Legislature(1997 - 1998)

04/07/1997 09:09 AM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
      SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                     
                         April 7, 1997                                         
                           9:09 a.m.                                           
                                                                               
  MEMBERS PRESENT                                                              
                                                                               
 Senator Gary Wilken, Chairman                                                 
 Senator Loren Leman, Vice Chairman                                            
 Senator Lyda Green                                                            
 Senator Jerry Ward                                                            
 Senator Johnny Ellis                                                          
                                                                               
  MEMBERS ABSENT                                                               
                                                                               
 All members present.                                                          
                                                                               
  COMMITTEE CALENDAR                                                           
                                                                               
                         CONFIRMATIONS                                         
                                                                               
 Board of Clinical Social Work Examiners - Diane DiSanto                       
 Board of Dispensing Opticians - Mary Seutter                                  
 Board of Education - Roy Nageak, Marilyn Webb                                 
 State Medical Board - Beverly Fletcher, Donald Hudson, Sarah Isto,            
                       Suzanne Lombardi, Donald Olson                          
 Board of Professional Teaching Practices Commission - Mary Lou                
                      Madden, Thomas Matheson, Christine Miller                
                                                                               
 SENATE BILL NO. 96                                                            
 "An Act regulating hospice care."                                             
                                                                               
  PREVIOUS SENATE COMMITTEE ACTION                                             
                                                                               
 SB 96 - See Senate Health, Education & Social Services Committee              
         minutes dated 2/24/97 and 3/21/97.                                    
                                                                               
  WITNESS REGISTER                                                             
                                                                               
 Ritchie Sonner                                                                
 Hospice & Home Care of Juneau                                                 
 3200 Hospital Drive, #100                                                     
 Juneau, Alaska                                                                
  POSITION STATEMENT:   Supported SB 96.                                       
                                                                               
 Charles Quarre, President                                                     
 Central Peninsula Hospice                                                     
 HC1 Box 3336                                                                  
 Sterling, Alaska 99672                                                        
  POSITION STATEMENT:   Expressed concerns with SB 96.                         
                                                                               
 Barbara Rich                                                                  
 Hospice of the Tanana Valley                                                  
 PO Box 80482                                                                  
 Fairbanks, Alaska 99708                                                       
  POSITION STATEMENT:   Indicated support for SB 96.                           
                                                                               
 Joy Janssen                                                                   
 Petersburg Hospice                                                            
 Petersburg, Alaska                                                            
  POSITION STATEMENT:   Discussed how this would apply to neighbor to          
                      neighbor care.                                           
                                                                               
 Maxine Worhatch                                                               
 Petersburg Hospice                                                            
 Petersburg, Alaska                                                            
  POSITION STATEMENT:   Discussed the need for insurance for volunteer         
                      hospices.                                                
                                                                               
 Erica Worhatch                                                                
 Petersburg Hospice                                                            
 Petersburg, Alaska                                                            
  POSITION STATEMENT:   Discussed liability for volunteer hospices.            
                                                                               
 Shelbert Larsen, Administrator                                                
 Health Facilities Licensing & Certification                                   
 Department of Health & Social Services                                        
 4730 Business Park Boulevard, Suite 18                                        
 Anchorage, Alaska 99503-7117                                                  
  POSITION STATEMENT:   Stated that SB 96 was a good bill.                     
                                                                               
  ACTION NARRATIVE                                                             
                                                                               
  TAPE 97-36, SIDE A                                                           
                                                                               
 Number 001                                                                    
                                                                               
  CHAIRMAN WILKEN  called the Senate Health, Education & Social                
 Services Committee (HES) to order at 9:09 a.m. and announced that             
 the committee would hear from appointees to the Board of Clinical             
 Social Work Examiners, the Board of Dispensing Opticians, the Board           
 of Education, the State Medical Board, and the Board of                       
 Professional Teaching Practices Commission.  Chairman Wilken                  
 invited the State Board of Education appointees to begin.                     
                                                                               
