Legislature(2001 - 2002)

03/16/2001 12:00 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                    
      SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE                                                                    
                         March 16, 2001                                                                                         
                           12:00 p.m.                                                                                           
MEMBERS PRESENT                                                                                                               
Senator Lyda Green, Chair                                                                                                       
Senator Loren Leman, Vice Chair                                                                                                 
Senator Gary Wilken                                                                                                             
Senator Jerry Ward                                                                                                              
MEMBERS ABSENT                                                                                                                
Senator Bettye Davis                                                                                                            
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 133                                                                                                             
"An Act  relating to a two-year  transition for  implementation of                                                              
the public high school competency  examination and to establishing                                                              
an  essential  skills  examination  as a  high  school  graduation                                                              
requirement; and providing for an effective date."                                                                              
     MOVED CSSB 133 (HES) OUT OF COMMITTEE                                                                                      
SENATE BILL NO. 67                                                                                                              
"An Act  relating to  assisted living homes  and to liability  for                                                              
acts or omissions in the licensing,  monitoring, or supervision of                                                              
assisted living homes; and providing for an effective date."                                                                    
     HEARD AND HELD                                                                                                             
SENATE BILL NO. 86                                                                                                              
"An  Act relating  to  employment of  teachers  who have  subject-                                                              
matter expertise; and providing for an effective date."                                                                         
     SCHEDULED BUT NOT HEARD                                                                                                    
SENATE BILL NO. 94                                                                                                              
"An  Act relating  to  education  funding;  and providing  for  an                                                              
effective date."                                                                                                                
     HEARD AND HELD                                                                                                             
SENATE BILL NO. 91                                                                                                              
"An  Act  relating  to  information   and  services  available  to                                                              
pregnant women and other persons; and ensuring informed consent                                                                 
before an abortion may be performed, except in cases of medical                                                                 
     HEARD AND HELD                                                                                                             
PREVIOUS COMMITTEE ACTION                                                                                                     
Ms. Alison Elgee, Deputy Commissioner                                                                                           
Department of Administration                                                                                                    
P.O. Box 110200                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT:  Commented on SB 67.                                                                                      
Gary Ward, Manager                                                                                                              
Assisted Living Licensing Program                                                                                               
Department of Administration                                                                                                    
P.O. Box 110200                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT:  Commented on SB 67.                                                                                      
Mr. Elmer Lindstrom                                                                                                             
Special Assistant to the Commissioner                                                                                           
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Commented on SB 67.                                                                                       
Mr. Shelby Larson, Administrator                                                                                                
Health Facilities Licensing and Certification                                                                                   
4730 Business Park Blvd.                                                                                                        
Anchorage AK 99503                                                                                                              
POSITION STATEMENT: Commented on SB 67.                                                                                       
Mr. Ron Parke, Housing Administrator                                                                                            
Friendship Services Assisted Living                                                                                             
3935 Svedlund                                                                                                                   
Homer AK 99603                                                                                                                  
POSITION STATEMENT: Commented on SB 67.                                                                                       
Mr. Carl Rose, Executive Director                                                                                               
Association of Alaska School Boards                                                                                             
POSITION STATEMENT: Opposed SB 94.                                                                                            
Ms. Sandy Altland                                                                                                               
Staff to Senator Ward                                                                                                           
State Capitol Bldg.                                                                                                             
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Presented SB 91.                                                                                          
Ms. Nancy Davis, Acting Director                                                                                                
Division of Public Health                                                                                                       
Department of Health &                                                                                                          
  Social Services                                                                                                               
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT:  Opposed SB 91.                                                                                           
Ms. Karen Vosburgh, Executive Director                                                                                          
Alaskans Right to Life                                                                                                          
PO Box 1847                                                                                                                     
Palmer AK 99645                                                                                                                 
