Legislature(1995 - 1996)
04/29/1996 09:09 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 29, 1996 9:09 a.m. MEMBERS PRESENT Senator Lyda Green, Chairman Senator Loren Leman, Vice-Chairman Senator Johnny Ellis Senator Judy Salo MEMBERS ABSENT Senator Mike Miller COMMITTEE CALENDAR HOUSE BILL NO. 529 "An Act giving notice of and approving the entry into, and the issuance of certificates of participation in, a lease-purchase agreement for a centralized public health laboratory." HOUSE BILL NO. 506 "An Act relating to establishment of a fire fighting and safety training program by the University of Alaska." PREVIOUS SENATE COMMITTEE ACTION HB 529 - No Senate action to record. HB 506 - No Senate action to record. WITNESS REGISTER Karen Perdue, Commissioner Department of Health & Social Services PO Box 110601 Juneau, Alaska 99811-0601 POSITION STATEMENT: Discussed the public health lab situation. Dr. Greg Hayes, Chief Laboratories Division of Public Health Department of Health & Social Services PO Box 110613 Juneau, Alaska 99811-0613 POSITION STATEMENT: Answered questions. Dr. John Middaugh, Chief Epidemiology Section Division of Public Health Department of Health & Social Services PO Box 240249 Anchorage, Alaska 99524-0249 POSITION STATEMENT: Answered questions. Representative Mike Navarre State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Prime sponsor of HB 506. ACTION NARRATIVE TAPE 96-36, SIDE A HB 529 APPROVE CENTRALIZED PUBLIC HEALTH LAB Number 002 CHAIRMAN GREEN called the Senate Health, Education and Social Services (HESS) Committee to order at 9:09 a.m. and introduced HB 529 as the first order of business before the committee. COMMISSIONER KAREN PERDUE, Department of Health & Social Services, emphasized that the public health laboratory is one of the most essential pieces of a public health system. Every state has a public health laboratory, Alaska has three. Alaska's public health laboratories were established as regional labs in the 1930s and 1940s due to the technology and transportation of that time. Technology and transportation has improved which has lead the labs in Alaska to serve a specialized function. The Anchorage laboratory processes about 60 percent of all the samples in the state, the Fairbanks lab processes about 30 percent, and the Juneau lab processes about 10 percent of the samples. The labs are in leased facilities. Number 050 Commissioner Perdue said that the Anchorage and Juneau labs are not safe, the labs do not meet health codes, and they are unsafe for people to work in. The buildings were not designed to support laboratory functions. These labs present some risks to the employees and the public. She noted that the Fairbanks facility was designed as a lab and is a safe facility, however, it has limitations for future growth. Commissioner Perdue informed the committee that a State Medical Examiner's System is being developed and is currently located in the crime lab in Anchorage. She expressed the desire to incorporate the state medical examiner into the state laboratory function which could be accomplished with the new building. Commissioner Perdue discussed the history of public health in Alaska when pointing out that the core responsibility to protect public health has not changed. When there is a threat to public health, it must be presented to the executive branch and the legislature. Furthermore, Commissioner Perdue felt that as an employer, if she felt that her employees were not working in a safe environment then that must be presented as well. She also believed that she should point out any possible cost efficient measures that could be taken. HB 529 addresses all three of those issues. There have been 14 separate studies of the laboratory system since Commissioner Perdue has been involved with the department; each of the studies have shown that something must be done. There is no longer the need to study this issue. Number 091 With regards to the Fairbanks laboratory, it is not a feasible option in the long-term. The Anchorage situation must be addressed. Commissioner Perdue explained that in the last 10 years, each time this matter was discussed nothing was resolved because the regional differences could not be worked out. Therefore, the most critical issues in Anchorage and Juneau have not been addressed. Under any plan by the department, the lab would not be built until the year 2,000 when attrition plans would be created. Commissioner Perdue believed that no one would lose their job in an untimely manner. Through attrition, no one would lose their job if they would transfer. SENATOR LEMAN asked if any of the public health functions in other states were contracted. Would that be a possibility? Number 130 DR. GREG HAYES, Chief of Laboratories for DHSS, informed the committee that no core laboratory functions are contracted. However, every public health lab does contract some work. For example, the Environmental Lab contracts for work that they are not capable of performing; it would not be cost effective for the lab to perform that work. There are core functions of tests, state regulatory functions, which are not contracted in any state. SENATOR LEMAN inquired as to why these functions cannot be contracted. DR. GREG HAYES explained that the state is responsible for many regulatory activities which is difficult to contract and have oversight. There are many costs associated with oversight. DR. JOHN MIDDAUGH, Chief of the Epidemiology Section of DHSS, identified one of the key functions of a state public health lab as maintaining special expertise and capacity to protect the public. The tests that are done may not occur frequently, but require much expertise. Dr. Middaugh used diphtheria and tuberculosis as an example. A certain number of tests must be run in order to maintain a high level of confidence in the result; those results determine public health decisions. Dr. Middaugh discussed some examples of the need to run many tests in order to maintain a high level of confidence. Today's technology also helps track and fingerprint viruses. In conclusion, Dr. Middaugh emphasized that the functions of state medical laboratories are important as well as their expertise and capacity to respond. Number 272 SENATOR LEMAN said that he was impressed with the state laboratory and Dr. Middaugh's work. He asked if there were any other medical laboratories in the state and if there was a sharing of specialist in order to avoid duplication