Legislature(1997 - 1998)

03/05/1997 09:06 AM Senate HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
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      SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                     
                         March 5, 1997                                         
                           9:06 a.m.                                           
                                                                               
  MEMBERS PRESENT                                                              
                                                                               
 Senator Gary Wilken, Chairman                                                 
 Senator Lyda Green                                                            
 Senator Jerry Ward                                                            
                                                                               
  MEMBERS ABSENT                                                               
                                                                               
 Senator Loren Leman, Vice Chairman                                            
 Senator Johnny Ellis                                                          
                                                                               
 COMMITTEE CALENDAR                                                            
                                                                               
 CS FOR HOUSE BILL NO. 45(HES)                                                 
 "An Act relating to runaway and missing minors; and providing for             
 an effective date."                                                           
                                                                               
  - MOVED HB 45 OUT OF COMMITTEE                                               
                                                                               
 SENATE BILL NO. 99                                                            
 "An Act relating to health care data and registration of births."             
                                                                               
  - MOVED SB 99 OUT OF COMMITTEE                                               
                                                                               
 SENATE BILL NO. 100                                                           
 "An Act relating to grant authority for services for                          
 developmentally delayed or disabled children and their families."             
                                                                               
  - MOVED SB 100 OUT OF COMMITTEE                                              
                                                                               
                                                                               
  PREVIOUS SENATE COMMITTEE ACTION                                             
                                                                               
 HB 45 - No previous Senate action to record.                                  
                                                                               
 SB 99 - No previous Senate action to record.                                  
                                                                               
 SB 100 - No previous Senate action to record.                                 
                                                                               
  WITNESS REGISTER                                                             
                                                                               
 Representative Kelly                                                          
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
  POSITION STATEMENT:   Prime Sponsor of HB 45.                                
                                                                               
 Monica Owen                                                                   
 980 Snowhill Avenue #1                                                        
 Wasilla, Alaska 99654                                                         
  POSITION STATEMENT:   Disagreed portions of HB 45.                           
                                                                               
 Venessa Grenung                                                               
 980 Snowhill Avenue #1                                                        
 Wasilla, Alaska 99654                                                         
  POSITION STATEMENT:   Agreed with Ms. Owen's testimony                       
                                                                               
 Angela Salerno, Executive Director                                            
 Alaska Chapter of the National Association of Social Workers                  
 525 Main Street                                                               
 Juneau, Alaska 99801                                                          
  POSITION STATEMENT:   Discussed a flaw in HB 45.                             
                                                                               
 Al Zangri, Chief                                                              
 Vital Statistics                                                              
 Division of Public Health                                                     
 Department of Health & Social Services                                        
 PO Box 110675                                                                 
 Juneau, Alaska 99811-0675                                                     
  POSITION STATEMENT:   Reviewed SB 99.                                        
                                                                               
 Dr. John Middaugh, Chief                                                      
 Epidemiology Section                                                          
 Division of Public Health                                                     
 Department of Health & Social Services                                        
 PO Box 240249                                                                 
 Anchorage, Alaska 99524-0249                                                  
  POSITION STATEMENT:   Answered questions.                                    
                                                                               
 Mary Diven                                                                    
 Department of Health & Social Services                                        
 PO Box 110612                                                                 
 Juneau, Alaska 99811                                                          
  POSITION STATEMENT:   Reviewed SB 100.                                       
                                                                               
 Elmer Lindstrom, Special Assistant                                            
 Office of the Commissioner                                                    
 Department of Health & Social Services                                        
 PO Box 110601                                                                 
 Juneau, Alaska 99811-0601                                                     
  POSITION STATEMENT:   Discussed SB 100.                                      
                                                                               
 Gigi Pilcher, Parent                                                          
 Ketchikan, Alaska                                                             
  POSITION STATEMENT:   Urged passage of SB 100.                               
                                                                               