  MARILYN WEBB , State Board of Education appointee, informed the              
 committee that she currently resides in Juneau.  Ms. Webb has two             
 children who graduated from the Anchorage School District.  Ms.               
 Webb and her husband arrived in Alaska many years ago to work in a            
 BIA school in Savoonga where Ms. Webb coordinated the bilingual               
 program and worked with the kindergarten, first and second grade              
 programs.  Ms. Webb, a certified teacher, noted that she currently            
 works in the Head Start program in Alaska.  Ms. Webb felt that it             
 is a privilege to work on the State Board of Education.                       
  SENATOR GREEN  noted that in Alaska, Head Start goes through a               
 department other than the Department of Education.  Is Head Start             
 located in the Department of Education in other states?   MARILYN             
 WEBB  said that it depended on the state.  Head Start is a federal            
 program and the funding goes directly to the grantee.                         
                                                                               
 Number 102                                                                    
                                                                               
  SENATOR GREEN  asked Ms. Webb if she had an opinion on child                 
 care/daycare grants.  There is more than one type of assistance;              
 one type of assistance goes to the licensed care provider and the             
 other goes to the user.  Therefore an individual could choose                 
 his/her own provider.  Senator Green noted the debate revolving               
 around whether the assistance should only be used for licensed                
 providers.   MARILYN WEBB  said that quality of care is of concern.           
 There is much research about the importance of what occurs with               
 home care.  Ms. Webb expressed the need to ensure that funding                
 supports quality care for children whether in licensed or exempt              
 homes.                                                                        
                                                                               
  SENATOR LEMAN  inquired as to Ms. Webb's possible role in                    
 encouraging local school districts to cooperate with home school              
 and private school students who want to participate in school                 
 district activities.  Senator Leman acknowledged that some school             
 districts have been cooperative in this area and others have not.             
  MARILYN WEBB  noted that she had just had a presentation from                
 Representative Dyson and the board voted to unanimously support his           
 bill.   SENATOR LEMAN  noted that the Anchorage School District has           
 been reluctant in this matter.                                                
                                                                               
  CHAIRMAN WILKEN  noted that Ms. Fletcher had a time constraint and           
 her testimony would be taken next.                                            
                                                                               
 Number 180                                                                    
                                                                               
  BEVERLY FLETCHER , appointee to the State Medical Board, pointed out         
 that most of her work in Alaska has been in the arena of domestic             
 violence and sexual assault.  She began in that field in Dillingham           
 in 1982.  Ms. Fletcher has been in Juneau since early 1991 to the             
 present and has been working for the Coast Guard as Family Programs           
 Administrator.  As a Family Programs Administrator, Ms. Fletcher              
 primarily works in the domestic violence and sexual assault field             
 as well as the Special Needs Program.  Ms. Fletcher felt that her             
 experience afforded her the understanding of rural health care                
 issues as well as issues effecting urban Alaska.                              
                                                                               
  ROY NAGEAK , appointee to the State Board of Education, informed the         
 committee that he had four children in the North Slope Borough                
 School District.  Mr. Nageak began in the school district when the            
 state took over the BIA schools.  When Mr. Nageak began with the              
 school district the Iowa Test of Basic Skills (ITBS) scores were in           
 the lower end of the national curve, below 10 percent.  In the last           
 10 years, those scores in the North Slope have moved into the 40              
 and 50 percentiles which Mr. Nageak attributed to the involvement             
 in hiring the teachers and the increased parental involvement.  The           
 North Slope has a belief that all children can learn.  Mr. Nageak             
 noted his involvement with the Alaska Association of School Boards            
 which has provided him with a good state perspective.                         
                                                                               
 Mr. Nageak informed the committee that he was a whaling captain.              
 He learned a value lesson from his father and uncle who were strict           
 with him due to the dangers involved.  Mr. Nageak emphasized the              
 need to do the same with today's children; children need to realize           
 that what they learn or do not learn early on effects them later.             
                                                                               
                                                                               
 Number 260                                                                    
                                                                               
  SENATOR LEMAN  noted that Mr. Nageak had attended a boarding school.         
 There have been results from schools, such as Mt. Edgecombe, that             
 are better than results in rural school districts.  What can be               
 taken from the boarding school experience that could be applied to            
 other schools to better the results?   ROY NAGEAK  recalled his               
 parents commitment to education; his parents sent him to boarding             
 school about the time, age 14 or so, when the return from                     
 subsistence education would surface.  Many people in leadership               
 positions today attended boarding schools.  No matter where                   
 students attend school, parental involvement is very important.               
 Mr. Nageak said that a learning curve of the transition from a BIA            
 operated system to a locally operated system is occurring, but that           
 has not yet occurred in some of the more isolated areas.  Mr.                 
 Nageak believed that educational scores would be higher once the              
 problem areas in Alaska are identified and a training process                 
 begins.  With regards to boarding schools, Mr. Nageak pointed out             
 that he missed the support of his parents during his time in an               
 Oregon boarding school.                                                       
                                                                               
