Legislature(1993 - 1994)

03/16/1994 01:40 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
    SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE                     
                         March 16, 1994                                        
                           1:40 p.m.                                           
                                                                               
  MEMBERS PRESENT                                                              
                                                                               
 Senator Steve Rieger, Chairman                                                
 Senator Bert Sharp, Vice-Chairman                                             
 Senator Loren Leman                                                           
 Senator Mike Miller                                                           
 Senator Jim Duncan                                                            
 Senator Johnny Ellis                                                          
 Senator Judy Salo                                                             
                                                                               
  MEMBERS ABSENT                                                               
                                                                               
 All members present.                                                          
                                                                               
  COMMITTEE CALENDAR                                                           
                                                                               
 SENATE BILL NO. 312                                                           
 "An Act relating to school construction grants; and providing for             
 an effective date."                                                           
                                                                               
 CS FOR SENATE BILL NO. 255(CRA)                                               
 "An Act establishing a comprehensive policy relating to human                 
 resource development in the state."                                           
                                                                               
 CS FOR HOUSE BILL NO. 2(RLS)                                                  
 "An Act requiring drug and alcohol tests for school bus drivers."             
                                                                               
 HOUSE CONCURRENT RESOLUTION NO. 31                                            
 Relating to Alcohol-Related Birth Defects Awareness Week.                     
                                                                               
 SENATE BILL NO. 270                                                           
 "An Act creating the Alaska Health Commission; relating to the                
 delivery, quality, access, and financing of health care; relating             
 to review and approval of rates and charges of health insurers;               
 relating to certain civil actions against health care providers and           
 health insurers; repealing Alaska Rule of Civil Procedure 72.1; and           
 providing for an effective date."                                             
                                                                               
 SENATE BILL NO. 284                                                           
 "An Act establishing the Alaska Health Insurance Corporation and              
 requiring licensed health care providers to comply with certain               
 statutes and regulations relating to the corporation; relating to             
 disability insurance claims processing and to approval of rates for           
 disability insurance, including health insurance; and providing for           
 an effective date."                                                           
                                                                               
  PREVIOUS SENATE COMMITTEE ACTION                                             
                                                                               
 SB 312 - No previous action to record.                                        
                                                                               
 SB 255 - See Community & Regional Affairs minutes dated                       
          1/25/94, 2/1/94, 2/3/94 & 2/8/94.                                    
                                                                               
 HB 2 - No previous action to record.                                          
                                                                               
 HCR 31 - No previous action to record.                                        
                                                                               
 SB 270 - See Health, Education & Social Services minutes dated                
          2/9/94, 2/18/94, 3/2/94, 3/9/94, 3/11/94 and 3/14/94.                
                                                                               
 SB 284 - See Health, Education & Social Services minutes dated                
          2/14/94, 2/18/94, 3/2/94, 3/9/94, 3/11/94 and 3/14/94.               
                                                                               
  WITNESS REGISTER                                                             
                                                                               
 Representative Jerry Mackie                                                   
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
  POSITION STATEMENT:   Supported SB 312.                                      
                                                                               
 Shirley Armstrong, Staff                                                      
 Senator Randy Phillips                                                        
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
  POSITION STATEMENT:   Reviewed SB 255.                                       
                                                                               
 Debbie Call, Chair                                                            
 Alaska Job Training Council                                                   
 12342 W. Prince of Peace                                                      
 Eagle River, Alaska 99577                                                     
  POSITION STATEMENT:   Supported SB 255 and Amendment 1.                      
                                                                               
 Mary Shields, General Manager                                                 
 Northwest Technical Services                                                  
 Vice-Chair, Alaska Job Training Council                                       
 4041 B Street, STE 102                                                        
 Anchorage, Alaska 99503                                                       
  POSITION STATEMENT:   Supported SB 255 and Amendment 1.                      
                                                                               
 Dan Middaugh                                                                  
 Alaska Training Coordinators Association                                      
 1822 W Northern Lights #305                                                   
 Anchorage, Alaska 99517                                                       
  POSITION STATEMENT:   Supported SB 255 and Amendment 1.                      
                                                                               
