Legislature(1995 - 1996)
04/19/1995 09:02 AM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE April 19, 1995 9:02 a.m. MEMBERS PRESENT Senator Lyda Green, Chairman Senator Loren Leman, Vice-Chairman Senator Mike Miller MEMBERS ABSENT Senator Johnny Ellis Senator Judy Salo COMMITTEE CALENDAR HOUSE BILL NO. 214 am "An Act relating to the maintenance by health care providers of medical records in an electronic format." CS FOR HOUSE BILL NO. 125(JUD) "An Act relating to disclosures to school officials of information about certain minors; and providing for an effective date." SENATE BILL NO. 138 "An Act relating to the state's tuberculosis control program, including provisions for certain penalties; and providing for an effective date." PREVIOUS SENATE COMMITTEE ACTION HB 214 - No previous action to record. HB 125 - No previous action to record. SB 138 - See Health, Education & Social Services minutes dated 4/12/95. WITNESS REGISTER Representative Gary Davis State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Prime sponsor of HB 214. Garrey Peska Alaska State Hospital and Nursing Home Association PO Box 240185 Douglas, Alaska 99824 POSITION STATEMENT: Supported HB 214. Melinda Gruening, Staff Representative Joe Green State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Discussed HB 125. Lieutenant Ted Bachman Alaska State Troopers Public Safety 9700 G. Tudor Road Anchorage, Alaska POSITION STATEMENT: Supported the concept of HB 125. Steve McPhetres, Executive Director Alaska Council of School Administrators 326 4th Street, #404 Juneau, Alaska 99801 POSITION STATEMENT: Supported current version of HB 125, but would like stronger version. Helen Mehrkens Department of Education 801 W. 10th Street Juneau, Alaska 99801 POSITION STATEMENT: Supported HB 125. John Cyr National Education Association-Alaska PO Box 2776 Palmer, Alaska POSITION STATEMENT: Supported CS HB 125(JUD). Margot Knuth, Assistant Attorney General Criminal Division Department of Law PO Box 110300 Juneau, Alaska 99811-0300 POSITION STATEMENT: Discussed disclosure between school districts. Russell Webb Division of Public Health, DHSS PO Box 110610 Juneau, Alaska 99811-0610 POSITION STATEMENT: Emphasized the importance of having the necessary tools available to control tuberculosis. Elfrida Nord, Chief Nursing Section Division of Public Health, DHSS PO Box 110611 Juneau, Alaska 99811-0611 POSITION STATEMENT: Explained the nature of tuberculosis. Kristen Bomengen, Assistant Attorney General Human Services Section Department of Law PO Box 110300 Juneau, Alaska 99811-0300 POSITION STATEMENT: Discussed SB 138. ACTION NARRATIVE TAPE 95-31, SIDE A HB 214 MEDICAL RECORDS IN ELECTRONIC FORM Number 002 CHAIRMAN GREEN called the Senate Health, Education and Social Services (HESS) Committee to order at 9:02 a.m. and introduced HB 214 as the first order of business. REPRESENTATIVE GARY DAVIS, prime sponsor, explained that HB 214 is an act relating to the maintenance of health care providers by health care providers keeping medical records in an electronic format. He informed the committee that electronic medical records are legally accepted in lieu of records on paper. Hospitals and nursing homes are moving towards paperless offices in an attempt to promote efficiency. Representative Davis explained that some providers hesitate to implement the electronic retention and maintenance of medical records without a hard copy backup due to the lack of explicit legal authority. Currently, statute does not prohibit or permit medical records being kept electronically. He indicated that Legislative Legal Services had noted a similar concern. HB 214 would clarify the medical records statute. GARREY PESKA, representing the Alaska State Hospital and Nursing Home Association, supported HB 214. SENATOR LEMAN moved that HB 214 am be reported out of committee with individual recommendations. Hearing no objection, it was so ordered. HB 125 JUVENILE RECORD INFORMATION TO SCHOOLS Number 086 CHAIRMAN GREEN introduced HB 125 as the next order of business before the committee. MELINDA GRUENING, staff to Representative Joe Green, informed the committee that violence is one of the leading problems facing Alaskan schools. There is no requirement that a school principal be given criminal records regarding a delinquent that is attending the school. She noted the hard work on SB 54 last year which was a juvenile waiver bill that addressed discretionary disclosure of agency records to school officials. There has been little effort to develop a protocol for the sharing of information; there are no regulations as of yet. She said that there is confusion regarding the disclosure of this information. As illustrated in two polls taken last month surveying school officials and teachers, little disclosure is actually occurring. School officials favor disclosure occurring as soon as possible. Ms. Gruening explained that HB 125 would require law enforcement and the Division of Family & Youth Services (DFYS) to disclose these criminal records to school officials. She pointed out that House HESS had approved a CS that provided mandatory disclosure of the courts and law enforcement of felonious crimes. The information provided with disclosure would protect the victims of juvenile crime, students, and teachers. Furthermore, the school principal could utilize the school's resources in order to provide assistance to a delinquent youth. Ms. Gruening discussed two meetings in which various agencies and interested parties came together to discuss the issue of disclosure. From the perspective of the school, disclosure which is not happening should be mandatory. From the perspective of the Department of Law and the Department of Public Safety, the new law should be afforded the opportunity to work on a discretionary basis. However, everyone agreed that disclosure should have a set procedure. These meetings resulted in the passage of