  SENATOR LEMAN  clarified that he was not suggesting that all                 
 children attend boarding schools rather what successes from                   
 boarding schools can be utilized in local schools in order to                 
 improve performance.   ROY NAGEAK  said that it was a matter of               
 communication, sharing successes between school districts.                    
                                                                               
  SENATOR GREEN  inquired as to Mr. Nageak's opinion on charter                
 schools.   ROY NAGEAK  informed the committee that the North Slope            
 Borough School District just reviewed a charter school proposal.              
 There were many unanswered questions during the application                   
 process.  Mr Nageak emphasized the need for a process to review               
 charter school proposals.   SENATOR GREEN  was not sure that statute          
 clearly specifies the role of the local school district versus that           
 of the State Board of Education.  Senator Green asked if anything             
 was necessary at the state level to ensure that the review                    
 processes were not duplicated.   ROY NAGEAK  noted that it takes time         
 to determine the responsibilities of a new law.  If local school              
 districts have an intensive process for a charter school, the state           
 board should reflect that process.                                            
                                                                               
 Number 319                                                                    
                                                                               
  DIANE DISANTO , appointee for the Board of Clinical Social Work              
 Examiners, informed the committee that she was a licensed clinical            
 social worker professionally trained in the bachelor and masters              
 level of social work.  Ms. DiSanto was the statewide Social Worker            
 of the Year.  Ms. DiSanto has worked in the direct practice and               
 with advocacy in the management of social work.  Ms. DiSanto is an            
 Anchorage resident.                                                           
                                                                               
  SENATOR LEMAN  commented that Ms. DiSanto had given him a tour of            
 the South Central Foundation which is quite impressive.  Senator              
 Leman thanked Ms. DiSanto for those services and, in many cases,              
 for less money than under traditional models.                                 
                                                                               
  DIANE DISANTO  noted that an addendum had been sent which specified          
 that she had left the South Central Foundation last January.                  
                                                                               
  MARY CATHY SEUTTER , appointee for the Board of Dispensing                   
 Opticians, informed the committee that she was licensed as an                 
 optician in Virginia in 1978.  Ms. Seutter moved to Alaska in 1983            
 and received her license in Alaska.  She reviewed her employment              
 history since moving to Alaska.  Ms. Seutter believed in continuing           
 education for all professionals and informed the committee of her             
 efforts in that vein.                                                         
                                                                               
  CHAIRMAN WILKEN  then moved to the Professional Teaching Practices           
 Commission appointees.                                                        
                                                                               
 Number 428                                                                    
                                                                               
  CHRISTINE MILLER , appointee to the Professional Teaching Practices          
 Commission, informed the committee that she was born, raised and              
 graduated from high school in Fairbanks.  Ms. Miller has a                    
 Bachelors degree from Western Washington State College in Speech              
 Pathology & Audiology and a Masters degree in Speech Pathology from           
 the University of Washington.  She also holds a Type A certificate            
 in Alaska with a K-12 special education, speech and hearing                   
 endorsement.  Ms. Miller specified that she had taught 18 years in            
 the Fairbanks schools, eight years as a classroom teacher and 10 as           
 support to the class in the area of speech and language.  Ms.                 
 Miller believed that Alaska has a highly educated and dedicated               
 teaching staff and in order to maintain that level, as                        
 professionals, teachers should police themselves.  In response to             
 Chairman Wilken, Ms. Miller said she had taught at North Pole                 
 Elementary for 12 years and Ticasuk Brown Elementary for six years.           
                                                                               
  SUZANNE LOMBARDI , appointee to the State Medical Board, noted that          
 she was the current chair of the State Medical Board.  Ms. Lombardi           
 informed the committee that she was instrumental in forming the               
 shelter in the Mat-Su Valley.  At that time, Ms. Lombardi worked              
 with the legislative delegation in order to obtain funding for the            
 shelter.  Ms. Lombardi then went to Law School and upon her return            
 to Alaska Ms. Lombardi was a clerk for the Honorable James K.                 
 Singleton, Jr.  Then Ms. Lombardi was appointed by Governor Hickel            
 to the Prosecutor's Office.  Currently, Ms. Lombardi is in private            
 practice with Faulkner, Banfield.                                             
                                                                               