 Mike Heimbuch, Staff                                                          
 Representative Gail Phillips                                                  
 State Capitol                                                                 
 Juneau, Alaska 99801-1182                                                     
  POSITION STATEMENT:   Reviewed HB 2.                                         
 Romayne Kareen, Program Coordinator                                           
 People Transportation, School Bus Safety                                      
 Department of Education                                                       
 Juneau, Alaska                                                                
  POSITION STATEMENT:   Reviewed HB 2.                                         
                                                                               
 Brad Whistler                                                                 
 Department of Health and Social Services                                      
 Juneau, Alaska                                                                
  POSITION STATEMENT:   Present for questions.                                 
                                                                               
 Dr. Peter Nakamura, Director                                                  
 Division of Public Health                                                     
 Department of Health and Social Services                                      
 P.O. Box 110610                                                               
 Juneau, Alaska 99811-0610                                                     
  POSITION STATEMENT:   Reviewed public health issues.                         
                                                                               
 Jay Livey, Deputy Commissioner                                                
 Department of Health and Social Services                                      
 P.O. Box 110601                                                               
 Juneau, Alaska 99811-0610                                                     
  POSITION STATEMENT:   Reviewed SB 270.                                       
                                                                               
  ACTION NARRATIVE                                                             
                                                                               
 TAPE 94-20, SIDE A                                                            
 Number 006                                                                    
 CHAIRMAN RIEGER called the Senate Health, Education and Social                
 Services (HESS) Committee to order at 1:40 p.m.  He introduced  SB
 312  (SCHOOL CONSTRUCTION GRANT REVIEW) as the first order of                 
 business before the committee.                                                
                                                                               
 SENATOR MILLER moved to adopt the CSSB 312 (HES) for discussion               
 purposes.  Hearing no objections, CSSB 312 (HES) was adopted.                 
                                                                               
 CHAIRMAN RIEGER pointed out that the HES CS adds language regarding           
 participation of interscholastic school activities to the original            
 bill.  Section 2 removes the Alaska School Activities Association             
 (ASAA), Inc. statutes AS 14.07.058 and AS 14.075.059 which would              
 preclude an appeal to the Department of Education on cases such as            
 eligibility.                                                                  
                                                                               
 REPRESENTATIVE JERRY MACKIE stated that SB 312 was a result of                
 discussions regarding school construction problems and the                    
 inability to set limits on school construction.  He felt that SB
 312 was necessary, especially during the current climate of                   
 declining revenues.  He urged that the bill be moved out of                   
 committee.                                                                    
                                                                               
 SENATOR MILLER moved CSSB 312 (HES) out of committee with                     
 individual recommendations.  Hearing no objections, it was so                 
 ordered.                                                                      
                                                                               
 Number 070                                                                    
 CHAIRMAN RIEGER introduced  SB 255  (STATE POLICY ON HUMAN RESOURCE           
 DEVELOPMT) as the next order of business before the committee.  He            
 noted the request for an amendment from Senator Randy Phillips.               
                                                                               
 SHIRLEY ARMSTRONG, staff to Senator Randy Phillips, stated that               
 SB 255 was introduced on behalf of the Alaska Joint Training                  
 Council.  She urged passage of SB 255.  The proposed amendment was            
 passed by the Alaska Joint Training Council at their last meeting             
 in order to assure the departments coordination of education and              
 training programs.  She offered to answer any questions.                      
                                                                               
 CHAIRMAN RIEGER moved Senator Randy Phillips amendment, Amendment             
 1, for discussion purposes.                                                   
                                                                               
  AMENDMENT 1                                                                
                                                                               
 Page 3, line 5:                                                               
  Insert a new subsection to read:                                             
  "(h) The legislative auditor shall conduct a performance audit               
  of the implementation of the policy provided in this section                 
  during fiscal year 1998 and every four years thereafter."                    
                                                                               
 SENATOR ELLIS asked if the Alaska Job Training Council was the                
 overall pick for the state under JTPA.  SHIRLEY ARMSTRONG said yes            
 and noted membership from the state, various industries, all the              
 departments, and various disciplines.                                         
                                                                               