  ACTION NARRATIVE                                                             
                                                                               
  TAPE 97-21, SIDE A                                                           
                                                                               
                                                                               
               HB  45 RUNAWAY AND MISSING MINORS                              
                                                                              
 Number 001                                                                    
                                                                               
  CHAIRMAN WILKEN  called the Senate Health, Education & Social                
 Services Committee (HES) to order at 9:06 a.m. and announced that             
 the meeting scheduled for Friday would be cancelled.  Chairman                
 Wilken introduced  HB 45  as the first order of business.                     
                                                                               
  REPRESENTATIVE KELLY , Prime Sponsor, informed the committee that            
 last year there were a number of bills dealing with juvenile                  
 issues, among those bills was SB 289 which became effective this              
 past September.  SB 289 sought to bring runaways into a protective            
 environment by designating the child as a child in need of aid.  SB
 289 established a scenario in which a police officer could take               
 custody of a child, bring the child to the parents, and if the                
 parents agreed, the child would be accepted back into the home or             
 placed in a shelter.  The police officer could also decide whether            
 there was an abusive situation in which case the child would be               
 taken to a shelter.  Representative Kelly explained that HB 45 is             
 before the committee because last year HB 387, a rewrite of the               
 juvenile code, separated in statute what constituted a child in               
 need of aid or a delinquent child.  HB 387 took statutes from                 
 Chapter 10 and created Chapter 12 in order to deal with delinquent            
 children in one manner and abused children in another.  When those            
 statutes were moved a key portion of SB 289 was lost.                         
 Representative Kelly said that it was not intended for the statutes           
 to read that a runaway minor must first consent to return home.               
 The main thrust of SB 289 was to place a minor in a safe                      
 environment where monitoring could occur while the court or                   
 department determined what to do.                                             
                                                                               
 Number 125                                                                    
                                                                               
  MONICA OWEN , testifying from Mat-Su, did not agree with the portion         
 of the bill that would allow police to place minors in a shelter or           
 back in the home.  Shelters can be just as bad as the home.  Ms.              
 Owen mentioned that mental abuse as well as physical abuse can                
 occur.                                                                        
                                                                               
  VENESSA GRENUNG , testifying from Mat-Su, agreed with Ms. Owen's             
 testimony.  She mentioned that perhaps a mutual agreement to place            
 the minor in a friend's house could occur.                                    
                                                                               
  ANGELA SALERNO , Executive Director for the National Association of          
 Social Workers, said that HB 45 has a flaw regarding the language             
 pertaining to the officer's decision whether or not to bring a                
 minor home.  Ms. Salerno believed that in this case caution should            
 be taken.  Police officer's are not qualified to assess the                   
 presence of physical or sexual abuse.  HB 45 could be improved by             
 changing the language to "cause to suspect physical or sexual                 
 abuse."  National research reports that 60-75 percent of runaways             
 report serious physical abuse, furthermore sexual abuse is higher             
 among young women.  The 1988 Governor's Interim Commission on                 
 Children and Youth in Alaska reported that at least two-thirds of             
 runaway youth say they have been abused at home.  Each year in                
 Alaska, there are 3,575 cases of abuse which have been verified.              
 Ms. Salerno believed that the state could be opened up to some                
 liabilities with the current language; liability, if a minor is               
 returned to the home and suffers a serious injury or worse from the           
 parents.  Ms. Salerno was concerned with dysfunctional families.              
                                                                               
 Number 201                                                                    
                                                                               
  REPRESENTATIVE KELLY  said that police officers are recognized in            
 statute as persons with a level of authority and experience in                
 determining child abuse.  Police officers are trained and must                
 report such abuse.                                                            
                                                                               
  ANGELA SALERNO  agree with Representative Kelly's comment regarding          
 the physical manifestations of abuse, however sexual abuse is                 
 another matter.  Ms. Salerno clarified that her testimony referred            
 to sexual abuse.                                                              
                                                                               
  CHAIRMAN WILKEN  asked Ms. Salerno if her suggestion was to change           
 the word "believe" to "suspect" on page 1, line 14.  He asked Ms.             
 Salerno if she wanted the officer to take the child for an advanced           
 interview to determine whether a problem exists at home.   ANGELA             
 SALERNO  replied yes.  If the police officer suspected child abuse,           
 the officer would be compelled to report that abuse to DFYS and               
 take the child to a safe environment.                                         
                                                                               