the House Judiciary CS which removed the mandatory nature of the disclosure and added language requiring that a mutually agreeable procedure between DFYS, law enforcement agencies, and local school officials be established. Such an agreement would ensure that criminal records would be transferred to schools. She noted that the transfer of information would be different in each school district. The Anchorage Police Department felt that a dedicated fax line would be the easiest manner in which to communicate this information. In smaller schools and communities, the procedure could be done by a phone call that is followed up by written confirmation. The option was left up to the local law enforcement and school districts to work out the procedure between them. Ms. Gruening pointed out that the bill has a 90 day deadline beginning at the time of the bill's effective date for establishing the procedures; it is critical that this be done quickly. She said that Representative Green encourages everyone involved with disclosure to begin now. Representative Green intends to follow up on this issue in the fall with polling in order to determine if disclosure is happening on a discretionary basis. If disclosure is not happening at that time, Representative Green plans to introduce legislation that would mandate disclosure next session. The CS gives the discretionary disclosure an opportunity to work. Ms. Gruening emphasized that school officials must have the necessary information regarding school violence, if the schools are to be held responsible for the safety of students and faculty. Number 189 CHAIRMAN GREEN asked if there was anything in this legislation that would require that one school communicate information to another school regarding a violent student. MELINDA GRUENING said there was not. The current disclosure under SB 54 has strict redisclosure confinements. LIEUTENANT TED BACHMAN, Alaska State Troopers assigned to the Directors Office in Anchorage, stated that the Department of Public Safety (DPS) supported the concept of the release of this type of information to the schools. There has been a policy drafted regarding disclosure for the State Troopers which should be in place by May 1st statewide. The State Troopers would utilize a form that would inform the school of incidents. The school would then fill out a portion of the form and fax it back to the Troopers in order to verify that the school received the information and to determine if the school has this student. He explained that the policy also provides for disclosure of information to other schools in which the student is not enrolled; this measure would protect surrounding areas which may be in danger from this student. Lieutenant Bachman specified that under current statutes the State Troopers can inform other schools that the student does not attend. He informed the committee that there would be a packet put together that would be passed out to all police departments in order to implement this procedure without any material changes needed. This packet should be distributed in the first week of May. STEVEN MCPHETRES, Executive Director of the Alaska Council of School Administrators, informed the committee that he represented over 500 elementary and high school principals and district staff as well. The Council supported the current version of HB 125, although a stronger version as originally introduced would be welcomed. Number 266 HELEN MEHRKENS, representing the Department of Education, supported Sections 2, 3, and 4. She discussed the escalating concerns for the safety of students from other students. This bill is appropriate. The cooperation between departments and agencies is important regarding the safety of students in school. CHAIRMAN GREEN asked if Ms. Mehrkens had heard of the need for district to district disclosure and would it be possible to do so. HELEN MEHRKENS said she had heard that concern, but was unable to comment on the possibility of that under this legislation. JOHN CYR, Vice President of NEA-AK, supported CS HB 125(JUD). He informed the committee that a telephone poll of its members had rated school violence as the number one concern amongst empolyees in both rural and urban Alaska. NEA-AK had hoped that the bill would have a mandatory provision. In response to Chairman Green regarding district to district disclosure, there is a problem. A district has no idea of the problems a transfer student may have; transfers are more of a problem than problem students in a district's own school because those students can be tracked. Mr. Cyr said that confidentiality is important, but confidentiality is superseded by the right to know. MARGOT KNUTH, Criminal Division of the Department of Law, said that district to district disclosures are permitted under existing law. There are two forms that the state has developed, one is from DHSS and the other is from the State Troopers. The form from DFYS indicates all reports about a juvenile specifies that the form may be placed in the student's record. School districts may adopt further policies for disclosure of this type of information. She appreciated the cooperation that Representative Green had extended with solving this problem. In time, refinement will occur as the system is used. CHAIRMAN GREEN noted that some information in a student's file is purged when their files are transferred. LIEUTENANT TED BACHMAN pointed out that AS 47.10.93 specifies that a state, municipal agency or employee may disclose information regarding a case to school officials. Most school employees are state or municipal employees which may allow school to school disclosure. CHAIRMAN GREEN indicated that perhaps, school to school disclosure is doable now, but it may not be the trend. SENATOR LEMAN moved that CS HB 125(JUD) be moved out of committee with individual recommendations. Hearing no objection, it was so ordered. SB 138 TUBERCULOSIS CONTROL