. REPRESENTATIVE CYNTHIA TOOHEY made a motion to adopt the committee substitute, version F for HB 39. Number 095 REPRESENTATIVE DAVID FINKELSTEIN wanted to know the difference between the committee substitute and the original bill. ANNE CARPENETI, House Judiciary Committee Council, said the only change she found was on page 3, line 13. This version of the committee substitute removes the material that was in the original bill, "by emergency medical technician." Number 110 REPRESENTATIVE THERRIAULT explained why that was done. What he wanted the committee to consider, also removes the same language from section (b) on page 3, lines 15 - 21. He said we are allowing individuals to make a declaration of death, if they have properly administered resuscitation efforts according to these two requirements. That power would be extended to EMTs and to physician assistants. The bill started out only providing this authority to EMTs. Now it includes physician assistants, along with other people already allowed by law. The intent of this language is to make the law consistent. Amendment F.2 makes it consistent. REPRESENTATIVE TOOHEY moved that F.2 dated 2/10/95, be adopted as Amendment Number 1. This amendment would delete "by an emergency medical technician" on page 3, lines 16 - 17. Hearing no objection, it was so ordered. Number 190 REPRESENTATIVE TOOHEY moved that F.1 be adopted as Amendment Number 2. This amendment would delete "cardiac arrest accompanied by" from two places: Page 2, line 31, after "means"; and page 3, line 2. There was discussion on the amendment. REPRESENTATIVE THERRIAULT explained there had been concern expressed by the Medical Association about the language on page 3, where it talks about acceptable medical standards. They were concerned over the presence of rigor mortis being enough, by itself to determine the state of death. The EMS providers say they would never just look at the postmortem lividity, discoloration; but they would also check for a pulse, so cardiac arrest would also be present. Section (a) says that cardiac arrest is part of its determining factor. We are trying to make cardiac arrest part of (a), (b), (c), and (d). So cardiac arrest and lividity would be factors in determining death. The EMS providers felt comfortable with that. He added that since the bill passed the Health, Education and Social Services (HESS) Committee, the Interior Fire Chiefs Association informed Representative Therriault they support this bill. Number 290 MARK JOHNSON, Chief, Emergency Medical Services Section, Department of Health and Social Services, testified in support of the bill. He said as Representative Therriault explained, sometimes our EMS providers around the state, especially in rural areas, are expected to continue resuscitative efforts long past the time when there is no hope whatsoever of resuscitating the patient. The attempt here is to give those workers a standard that will allow them to stop efforts when the patient is dead. There is no case where somebody met only one of the criteria in this bill and actually lived, so this is a very tight standard we would be applying. The president of the Alaska State Medical Society expressed concern that the presence of postmortem lividity was not sufficient criteria by itself. After a conference with Dr. Peter Nakamura, Director of Public Health for Alaska and Dr. Michael Probst, Medical Examiner for Alaska, Mr. Johnson concluded that the safe language would be to say that the patient needed to have cardiac arrest accompanied by (a), or (b), or (c), or (d). This would satisfy the criteria. He felt a situation in which a patient could have lividity and not be dead, was rare. The Department of Health and Social Services felt comfortable with the language in this bill, after those concerns were addressed. Number 335 REPRESENTATIVE JOE GREEN asked if there was any potential for someone coming back against the state for deficient training in the situation where someone, other than a doctor makes this judgement call. MR. JOHNSON did not believe they could because they would have to show that there was a chance the patient would have survived. He felt the state training standards were up to national standards. Number 365 REPRESENTATIVE TOOHEY said, having been an EMT for 15 years on the highway, they are very thoroughly trained in knowing death, seeing death, and trying to prevent deaths. You will not find a better, more aggressive group of people to prevent it, when possible. She believed the language covered what was necessary, very well. CHAIRMAN PORTER asked if there was any other discussion on Amendment Number 2, or objection. Seeing none, the amendment was adopted. Number 420 REPRESENTATIVE TOOHEY made a motion to move the bill, with individual recommendations and fiscal notes. Hearing no objection, it was so ordered. HJUD - 2/10/95 CSHB 4(STA) PERMANENT FUND DIVIDEND ELIGIBILITY Number 440 ROD MOURANT, Legislative Aide to Representative Pete Kott, presented the sponsor statement for CSHB 4(STA). It reads as follows: "This legislation would remedy a problem as a result of a recent court ruling. That ruling declared spouses of a Permanent Fund Dividend (PFD) recipient from being considered eligible to receive a dividend if they were accompanying an eligible spouse out of state on an allowable absence. "This legislation would allow individuals who accompany an eligible spouse out of state on an allowable absence to retain their eligibility for a PFD if that was the only reason that they would have been disallowed. "This correction applies retroactively to January 1, 1994, the first time the Permanent Fund Dividend Division disallowed dividends for that reason. It makes provision for those individuals to receive the previously denied dividend. "I encourage you to support this legislation." Number 530 JUDY ERICKSON, Juneau resident, described her ex-husband's experience with his permanent fund dividend. He was denied his dividend because of an unexpected absence outside of Alaska, due to a medical emergency. He has lived in Juneau for years, and maintains a home here. He can only get his experimental treatment for advanced kidney cancer in Seattle. Because they have two children, it is very important for him to go through any kind of treatment he can, to prolong his life. His wife has been denied her PFD also because her staying in Seattle with him was not an allowable absence. He is on pain medication 24 hours a day, should not drive, needs constant care, and he needs her there to help. He already has tremendous medical expenses and it does not seem right to withhold her dividend because of this. Number 555 THOMAS WILLIAMS, Director, Permanent Fund Dividend Division, Department of Revenue, introduced Nancy Jones, who will be the new director starting next Thursday. He said the department strongly supports the reinstatement of the "piggyback" allowable absence, which had been available in the past, up until the inadvertent conflict between statute and regulation; which caused the regulation to fall, as ruled by the court a little over a year ago. He said they have taken steps to append applications so they can be easily identified, should corrective legislation be enacted. Then they can go ahead and pay folks who would have received their dividends had it not been for this regulation conflict. Number 650 REPRESENTATIVE FINKELSTEIN asked Mr. Williams if it would be practical and manageable for the Permanent Fund Dividend Division to hold people's dividends, and then gave them to the people when they returned to the state. MR. WILLIAMS answered there was a mechanism by which that could work. We could administer a system that would hold the dividends of anyone who was absent for 180 consecutive days during the qualifying year, until they returned and lived in the state for 90 days, basically qualifying for dividends during that time. Number 700 REPRESENTATIVE VEZEY moved to adopt draft F of the committee substitute. Hearing no objection, CSHB 4, version F was adopted. Number 780 REPRESENTATIVE CON BUNDE said he would like to see some future exploration on the possibility of holding juveniles' dividend checks until they turn 18. REPRESENTATIVE TOOHEY made a motion to pass the bill from committee with individual recommendations and the zero fiscal note. Seeing no objection, it was so ordered. ADJOURNMENT There being no further business to come before the House Judiciary Committee, Chairman Porter adjourned the meeting at 2:00 p.m.