 In response to Chairman Wilken,  REPRESENTATIVE KELLY  specified that         
 he had referred to Title 47 Chapter 17.020.                                   
                                                                               
  SENATOR GREEN  moved to report HB 45 out of committee with                   
 individual recommendations and accompanying fiscal notes.  Without            
 objection, it was so ordered.                                                 
                                                                               
                                                                               
          SB  99 HEALTH CARE DATA; BIRTH REGISTRATIONS                        
                                                                              
                                                                               
 Number 252                                                                    
                                                                               
  CHAIRMAN WILKEN  introduced  SB 99  as the next order of business            
 before the committee.                                                         
                                                                               
  AL ZANGRI , Chief of the Bureau of Vital Statistics for DHSS,                
 explained that Sections 1 and 2 of SB 99 establish civil immunity             
 for institutions and providers who report diseases and conditions             
 to the department as required under other portions of the statute.            
 Without SB 99, the department could lose $300,000 to $400,000 per             
 year in cancer grants.  Sections 3 and 4 clarify the language in              
 the Vital Statistics Act regarding the reporting requirements for             
 births and institutions as well as shortening the time period from            
 seven to five days.  There is also a language change in determining           
 how reports are made for moving conveyances.  Mr. Zangri noted the            
 most important change as being the elimination of a signature for             
 every birth certificate produced in a hospital.  This would allow             
 the bureau to operate its electronic birth certificate system.  All           
 but two hospitals in the state have electronic birth certificate              
 systems.  Currently, each hospital must send a paper copy of the              
 birth certificate with a hand signature.  SB 99 would allow                   
 electronic signatures or group signatures for all the births during           
 a week.                                                                       
                                                                               
   In response to Senator Green,  AL ZANGRI  clarified that SB 99 does         
 not release information.  SB 99 grants civil immunity to facilities           
 already required to report that information.  Current law requires            
 that providers report this information to the department, however             
 if the information has not been properly used then the individual             
 can be sued.  SB 99 grants civil immunity for providing that                  
 information unless the case is pure negligence.  Mr. Zangri pointed           
 out that this immunity is required under federal statutes if the              
 cancer grant is to continue.                                                  
                                                                               
 Number 318                                                                    
                                                                               
  DR. JOHN MIDDAUGH , Chief of the Epidemiology Section in DHSS,               
 explained that the immunity protection is only for those reporting            
 in compliance with state law.  The data is being reported to the              
 Division of Public Health.  The data is not disclosable under                 
 Alaska's public records law and can only be released if there is an           
 eminent and direct public health threat to another person.  Dr.               
 Middaugh noted that the data is provided with identifiers only so             
 that duplicate reporting can be eliminated.  Dr. Middaugh                     
 reiterated that the data is protected by the Alaska statutes                  
 regarding confidentiality.                                                    
                                                                               
  SENATOR GREEN  expressed concern with the sectional analysis of              
 Section 1 which says that, "This immunity protects the person                 
 reporting the information regardless of how the Department uses the           
 information."  Senator Green did not know if that accurately                  
 reflected the intent of the bill.  Senator Green wanted to be sure            
 that a medical provider would not be required to provide                      
 information that would not ordinarily be provided.                            
                                                                               
  DR. JOHN MIDDAUGH  said that the bill only provides protection for           
 the information required to be reported under Alaska statutes and             
 regulations.                                                                  
                                                                               
  CHAIRMAN WILKEN  pointed out that he had a list of the diseases              
 required to be reported on a daily basis.                                     
                                                                               