 CHAIRMAN RIEGER reminded the committee of the motion before them.             
 Hearing no objection, Amendment 1 was adopted into a HES CS.                  
                                                                               
 DEBBIE CALL, Chair of the Alaska Job Training Council, supported              
 SB 255 and Amendment 1.  She clarified that the Alaska Job Training           
 Council is an advisory council to the Governor which oversees the             
 Private Industry Council around the state.  The Council advises the           
 Governor on JTPA programs and human resource development issues.              
 She stated that SB 255 is a comprehensive policy relating the human           
 resource development in Alaska.  Alaska will have to better                   
 coordinate the human resource development programs, especially in             
 rural areas.  She noted her own experience as a private sector                
 employer who was attempting her own human resources development               
 programs on the North Slope.  SB 255 would help achieve better                
 coordination and programs.                                                    
                                                                               
 Number 182                                                                    
                                                                               
 SENATOR ELLIS thanked Ms. Call for her testimony and the language             
 on page 2 that addresses incentives and disincentives regarding the           
 state public assistance programs to move people from public                   
 assistance to private sector employment.  He encouraged everyone to           
 be aware of federal level tools and initiatives, such as President            
 Clinton's apprenticeship proposal, that could be used.                        
                                                                               
 DEBBIE CALL said that SB 255 does realize the national issues.  She           
 noted that some council members attend meetings in Washington, D.C.           
                                                                               
 MARY SHIELDS, General Manager of the Northwest Technical Services             
 and Vice-Chair of the Alaska Job Training Council, stated that                
 SB 255 would enable movement forward on these human resource                  
 development issues.  She urged passage of SB 255 with Amendment 1.            
 She mentioned that the business community does like SB 255.                   
                                                                               
 DAN MIDDAUGH, Alaska Training Coordinators Association, explained             
 that he is currently recoordinating labor's attempt to create a               
 statewide job placement referral system, the Apprenticeship                   
 Information Center.  He asserted that apprenticeship is the primary           
 manner in which to train individuals to their highest potential               
 through the trade.  He expressed the need and desire to improve on            
 these issues in rural areas.  He stated support for SB 255 and                
 Amendment 1 from the Alaska Training Coordinators Association.                
                                                                               
 SENATOR MILLER moved SB 255 as amended out of committee with                  
 individual recommendations.  Hearing no objections, it was so                 
 ordered.                                                                      
                                                                               
 Number 267                                                                    
 CHAIRMAN RIEGER introduced  HB 2  (DRUG TESTING FOR SCHOOL BUS                
 DRIVERS) as the next order of business before the committee.                  
                                                                               
 SENATOR SALO asked if HB 2 applies to temporary drivers and how               
 does HB 2 apply to volunteer drivers.                                         
                                                                               
 MIKE HEIMBUCH, staff to Representative Gail Phillips, stated that             
 the intent of HB 2 was to speak to those employed by the school               
 district.  The language seemed to be flexible enough to allow the             
 Department of Education (DOE) to adopt the scope of the bill                  
 through regulations.                                                          
                                                                               
 SENATOR SALO noted that contracted drivers also fall within the               
 scope of the bill.  She informed the committee that currently, some           
 districts are drug testing upon initial employment, randomly                  
 testing, or testing for cause.  She expressed her belief that                 
 testing for cause was of primary importance.  HB 2 would mandate              
 drug testing.  She asked who would pay for the testing.                       
                                                                               
 MIKE HEIMBUCH stated that at present there is an $84,000 fiscal               
 note for DOE.                                                                 
 SENATOR DUNCAN believed that the fiscal note does not specify who             
 would pay for the testing.  He assumed that the $79,000 contractual           
 portion of the fiscal note would pay for the testing.  He inquired            
 of the possibility that individual drivers would be required to pay           
 for the drug test if the fiscal note was zeroed out.  MIKE HEIMBUCH           
 could not answer.  SENATOR DUNCAN did not believe that school bus             
 drivers should have to pay for the testing.                                   
                                                                               