POSITION STATEMENT: Supported SB 91.                                                                                          
Mr. Bob Lynn, President                                                                                                         
Alaskan Right to Life                                                                                                           
Anchorage AK                                                                                                                    
POSITION STATEMENT: Supported SB 91.                                                                                          
Dr. Colleen Murphy                                                                                                              
Anchorage AK                                                                                                                    
POSITION STATEMENT: Opposed SB 91.                                                                                            
Ms. Sherry Goll                                                                                                                 
Alaska Pro Choice Alliance                                                                                                      
Haines AK                                                                                                                       
POSITION STATEMENT: Opposed SB 91.                                                                                            
Ms. Anna Franks                                                                                                                 
Fairbanks AK                                                                                                                    
POSITION STATEMENT: Opposed SB 91.                                                                                            
Ms. Jennifer Rudinger, Executive Director                                                                                       
Alaska Civil Liberties Union (ACLU)                                                                                             
POSITION STATEMENT: Opposed SB 91.                                                                                            
Ms. Dietrick Sitler                                                                                                             
Anchorage AK                                                                                                                    
POSITION STATEMENT: Opposed SB 91.                                                                                            
Ms. Mary Dye                                                                                                                    
Citizen of Alaska                                                                                                               
POSITION STATEMENT: Supported SB 91.                                                                                          
Mr. Sid Heidersdorf                                                                                                             
Juneau Resident                                                                                                                 
POSITION STATEMENT:  Supported SB 91.                                                                                         
Ms. Mary Horton                                                                                                                 
Juneau AK                                                                                                                       
POSITION STATEMENT: Supported SB 91.                                                                                          
WITNESS REGISTER                                                                                                              
ACTION NARRATIVE                                                                                                              
TAPE 01-23, SIDE A                                                                                                            
Number 001                                                                                                                      
          SB 133-PUBLIC SCHOOL COMPETENCY EXAM/REPORTS                                                                      
CHAIRWOMAN  LYDA  GREEN  called the  Senate  Health,  Education  &                                                            
Social  Services Committee  meeting  to order  at  12:00 p.m.  and                                                              
announced SB  133 to be  up for consideration.  She said  they had                                                              
language  from  the  Department  that  dealt  with  two  of  their                                                              
concerns regarding the waiver.                                                                                                  
                           AMENDMENT 1                                                                                        
Page 1, line 16: following "rates,";  insert "including the number                                                              
of  students  who received  a  diploma  under  a waiver  from  the                                                              
competency examination required under AS 14.03.075(a),"                                                                         
Page  3,  line   27:  following  "student":  insert   ";  criteria                                                              
regarding  granting a  waiver  must include  provisions  requiring                                                              
that a student  satisfy the performance standards  developed under                                                              
AS 14.07.020(b)  to the maximum extent  possible" - She  said they                                                              
would also  have a reporting section  that would bring  this issue                                                              
back before the legislature in 2003.                                                                                            
Page 4, line 26: delete "Sections  2 - 4" and insert "Sections 2 -                                                              
Page 4, line 30: delete "Sections  5 and 8" and insert "Sections 6                                                              
and 9"                                                                                                                          
Page 4, line  31: delete "Sections 9 and 10"  and insert "Sections                                                              
10 and 11"                                                                                                                      
SENATOR WARD moved  to adopt Amendment 1, version  0.4 to CSSB 133                                                              
(HES). There were no objections and it was so adopted.                                                                          
                           AMENDMENT 2                                                                                        
Page 4, following line 28:  Insert a new bill section to read:                                                                  
     "*Sect.9. The uncodified law of the State of Alaska is                                                                     
amended by adding a new section to read:                                                                                        
     REPORT. The Department of Education and Early Development                                                                  
shall, by January  31, 2003, deliver a report to  the Alaska State                                                              
Legislature  that describes  the proposed  criteria and  procedure                                                              
under  which a  school  district could  use  a waiver  to grant  a                                                              
diploma to a student."                                                                                                          
Page 4, line 31: delete "9 and 10" and insert "10 and 11"                                                                       
SENATOR WARD moved to adopt Amendment  2, version 0.3, to CSSB 133                                                              
(HES). There were no objections and it was so adopted.                                                                          
SENATOR WILKEN said he was concerned  about the requirement in the                                                              
exit exam to  be proficient in the English language.  He hoped the                                                              
State Board  of Education  would consider  his language  when they                                                              
enact SB 133. He read for the record:                                                                                           
     In  regard to  the waivers,  that  each student  achieve                                                                   