  SENATOR WARD  asked if this was necessary to receive the first of            
 five increments of $420,000; is this a new program?   DR. JOHN                
 MIDDAUGH  clarified that the grant was awarded in October of 1994.            
 During the first year, regulations were revised in order to be in             
 compliance with establishing the cancer registry component of the             
 reporting requirements.  The regulations went into effect in                  
 January of 1996.  The first year of collection of this information            
 on cancer statewide has been completed.  The other disease reports            
 for infectious disease in some cases go back to territorial days.             
 The funds received to establish the cancer registry are part of the           
 federal legislative program, the Cancer Registries Amendment Act,             
 which establishes uniform cancer registries in all 50 states.  Dr.            
 Middaugh noted that work to establish a cancer registry in Alaska             
 had been going on for 20 years; these funds allowed such a                    
 registry.  In order to maintain compliance of the requirements of             
 the federal law, these three provisions require statutory changes             
 and cannot be dealt with in regulation.  Dr. Middaugh informed the            
 committee that SB 99 has been endorsed by the Alaska Hospital &               
 Nursing Home Association, the Alaska State Medical Association, and           
 the Alaska Division of the American Cancer Society.                           
                                                                               
 Number 375                                                                    
                                                                               
  SENATOR WARD  asked if the program comes out of the $420,000 or is           
 this an additional program.  Are there matching funds?   DR. JOHN             
 MIDDAUGH  said that there are no matching funds involved.  This is            
 an ongoing grant which is now in the third year of a five year                
 project.  Without these additional statutory changes, there may be            
 a risk in losing the award.  Dr. Middaugh noted that this really              
 protects the data, the patients, and the providers.  In response to           
 Senator Ward, Dr. Middaugh replied that there has not been any                
 implication that the money would be withdrawn without the                     
 implementation.  However as part of the federal law and the grant             
 award, the department has to certify that efforts attempting to               
 comply with the federal legislation have been made.                           
                                                                               
                                                                               
  SENATOR WARD  inquired as to what portion of the funds goes towards          
 the cancer reporting.   DR. JOHN MIDDAUGH  specified that all of the          
 funds are used for cancer reporting.  All other diseases are                  
 required to be reported to the Division of Public Health for public           
 health protection.  Dr. Middaugh noted that the other diseases were           
 included due to the rationale for uniformity and protection for               
 patients, physicians, and the state.  In response to Senator Ward,            
 Dr. John Middaugh agreed that the inclusion of the other diseases             
 was not necessary to receive the funds.                                       
                                                                               
  DR. MIDDAUGH  reiterated the strong support for SB 99 from the               
 medical community.                                                            
  CHAIRMAN WILKEN  said that he would entertain a motion to report SB
 99 to its next committee of referral.                                         
                                                                               
  SENATOR WARD  moved to report SB 99 out of committee   with individua        
 recommendations and a zero fiscal note.  Without objection, it was            
 so ordered.                                                                   
                                                                               
                                                                               
        SB 100 DEVELOPMENTALLY DISABLED CHILDREN/GRANTS                       
                                                                              
 Number 419                                                                    
                                                                               
  CHAIRMAN WILKEN  announced that the final order of business before           
 the committee was  SB 100 .                                                   
                                                                               
  MARY DIVEN , with the Department of Health & Social Services,                
 explained that SB 100 is a technical change that would place the              
 grant authority for the Infant Learning Program into the                      
 authorizing statute.  This change was requested by the Department             
 of Law in order to have all the statutes consistent; so that the              
 grant authority is in the authorizing statute rather than the                 
 general department authority to issue grants.                                 
                                                                               
  CHAIRMAN WILKEN  requested that Ms. Diven give an example of what            
 SB 100 would accomplish.   MARY DIVEN  said that the department would         
 like to update the regulations making them consistent with federal            
 law.  The regulations were last updated in 1982.  The Department of           
 Law will not allow the regulations to be open to public comment               
 until this technical correction occurs.  The bill will allow the              
 updating of regulations.                                                      
                                                                               
  SENATOR GREEN  asked what happens with the Infant Learning Program           
 (ILP) now.   MARY DIVEN  clarified that the department has general            
 grant authority to issue grants and the Legislature puts the funds            
 in the grant line.  However, at this point, the department cannot             
 revise any regulations until this technical change is made.                   
                                                                               