 MIKE HEIMBUCH said that he read HB 2 as saying that the school                
 districts or areas that provide for transportation would provide              
 for the random drug testing.  SENATOR DUNCAN noted that the                   
 language was "shall require."  MIKE HEIMBUCH stated that HB 2                 
 requires that the driver would submit to the testing, but not                 
 requiring that the driver pay for the testing.                                
                                                                               
 SENATOR DUNCAN explained that without funding for the state to pay            
 for the testing, then the bill would not prohibit a school district           
 requiring the drivers to submit and pay for the testing.  He                  
 expressed the need to make the language explicit.                             
                                                                               
 MIKE HEIMBUCH pointed out that the language referring to developing           
 regulations was thought to speak to the possibility that DOE and              
 different districts could not adequately administer the testing,              
 this language would allow them to address it quicker than through             
 the statutes.                                                                 
                                                                               
 SENATOR DUNCAN requested a DOE representative.                                
                                                                               
 SENATOR SALO inquired of the percentage of Alaska school bus                  
 drivers currently under a drug testing program.                               
                                                                               
 Number 345                                                                    
                                                                               
 ROMAYNE KAREEN, Program Coordinator for People Transportation in              
 the School Bus Safety section, the Department of Education, did not           
 know the percentage of the large districts with the contracted                
 operations.  She noted some internal requirements of drug testing             
 in the contracted operations.  On the peninsula, random testing is            
 prohibited by the union contract with the drivers, the company and            
 the school district.  SENATOR SALO suggested that perhaps 80 or 90            
 percent of the drivers are under drug testing.  ROMAYNE KAREEN                
 thought the percentage was probably not that high.                            
                                                                               
 SENATOR DUNCAN asked who would be charged under HB 2.  ROMAYNE                
 KAREEN explained that the fiscal note was present with the                    
 understanding that DOE would coordinate and oversee the program on            
 a statewide basis.  If the fiscal note was zeroed out, Ms. Kareen             
 assumed that DOE would have to address that situation.                        
                                                                               
 SENATOR DUNCAN expressed concern that the bus drivers may be                  
 required to pay for the drug testing.  He suggested that the                  
 language be made more explicit.  ROMAYNE KAREEN stated that                   
 regarding the contractual amount, the fiscal note would include the           
 cost of the testing.  She pointed out various ways to handle this             
 issue:  a written contract between the school district and the                
 school bus contractor, and an agreement between the department and            
 school districts who run their own transportation system.                     
                                                                               
 SENATOR DUNCAN did not understand why the language could not be               
 more explicit and say that the school bus driver would not be                 
 charged for the drug testing.  ROMAYNE KAREEN explained that school           
 bus drivers have a high turnover rate and there are incentives for            
 the employer to pick up some costs.  For instance, the commercial             
 drivers license and the mandatory training program are some of the            
 up front costs a bus driver may face.                                         
                                                                               
 SENATOR SALO stated that there are reasons that contacts between              
 companies and bus drivers have opposed random testing.  Many                  
 believe that random drug testing is demeaning not to mention the              
 possibilities of a false positive.  She felt that drug testing for            
 cause is appropriate.   She explained that in this time of fiscal             
 constraints with educational funding, money could be better spent             
 elsewhere.  She indicated that HB 2 could open up to drug testing             
 in other areas, such as food service workers.  She believed that              
 the drug testing of HB 2 does not in general protect the                      
 individual.  Perhaps, it would act as a deterrent to some extent.             
 She said that the fiscal note must only be coordination of the                
 program, how could that include the testing.                                  
                                                                               
 ROMAYNE KAREEN informed the committee that the $84,000 fiscal note            
 included the testing.  She detailed the fiscal note for the                   
 committee:  $5,000 for a hearing officer, $3,000 for travel, $2,000           
 for supplies, $2,000 for printing and postage, and the remaining              
 $72,000 for testing.  She stated that there should have been an               
 attachment to the fiscal note explaining the details.                         
                                                                               