Number 374 CHAIRMAN GREEN introduced SB 138 as the next order of business before the committee. RUSSELL WEBB, Division of Public Health, said that tuberculosis remains a serious public health problem in Alaska. There have been several serious outbreaks in the last year. Current law makes it difficult to combat tuberculosis and its threat to the public's health. He explained that tuberculosis is an airborne disease that is easily spread by routine contact such as coughing in a confined area. Tuberculosis can be successfully treated, however, the treatment can be lengthy. He specified that treatment can take 6 to 24 months and may require taking multiple drugs. Some persons may find it difficult to voluntarily complete treatment. Mr. Webb emphasized that it is critical to complete the entire treatment because tuberculosis can develop a resistance to drugs. He informed the committee that there are strains that are resistant to all known antibiotics. Therefore, someone who does not complete treatment could possibly pass on a drug resistant strain to others. Mr. Webb emphasized the importance of having the tools to ensure that people who fail to voluntarily comply with treatment are required to comply with treatment. SB 138 would provide such tools and update the current law. SB 138 would provide some constitutional safeguards for persons who are involuntarily required to comply with treatment. He anticipated that quarantine and isolation would be necessary in rare cases, however, when that is necessary the ability to implement that is critical. In conclusion, Mr. Webb reiterated the importance of SB 138 to Alaska and the efforts to control tuberculosis. SENATOR LEMAN asked if there were other diseases such as tuberculosis where this type of action, quarantine, may be necessary. He also asked what was being done about those disease if they exist. RUSSELL WEBB clarified that he was not a medical doctor. Mr. Webb said that he had been informed, after discussions with Dr. Nakamura and Dr. Middaugh, that tuberculosis is a particular case because of the manner in which the disease is spread as well as the difficulty faced in treatment. Treatment for tuberculosis often requires taking a combination of drugs for a lengthy time period. Number 443 ELFRIDA NORD, Chief of Public Health Nursing, explained that there are no other diseases that are like tuberculosis as far as quarantine is concerned. The air-sharing nature of tuberculosis allows a person to get the disease without any effort on their part; that is the specialness of tuberculosis. Most other diseases require an individual to have some part in getting the disease. SENATOR LEMAN said that he did not have a problem with this procedure. However, there may be other diseases which could have a better effort to protect the public for the same reasons as SB 138. Why are those aggressive procedures not being done with those other diseases? He commended everyone for bringing this issue to everyone's attention. RUSSELL WEBB pointed out that there are a variety of other control mechanisms being used for other diseases and those mechanisms are being utilized. Tuberculosis is a special case which requires a change in the law in order to address the disease. CHAIRMAN GREEN asked if tuberculosis was more of a problem in Alaska because of the circumstances of Alaska. ELFRIDA NORD replied no. Ms. Nord specified that with tuberculosis the problem stems from the nature of the disease and the nature by which this disease is spread to others. Furthermore, the long term aspect of tuberculosis also poses problems. Ms. Nord indicated that the goal is to keep a person with tuberculosis under surveillance while the treatment is given to the person regularly. Number 474 SENATOR MILLER informed the committee that he had a proposed amendment from the department. Senator Miller moved that Amendment 1 be adopted. RUSSELL WEBB explained that the amendment provides for protection of the privacy rights by allowing the option of closed court proceedings relating to a tuberculosis court order. The other portion of the amendment would eliminate the criminal penalty for failure to comply with a tuberculosis order. He noted that provision had been left in due to a drafting error. He indicated that the criminal penalty is ineffective and unnecessary. SB 138 provides more effective civil means in which to protect the public health. DHSS and the Division of Public Health are interested in protecting the public health without imposing criminal penalties. CHAIRMAN GREEN asked if there was any objection to Amendment 1. Hearing no objection, Amendment 1 was adopted. KRISTEN BOMENGEN, Human Services Section with the Department of Law, explained that currently in tuberculosis cases the State Medical Officer can order an examination and quarantine. The next tool is the enforcement of the order by notifying law enforcement officials and leveling a criminal charge for failure to follow a medical order. SB 138 would provide the needed intermediate steps between the initial order and the enforcement of the order. She noted that the bill is designed to provide due process considerations such as a hearing before an impartial decision- maker, an opportunity to be represented by council and raise constitutional issues. Ms. Bomengen informed the committee that this was before the legislature now because of a case encountered in the past year in which the department was before the courts with a criminal order to enforce the quarantine provisions. In regards to the amendment, the criminal penalties were not necessary when the intermediate steps were in place; a civil contempt proceeding is more appropriate to enforce the order. SENATOR MILLER moved that CS SB 138(HES) be moved out of committee with individual recommendations. Hearing no objection, it was so ordered. There being no further business before the committee, the meeting adjourned at 9:43 a.m.