  SENATOR WARD  asked if the current regulations were inadequate.              
  MARY DIVEN  replied yes, the regulations were last updated over 15           
 years ago and the federal law has changed.  Ms. Diven noted that              
 the statute was revised in 1992 or 1993, but the regulations need             
 to be revised in order to be consistent with the current statute.             
 In response to Senator Ward, Ms. Diven said that the regulations              
 are causing administrative problems and problems for local service            
 providers.  There is a small list of eligible providers in the                
 existing regulations.  The local providers must request waivers of            
 the state in order to be eligible providers.  The federal statute             
 and regulations has a more extensive list.                                    
                                                                               
 Number 452                                                                    
  SENATOR WARD  noted that Representative James has a Joint Regulatory         
 Task Force.  He believed this would be an appropriate item for the            
 task force to review in order to determine that regulations that              
 are necessary are being created.  Senator Ward did not believe that           
 more regulations were necessary if people were being served under             
 the existing regulations.                                                     
                                                                               
  CHAIRMAN WILKEN  informed the committee that he was a member of the          
 Joint Regulatory Task Force whose agenda is full.  This bill seems            
 to be more of an alignment than a creation.  If this bill was given           
 to the task force, the task force would most likely not have time             
 for its consideration.                                                        
                                                                               
  ELMER LINDSTROM , Special Assistant in DHSS, agreed that SB 100 does         
 raise some questions because what is being done now, what has been            
 done in the past, and what is desired for the future is to run the            
 ILP as a grant program.  When the need arose to update regulations            
 consistent with the recommendations of the regulations group, the             
 Department of Law said that the department did not have specific              
 statutory authority to make grants and therefore could not update             
 the regulations.  The Department of Law denied such although, DHSS            
 has done that in the past and the Legislature has appropriated                
 those grant lines in the budget.  Mr. Lindstrom believed that the             
 provisions in SB 100 were included in a bill that passed out of               
 Representative James' committee last year.  This was also included            
 in an omnibus bill last year which created administrative                     
 efficiencies and ultimately did not pass the Legislature.  Mr.                
 Lindstrom pointed out that if this is not done, at some point the             
 programs would have to be implemented through a contract mechanism            
 which would be very inefficient.                                              
                                                                               
  SENATOR GREEN  asked if there would be any increased cost if the             
 legislation did not pass.   MARY DIVEN  said that there was a                 
 possibility that there would be questions from the federal funding            
 source because of the inconsistency of the regulations with the               
 federal regulations or existing statute.  There has been no                   
 indication that funding would cease, but the potential is present             
 if the inconsistency continues.                                               
                                                                               
  SENATOR GREEN  asked if any exponential growth of the program could          
 occur once this is in statute.   MARY DIVEN  replied no.                      
                                                                               
 Number 511                                                                    
                                                                               
  SENATOR WARD  asked if anything in law would stop this grant process         
 and allow it to become an RFP.   MARY DIVEN  stated that the existing         
 grant regulations require nonprofits and believed that the                    
 departments authorizing statute requires that it be nonprofits.               
                                                                               
  SENATOR WARD  believed that an RFP could go out to profit                    
 corporations in order to supply this service.  Could the grant                
 process be issued in a public bidding process through RFPs to for-            
 profit corporations?                                                          
                                                                               
  MARY DIVEN  said that the existing departmental regulations do not           
 allow such nor do the ILP regulations.                                        
                                                                               
  ELMER LINDSTROM  offered to provide that information to Senator              
 Ward.                                                                         
                                                                               
 In response to Chairman Wilken,  MARY DIVEN  specified that the ILP           
 served children ages zero to three.                                           
                                                                               
  GIGI PILCHER , parent, informed the committee that she was the               
 mother of six children two of which are disabled/developmentally              
 disabled children.  Ms. Pilcher urged the passage of SB 100 in                
 order to comply with federal legislation and continue to serve                
 disabled children.                                                            
                                                                               
  SENATOR GREEN  moved to report SB 100 out of committee with                  
 individual recommendations and accompanying fiscal notes.  Without            
 objection, it was so ordered.                                                 
                                                                               
 There being no further business before the committee, the meeting             
 was adjourned at 9:50 a.m.                                                    
                                                                               
                                                                               

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