 Last session a sexual misconduct statute was passed which left the            
 promulgation of regulations regarding the definition of sexual                
 misconduct to the State Medical Board.  The board accomplished that           
 and hoped that by the next meeting the Department of Law would have           
 passed those regulations.  The board has also passed regulations              
 regarding record keeping and prescriptions.                                   
                                                                               
  SENATOR LEMAN  said that the Legislature is poised to pass SB 24             
 which creates a judicial by-pass for a minor seeking an abortion,             
 enabling the parental consent provision to be enforced.  Senator              
 Leman asked if Ms. Lombardi would, as a member of the State Medical           
 Board, enforce that law.   SUZANNE LOMBARDI  stated that the board is         
 obligated to enforce any statute passed by the Legislature.                   
                                                                               
  SENATOR LEMAN  noted the unfortunate dismissal of some qualified             
 people from the State Medical Board.  Senator Leman asked if the              
 board was in a position so as not to suffer such a blow again?                
 Senator Leman said that he would take this matter up in a later               
 conversation.  Senator Leman understood that the previous board did           
 not have all the information on James McGuire which lead to the               
 dismissal of the previous board.  That action indicated that the              
 Governor was held responsible for information that the board did              
 not have.  Senator Leman wanted to ensure that the board was not              
 placed in that position again, that there is a provision in place             
 to obtain such information.                                                   
                                                                               
  SUZANNE LOMBARDI  did not believe it unusual for a governor to               
 change boards.  Ms. Lombardi did not know the reasons why the                 
 former board is not in tact.  Ms. Lombardi believed that the                  
 Legislature would be proud of the work of those on this board.                
                                                                               
  SENATOR GREEN  indicated that she needed to converse with Ms.                
 Lombardi about a complaint the Senator had received regarding a               
 matter before the board.  Senator Green expressed concern with the            
 style of the board.   SUZANNE LOMBARDI  noted that she had been in            
 frequent contact with Senator Green's staff and would be happy to             
 discuss any matter with Senator Green.                                        
                                                                               
 Number 522                                                                    
                                                                               
  DON HUDSON , appointee to the State Medical Board, informed the              
 committee that he was board certified in Emergency Medicine and               
 specialized in Emergency Medicine and Aerospace Medicine.  Dr.                
 Hudson noted that he had been involved with mid-level                         
 practitioners, using them in a variety of remote situations.  Dr.             
 Hudson had been involved in the training and sponsoring of                    
 paramedics.  Dr. Hudson said that his expertise lies in rural                 
 Alaska.  In response to Chairman Wilken, Dr. Hudson specified that            
 he was discharged from the U.S. Airforce in 1981 as Major.  In                
 response to Senator Green, Dr. Hudson said that part of his love              
 was the safety of snowmobilers.  Dr. Hudson has encouraged marked             
 and safe trails around Alaska in order to encourage tourism.                  
                                                                               
  SENATOR LEMAN  noted that Dr. Hudson was the Director of the                 
 Iliuliak Family Clinic in Unalaska which the Legislature worked on            
 several years ago.   DON HUDSON  said that the clinic has had its ups         
 and downs, but almost always consistently on a positive note.  Dr.            
 Hudson discussed the interaction with the fishing industry.  The              
 Iliuliak Family Clinic is a great rural clinic with 60 weeks of               
 physician coverage and tremendous community involvement.                      
                                                                               
  DON OLSON , appointee to the State Medical Board, commented that             
 influence of his high school teachers in Unalakleet lead him to               
 medical school.  Dr. Olson discussed his college education.  Since            
 1984, Dr. Olson has been practicing medicine in Nome and focusing             
 on rural Alaska.  Dr. Olson went to law school in the early 1990s.            
                                                                               
  CHAIRMAN WILKEN  pointed out that Dr. Olson and Dr. Hudson were both         
 pilots.  Chairman Wilken informed the committee that Dr. Sarah Isto           
 is not present today, she is on a long planned family vacation.               
                                                                               
  TAPE 97-36, SIDE B                                                           
                                                                               
  MARY LOUISE MADDEN , appointee to the Professional Teaching                  
 Practices Commission, informed the committee that she was                     
 completing her first year on the PTPC.  Ms. Madden has been in                
 Alaska since 1971 and has been involved in education most of that             
 time at various levels.  Currently, Ms. Madden is an adjunct                  
 teacher at the University of Alaska.  Ms. Madden believed that PTPC           
 was a valuable commission and she was pleased to serve.                       
                                                                               
