Legislature(1995 - 1996)

04/19/1995 09:02 AM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
    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.                                                        
                                                                               

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