 Number 427                                                                    
                                                                               
 SENATOR DUNCAN asked if HB 2 would override those contracts such as           
 the Kenai Peninsula that prohibit random drug testing.  ROMAYNE               
 KAREEN said that HB 2 would override those contracts that currently           
 prohibit random drug testing.  She indicated that the school bus              
 industry believes random drug testing would be a deterrent.                   
                                                                               
 SENATOR SALO asked if the school bus industry believes there is a             
 problem.  ROMAYNE KAREEN said yes, the industry does feel there is            
 a problem in some areas that they are notable to address currently.           
                                                                               
 SENATOR SALO inquired of the industries' ability to test for cause.           
 ROMAYNE KAREEN stated that it would depend upon the internal                  
 structure between the school and the bus contractor within the                
 company.                                                                      
                                                                               
 SENATOR SHARP moved HB 2 out of committee with individual                     
 recommendations and the accompanying fiscal note.  Senator Salo               
 objected.  A hand vote was taken and the bill moved.                          
                                                                               
 Number 455                                                                    
 CHAIRMAN RIEGER introduced  HCR 31  (ALCOHOL-RELATED BIRTH DEFECTS            
 AWARENESS) as the next order of business before the committee.                
                                                                               
 SENATOR MILLER moved HCR 31 out of committee with individual                  
 recommendations.  Hearing no objections, it was so ordered.                   
                                                                               
                                                                               
 Number 465                                                                    
 CHAIRMAN RIEGER introduced  SB 270  (COMPREHENSIVE HEALTH CARE)               
 and  SB 284  (COMPREHENSIVE HEALTH INSURANCE ACT) as the final order     r    
 of business before the committee.  He directed the committee to a             
 discussion of public health regarding these bills.                            
                                                                               
 BRAD WHISTLER, Department of Health and Social Services, deferred             
 the discussion of public health to Dr. Nakamura.                              
                                                                               
 DR. PETER NAKAMURA, Director of the Division of Public Health in              
 the Department of Health and Social Services, deferred to Jay Livey           
 to present the position of the department.  He said that he could             
 address public health and those elements critical to any health               
 care reform.                                                                  
                                                                               
 JAY LIVEY, Deputy Commissioner of the Department of Health and                
 Social Services, noted that they had proposed an amendment in the             
 House that had been adopted, which would be suggested for SB 270.             
 He explained that the amendment has a public health focus in terms            
 of developing a public health plan and providing public health                
 information and guidance through the Commission.                              
                                                                               
 CHAIRMAN RIEGER asked if the establishment of a Public Health                 
 Advisory Committee was the only amendment from Healthy Alaska 2000            
 that the department would like in this legislation.  JAY LIVEY said           
 that they were not ready to propose legislation regarding Healthy             
 Alaska 2000.  At this point, the public health focus would be                 
 included in SB 270.                                                           
                                                                               
 DR. PETER NAKAMURA pointed out that the proposed amendment includes           
 a public health improvement plan which would identify the essential           
 functions necessary to ensure that public health is addressed.  He            
 explained that health care reform usually addresses cost                      
 containment, access, universal coverage, and tort reform; those               
 issues relating to clinical services.  He observed that population            
 based public health services, such as safe water and food, never              
 seem to be addressed.  In order to develop a public health plan,              
 those major population based public health services must be                   
 addressed; that would include the Healthy Alaska 2000 objectives.             
                                                                               
 Number 524                                                                    
                                                                               
 SENATOR DUNCAN did not see any directives toward public health in             
 the proposed amendment.  JAY LIVEY noted that the amendment before            
 the committee was not the version that the House passed.  Mr. Livey           
 stated that they supported the House version amendment being added            
 to SB 270.                                                                    
                                                                               
 DR. PETER NAKAMURA explained that the House version of the                    
 amendment is similar to Representative Sitton's bill.  He clarified           
 for Senator Duncan that the development of the health improvement             
 plan is permissive, not required.                                             
                                                                               
 SENATOR DUNCAN inquired of the rationale behind adopting permissive           
 language.  JAY LIVEY noted that the majority of the discussion was            
 centered on available resources and what could be achieved without            
 attaching the large fiscal note of the original public health bill.           
                                                                               