 Number 588                                                                    
                                                                               
  SENATOR LEMAN  noted that in 1990 a bill dealing with the sexual             
 misconduct of teachers passed; has that bill been effective?   MARY           
 LOUISE MADDEN  said that such incidents were rare, but not nil which          
 is preferred.  Such incidents are vigorously pursued as the                   
 profession has better information.  Now perpetrators cannot come to           
 Alaska and receive certification without Alaska knowing his/her               
 background.  In further response to Senator Leman, Ms. Madden said            
 that there are ways to identify inappropriate behavior and everyone           
 is becoming more aware of those indicators.                                   
                                                                               
  SENATOR GREEN  commented on the problems surrounding a student that          
 turns 18 before graduation.  Senator Green also noted the loophole            
 for persons hired through consultants who do not adhere to the same           
 level of scrutiny as persons hired through the regular personnel              
 process.  Senator Green requested that Ms. Madden notify her of any           
 way she may attack that problem.                                              
                                                                               
 In response to Chairman Wilken,  MARY LOUISE MADDEN  said that she            
 was a Juneau resident and was teaching her class at the University            
 which is why she could not be present at the hearing.                         
                                                                               
  LOU MATHESON , appointee to the Professional Teaching Practices              
 Commission, informed the committee that he had been in Alaska for             
 18 years as an administrator in rural Alaska.  Currently, Mr.                 
 Matheson represents the Secondary School Principals Association on            
 the PTPC.  Mr. Matheson said that he was appointed by Governor                
 Hickel and served a three year term which expired June 6, 1996.               
 Upon that expiration, the Secondary School Principals Association             
 nominated Mr. Matheson for another term, 1996-1997 school year.               
 Mr. Matheson endorsed the previous comments regarding the                     
 importance of the PTPC.                                                       
                                                                               
  CHAIRMAN WILKEN  asked the committee to review the resumes. If any           
 additional information is necessary that should be requested by               
 Wednesday's hearing otherwise, Chairman Wilken assumed that he                
 could report the names back to the Senate.                                    
                                                                               
                                                                               
               SB  96 REGULATION OF HOSPICE CARE                             
                                                                              
 Number 530                                                                    
                                                                               
  CHAIRMAN WILKEN  announced that  SB 96  would be the next order of           
 business before the committee.  Chairman Wilken noted that the K              
 version of the bill was before the committee.                                 
                                                                               
  BEN BROWN , Staff to Senator Kelly, discussed the changes that               
 version K includes.  On page 8, line 21 after "which" the word                
 "including" was deleted and "may include" was inserted.  That                 
 language was inserted because sometimes a volunteer hospice would             
 not include all the items listed for bereavement services.  Page 9,           
 line 14 the reference to 24 hour, seven days a week was deleted               
 because in a volunteer context that would not occur.  That language           
 is on page 5 under the definition of nursing services as provided             
 by nonvolunteer hospice programs.                                             
                                                                               
  CHAIRMAN WILKEN  asked Ms. Sonner to provide her testimony and noted         
 that the packet included her letter.                                          
                                                                               
  RITCHIE SONNER , Hospice & Home Care of Juneau, supported SB 96 as           
 written.  With the changes to SB 96, Ms. Sonner did not believe it            
 to be burdensome administratively or financially.  Hospice & Home             
 Care of Juneau is a small volunteer hospice with few funds.  SB 96            
 is written to protect the consumer.  Ms. Sonner noted that she was            
 not a supporter of regulation, but in this situation she                      
 recommended the passage of SB 96.                                             
                                                                               
  SENATOR LEMAN  asked Ms. Sonner if her notion that SB 96 was not             
 burdensome was the general consensus among volunteer hospices.                
  RITCHIE SONNER  believed so, but noted there were folks on line who          
 could speak to that.   SENATOR LEMAN  did not want to burden such             
 organizations unnecessarily.                                                  
                                                                               