when the test may occur so infrequently. DR. GREG HAYES acknowledged that testing is available in the private sector. Often that technology would be transferred to the private sector. Dr. Hayes pointed out that the state lab tries to maintain communicable disease testing and the latest technology. DR. JOHN MIDDAUGH said that the state lab works closely with many of the private labs around the state. Some of the tests these labs offer are not offered by the state medical lab. The state lab serves as a reference lab for all the private labs. He pointed out that the state lab can do serial groupings which the private labs cannot. It would be unethical for private hospitals to fingerprint antibiotic resistance tests because that would not help the patient, but it is a core public health function to target better intervention. There are 650 infectious and controlled communicable diseases known to man which are adopted in the state laboratory regulations for surveillance. Number 328 COMMISSIONER PERDUE emphasized that the state medical lab looks for trends. If the public health system works, no one notices; but if it does not work, it could effect our economy. The public health system needs to be ready for the future. SENATOR LEMAN asked if the other facilities the state works with such as Alaska Regional Providence support this centralized lab in Anchorage. DR. JOHN MIDDAUGH replied yes. The State Medical Association passed a formal resolution in support of HB 529 and the efforts to obtain the funds for the new lab. In response to Senator Leman, COMMISSIONER PERDUE said that the preferred location of the lab would be next to the crime lab. SENATOR LEMAN said that he was satisfied with the networking being done between the state and private medical labs. DR. JOHN MIDDAUGH reiterated that all states maintain a central core public health laboratory. CHAIRMAN GREEN assumed that the state lab was obliged to be connected with the nationwide disease control centers. DR. GREG HAYES informed the committee that data is transferred on a daily basis. SENATOR LEMAN asked if the Municipality of Anchorage had a public health laboratory. DR. JOHN MIDDAUGH replied no, the municipality uses the states. SENATOR SALO commented that HB 529 is an excellent bill. She inquired as to why it would take until the year 2,000 to begin. COMMISSIONER PERDUE explained that this would begin from the very beginning. No design work has been done. There is a fair amount of complicated design work for this building. CHAIRMAN GREEN announced that the department requested that HB 529 be held until Wednesday. HB 506 UNIVERSITY FIRE FIGHTING PROGRAM Number 377 CHAIRMAN GREEN introduced HB 506 as the next order of business before the committee. REPRESENTATIVE MIKE NAVARRE, Prime Sponsor, explained that HB 506 would allow the University of Alaska to establish the fire training program in Kenai. The fire training program is currently being run as part of the MAPTS program. Lines 9-12 of the bill illustrate the thrust of the bill: how much money is generated at the facility in order to be used to buy additional props. Approximately $3,000 to $5,000 worth of additional props are needed in order to provide training that is not provided elsewhere in Alaska. For example, industrial training for the oil industry. Currently, that type of training is received in Nevada and Texas. Representative Navarre acknowledged the concern that this would be the only fire training required in statute by the university. This bill does not preclude the university from doing the training elsewhere. There is a fire training degree program at the Fairbanks campus. Representative Navarre did not expect that to change. This bill does not intend to take over all the fire training for the state. There would still be the need to do regional fire training in Anchorage and Fairbanks. Representative Navarre believed all the concern to be because Kenai is working on receiving federal funds for the FAA for a $6 million aircraft training rescue program. There is competition between Anchorage and Kenai over who would receive that program which is not related to this bill. HB 506 would address the need for additional props to train for the oil industry. Number 424 SENATOR LEMAN did not believe that the title of the bill addressed what the bill actually does. Senator Leman said that the intent was to establish the institute in Kenai. REPRESENTATIVE NAVARRE said that this was how it came back from the drafter. He intended to establish a separate entity in Kenai in order to determine the amount of revenue generated and how much the university uses for other programs. The goal is to establish it so as the fire training program keeps their receipts in order to purchase the additional props for additional training. SENATOR LEMAN asked Representative Navarre if he had seen the letter from Evans & Associates which opposes HB 506. REPRESENTATIVE NAVARRE said that he had discussed this with some of the local fire chiefs. The concern is that Kenai is trying to take all the fire training in the state which is not the case. He informed the committee that he had explained it to the head of the Fire Chiefs Association who are concerned that this will be the only area in statute that requires the university to establish a training center. The Anchorage facility is not part of the university. The Kenai campus is part of the University of Alaska- Anchorage. The university determines the scope, range, and size of the Kenai program. SENATOR SALO asked if the focus of the Kenai facility is different because of the industrial training. REPRESENTATIVE NAVARRE agreed. CHAIRMAN GREEN inquired as to the path of the money received for this fire training. REPRESENTATIVE NAVARRE stated that the legislature controls this funding. Representative Navarre believed that separate accounts for Kenai would be established. CHAIRMAN GREEN asked if any other parts of the university are run like this. REPRESENTATIVE NAVARRE did not know. The university does not oppose HB 506. SENATOR LEMAN inquired as to the vote on the House floor. REPRESENTATIVE NAVARRE said that the vote was 28-11. The opposition rose from the letter and the fear that this would take funds from other fire training. SENATOR SALO moved that HB 506 be moved out of committee with individual recommendations. Hearing no objections, it was so ordered. There being no further business before the committee, the meeting was adjourned at 9:47 a.m.