 SENATOR DUNCAN informed the committee that the fiscal note of                 
 Representative Sitton's public health bill was approximately                  
 $300,000.  He suggested that the permissive language indicates that           
 they are not going to do public health because they are not going             
 to have the money.  He expressed surprise that Dr. Nakamura would             
 agree with this language.  Public health can already be addressed             
 now, legislation is not necessary.  He stated that the language               
 should require public health be addressed.                                    
                                                                               
 JAY LIVEY said that the public health issue was a matter of scope             
 regarding what could be reasonably achieved given current                     
 resources.  He noted that some additions to the original fiscal               
 note were made in order to provide some resources to do public                
 health work.  He agreed with Senator Duncan, the scope is not as              
 broad as that of Representative Sitton's bill.  Getting a start on            
 public health planning is reasonable even if a comprehensive plan             
 cannot be achieved.                                                           
                                                                               
 SENATOR DUNCAN did not understand how a start could be made with              
 this permissive language.  He suggested that they develop a scope             
 that could be achieved in the first year and use mandatory                    
 language.  He expressed frustration with the Administration's view            
 that nothing can be done; therefore, resources, which are not                 
 present anyway, should not be committed.                                      
                                                                               
 JAY LIVEY offered to work with the committee on the scope and                 
 language regarding the public health issue.                                   
                                                                               
 SENATOR DUNCAN discussed Dr. Nakamura's efforts towards public                
 health.  He stated that there was not a piece meal approach to                
 public health or comprehensive health care reform.  He suggested              
 that the Administration say exactly what they are doing with these            
 issues so that the legislature could continue its work.                       
                                                                               
 JAY LIVEY reiterated the added resources for public health.  He               
 expected that if the amendment passes they would work on a public             
 health plan.                                                                  
                                                                               
 TAPE 94-20, SIDE B                                                            
 Number 593                                                                    
 CHAIRMAN RIEGER stated that Healthy Alaska 2000 had more specific             
 recommendations than occur in either SB 270 or SB 284.  He                    
 indicated that he may choose some of those recommendations to bring           
 before the committee for consideration.  He welcomed other                    
 committee members to do the same.  He regarded both bills as                  
 setting up an entity to further develop the public health                     
 improvement plan.  This hearing was an opportunity to review                  
 specific legislative recommendations from Healthy Alaska 2000 which           
 are not present in either bill.                                               
                                                                               
 SENATOR DUNCAN disagreed with Chairman Rieger and pointed out that            
 page 16 of SB 284 has recommendations that the public health                  
 improvement plan must include.  He said that this section basically           
 takes the language from Representative Sitton's bill.                         
                                                                               
 DR. PETER NAKAMURA explained that they are trying to avoid choosing           
 specific activities without knowing the trade-off costs of those              
 activities.  He stated that choosing something at the cost of                 
 something else could result in a greater deficit situation.  He               
 indicated that knowing all the issues and the base core functions             
 would create the ability to choose specific activities identified             
 in Healthy Alaska 2000 and know their actual cost.                            
                                                                               
 Dr. Nakamura expressed concern that the issue of public health                
 often gets lost in dialogue.  He stated that the public health                
 improvement plan can be done while the dialogue regarding cost                
 containment, financing, insurance, deductibles, and comprehensive             
 coverage issues continues.  He did not want public health                     
 improvement to be lost in this debate.                                        
                                                                               
 Number 552                                                                    
                                                                               
 SENATOR DUNCAN asked for the total of the fiscal note for                     
 Representative Sitton's bill.  DR. PETER NAKAMURA estimated that it           
 was about $358,000.  JAY LIVEY  believed the fiscal note was around           
 $350,000.                                                                     
                                                                               
 SENATOR DUNCAN was interested in how Representative Sitton's fiscal           
 note matches that of SB 284.                                                  
                                                                               
 There being no further business before the committee, the meeting             
 was adjourned at 2:30 p.m.                                                    
                                                                               

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