  CHARLES QUARRE , President of the Central Peninsula Hospice, stated          
 that he maintained his previous testimony regarding concerns of the           
 administrative and financial burdens of SB 96.  Mr. Quarre noted              
 that many industries are regulated by market forces.  The volunteer           
 hospices adhere to the guidelines of the National Hospice                     
 Organization which are almost identical to those specified in the             
 bill.  Mr. Quarre suggested reviewing the advisability of incurring           
 additional expense and regulations in this area.  Mr. Quarre                  
 questioned if there are current statutes that address abuses in               
 this system.  In response to Chairman Wilken, Mr. Quarre agreed               
 that he was speaking in opposition to SB 96.  Mr. Quarre requested            
 that the volunteer hospice may be noted in the bill, but be                   
 excluded from the provisions if not entirely.                                 
                                                                               
  CHAIRMAN WILKEN  asked Mr. Quarre if he had any suggestions                  
 regarding how to accomplish that within SB 96.   CHARLES QUARRE               
 suggested that if the bill is to pass, the volunteer hospice could            
 be recognized but excluded from the provisions of the bill.                   
                                                                               
 Number 427                                                                    
                                                                               
  BEN BROWN  explained that if hospices are to be regulated, there             
 must be a standard that applies to any organization using the term            
 hospice.  In the Commonwealth of Virginia, a bill excluding the               
 volunteer hospices was passed which resulted in volunteer hospices            
 being unable to use the term hospice in their name.  Mr. Brown                
 acknowledged that language could be used to avoid that problem.               
 However, that would result in regulating only a portion of the                
 industry providing hospice services.  Mr. Brown recognized that the           
 volunteer hospices in Alaska are exceeding the standards specified            
 in the bill, but that may not continue as time passes.  Eliminating           
 the reference to the volunteer programs in SB 96 would not                    
 accomplish the primary goal and the remainder of the hospice                  
 community may not want that to go forward.                                    
                                                                               
  RITCHIE SONNER  noted that there are shams, although not in Alaska           
 currently.  Thirty-eight states have had to regulate hospices in              
 even a more restrictive manner.  SB 96 is a proactive bill to                 
 protect consumers who are in a vulnerable state.  Ms. Sonner feared           
 the possibility of an opportunist.  Ms. Sonner pointed out that               
 eliminating the reference to volunteer hospices would allow anyone            
 to refer to themselves as a hospice.  SB 96 should be passed as is            
 or not at all.                                                                
                                                                               
  SENATOR WARD  inquired as to the number of cases of abuse in Alaska          
 this year.   BEN BROWN  did not believe there was a situation of              
 abuse in Alaska currently.   SENATOR WARD  suggested that regulation          
 could harm the process that is currently working.   BEN BROWN                 
 referred to Article 2 when saying that the Administrator of Health            
 Facilities Licensing & Certification will be reviewing mainly                 
 nonvolunteer hospices a couple days a year.  The volunteer programs           
 have a lower standard to adhere and the department has no intention           
 of charging volunteer hospices.  Mr. Brown reiterated that the                
 volunteer hospices are already exceeding the standards in SB 96.              
 Mr. Brown noted that nurses and doctors have associations that                
 regulate them, only attorneys regulate themselves.  Mr. Brown did             
 not know what more could be done to lighten the burden without                
 making the legislation meaningless.                                           
                                                                               
 Number 366                                                                    
                                                                               
  SENATOR WARD  agreed that there was no middle ground.  Senator Ward          
 inquired as to the public safety reasons for SB 96 within Alaska.             
  BEN BROWN  could not give an example within the hospice community.           
 There was a problem in an assisted living home which lead to                  
 changes in law.  Mr. Brown noted that an assisted living home was             
 a comparable field.                                                           
                                                                               
  BARBARA RICH , Hospice of the Tanana Valley, said that she was               
 speaking for the Board of Directors.  Ms. Rich noted that all of              
 the concerns regarding the bill initially speaking only to                    
 volunteer hospices when relevant were addressed.  Ms. Rich noted              
 that she was concerned with the administrative and financial costs            
 of SB 96.  Mr. Shelby of the Department of Health & Social Services           
 assured Ms. Rich that it would be very minimal: a yearly on-site              
 inspection would occur with a report following.  The standards in             
 the bill are minimal.  SB 96 would protect vulnerable patients and            
 families.  Ms. Rich said that there has never been a problem in               
 this area and the impetus is to continue that record.                         
                                                                               
 In response to Senator Ward, Ms. Rich said that the Hospice of the            
 Tanana Valley has not experienced any problems.  Ms. Rich was                 
 concerned that others may not do so.  With regard to the expansion            
 of the regulations, Ms. Rich did not believe there could be                   
 expansion.  Ms. Rich said that she had heard of others who have               
 lower standards as well as problems with this in other states.                
                                                                               
  SENATOR WARD  was not sure that regulation was necessary for a               
 problem that does not exist.   BARBARA RICH  believed that the                
 certified hospices would be regulated due to the presence of                  
 nursing staff and such.                                                       
                                                                               
  JOY JANSSEN , representing the forming Petersburg Hospice, informed          
 the committee that Petersburg was in the process of forming a                 
 hospice beginning with neighbor to neighbor care.  Ms. Janssen                
 asked if neighbor to neighbor care was given without using the name           
 hospice, would the organization still be regulated under this bill.           
                                                                               
  BEN BROWN  replied no.  SB 96 applies only to groups representing            
 themselves as hospices.  Mr. Brown said that it would be a                    
 judgement call for the Department of Law upon the request of the              
 Department of Health & Social Services.  Mr. Brown pointed out the            
 definition of "hospice services" when noting that providing only              
 one service at home or not meeting all the needs listed could                 
 possibly eliminate Ms. Janssen's concerns.  Identifying an                    
 organization as a hospice is the triggering mechanism and the                 
 secondary definition is providing hospice services.                           
                                                                               
 Number 251                                                                    
                                                                               
  MAXINE WORHATCH , testifying from Petersburg, asked if insurance,            
 personal or group, would be necessary if a group fell under this              
 bill as a volunteer.   BEN BROWN  said that was not covered by SB 96.         
 Mr. Brown believed that most volunteer hospices carried insurance.            
 SB 96 does not mandate liability insurance.  Mr. Brown referred Ms.           
 Worhatch to Ms. Sonner or Ms. Rich.   MAXINE WORHATCH  commented that         
 it does not seem necessary to regulate volunteer hospices.  Why               
 would someone volunteer and then take advantage of a patient?                 
                                                                               
  ERICA WORHATCH  asked if a hospice became licensed would the hospice         
 be liable if a neighbor who was not a hospice volunteer wanted to             
 help.   BEN BROWN  said that if a person wanted to help a dying               
 neighbor, of course that can be done.  As long as that neighbor did           
 not say he/she was affiliated with a particular hospice, that                 
 hospice would not be liable for his/her actions.                              
                                                                               
  CHAIRMAN WILKEN  suggested that those in Petersburg could consult            
 the many successful volunteer hospices such as those represented by           
 Ms. Sonner and Ms. Rich.                                                      
                                                                               
  SHELBERT LARSEN , Administrator of Health Facilities Licensing &             
 Certification for DHSS, said that his agency would probably develop           
 and enforce the regulations if this statute were to pass.  Mr.                
 Larsen believed that SB 96 was a good bill, providing minimum                 
 standards for hospice programs.  Mr. Larsen did not believe SB 96             
 would be burdensome for either the for profit or volunteer                    
 hospices.                                                                     
                                                                               
  CHAIRMAN WILKEN  referred to Article 2, page 7, line 18 when asking          
 if other volunteer organizations were required to show proof of               
 auto insurance and valid drivers license.   BEN BROWN  said that he           
 had asked Terri Lauterbach about that matter.  Ms. Lauterbach was             
 unaware of other volunteer organizations requiring such.  That                
 requirement was included because it was in the main statute and               
 seemed appropriate to put in SB 96.  This has not been a concern              
 for anyone.  Mr. Brown said that it would not be appropriate for an           
 individual to be driving around a terminally ill patient without              
 auto insurance and a valid drivers license.  This is one reason for           
 a hospice to have liability insurance.  Liability would be                    
 increased if the two requirements were not met.                               
                                                                               
  SENATOR GREEN  informed everyone that her husband was employed by            
 the Auto Insurance Provider.  Senator Green recalled that when she            
 drove for Scouts or her church, she was required to have proof of             
 insurance.  Senator Green did not believe that those requirements             
 were unique to hospices.                                                      
                                                                               
  SENATOR WARD  requested that SB 96 be held until Kenai could provide         
 an amendment to eliminate the volunteers from the bill.  Senator              
 Ward did not know when the amendment would be ready.  Senator Ward            
 said that he did not want to move SB 96 out of committee; people              
 should not be regulated for a problem that does not exist.                    
                                                                               
  CHAIRMAN WILKEN  said that he would prefer not to hold SB 96 beyond          
 Wednesday.  There being no further business before the committee,             
 the meeting was adjourned at 10:35 a.m.                                       
                                                                               

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