     competency  in the  English  language before  graduation                                                                   
     from  high school  and that the  waiver process  enacted                                                                   
     and the regulations  governing the issuance  of a waiver                                                                   
     for   the  secondary   student  competency   examination                                                                   
     adopted  by  the  Department   of  Education  and  Early                                                                   
     Development should not be used  to allow a diploma to be                                                                   
     given  to  a  student  who  lacks  a  minimal  level  of                                                                   
     competency in the English language.                                                                                        
CHAIRWOMAN  GREEN  thanked  the  members  of  the  committee,  the                                                              
agencies,   the departments  and the many  other people  for their                                                              
work on this issue.                                                                                                             
Number 577                                                                                                                      
SENATOR DAVIS  said she appreciated  the Senator's  statement, but                                                              
she didn't  know what they were doing  with it. It is  not part of                                                              
the bill.                                                                                                                       
CHAIRWOMAN  GREEN  said  that  is  correct.  She  thought  it  was                                                              
reasonable  for them to  be able  to have  their interests  on the                                                              
record and how they would continue to be reviewed.                                                                              
SENATOR DAVIS said that she wanted  to go on record not supporting                                                              
that statement.                                                                                                                 
SENATOR  LEMAN  said  he appreciated  the  Chair's  leadership  in                                                              
pulling this issue together. He moved  to pass CSSB 133 (HES) from                                                              
committee   with  individual   recommendations.   There  were   no                                                              
objections and it was so ordered.                                                                                               
CHAIRWOMAN GREEN announced an at ease from 12:10 - 12:14.                                                                       
                  SB  67-ASSISTED LIVING HOMES                                                                              
CHAIRWOMAN GREEN announced  SB 67 to be up for  consideration. She                                                              
said she did not intend to pass it  out today and wanted people to                                                              
have time to work on it.                                                                                                        
MS.   ALISON    ELGEE,   Deputy   Commissioner,    Department   of                                                              
Administration,  explained  that  SB  67  is the  outgrowth  of  a                                                              
regulation  project that  they worked  on with  the Department  of                                                              
Health and  Social Services (DHSS)  on assisted living  licensing.                                                              
She said:                                                                                                                       
     Our  two  departments  have  joint  responsibility.  The                                                                   
     Department of  Administration licenses homes  for senior                                                                   
     residents  and  the  DHSS  licenses  homes  under  their                                                                   
     Division    of   Mental    Health   and    Developmental                                                                   
     Disabilities for those two population groups.                                                                              
     When the  licensing law was  passed in about  1995, this                                                                   
     was a  brand new venture for  us and we decided  that it                                                                   
     was  important  that we  review  the operations  of  the                                                                   
     assisted living industry against  our regulations at the                                                                   
     time  and our  statutes to  see  whether everything  was                                                                   
     working,  whether there  were  areas that  needed to  be                                                                   
     strengthened and/or changed.                                                                                               
Public hearings  were held throughout  the state and they  came up                                                              
with  several items  that  were  recommendations  and couldn't  be                                                              
dealt   with  in   regulation.   They  required   some   statutory                                                              
modification. SB 67 addresses those  areas. The regulation package                                                              
has  been publicly  noticed  and is  just  beginning the  adoption                                                              
This particular bill  requires that any assisted  living home that                                                              
receives  public funding  be  licensed. Current  statute  requires                                                              
homes with  three or more residents  to be licensed.  The Division                                                              
of  Senior Services  has  been licensing  any  home that  receives                                                              
public funding  just as a  matter of policy.  This would be  a new                                                              
effort  on  the  part  of  the  Division   of  Mental  Health  and                                                              
Developmental  Disabilities. It also  sets some standards  against                                                              
which background checks  would be conducted. This  is required for                                                              
employees  of  an assisted  living  home.  This would  expand  the                                                              
number of  people that  would be subject  to background  checks so                                                              
that they could  pick up other people who had  unsupervised access                                                              
to residents  of an assisted  living home  on a regular  basis. It                                                              
would include family  members who actually live in  the home along                                                              
with the assisted  living residents. It would  include contractors                                                              
so that they  don't have a loophole where somebody  is not subject                                                              
to a background  check because they are put on  a contract instead                                                              
of being set up as an employee. Regular  volunteers would also get                                                              
a background  check where they  have unsupervised access.  It also                                                              
identified  those people who  would not  be subject to  background                                                              
checks, like  occasional visitors  or people who  are only  in the                                                              
home along with the professional staff.                                                                                         
Number 916                                                                                                                      
CHAIRWOMAN GREEN asked where that section was.                                                                                  
MS. ELGEE  replied that  Section 3 says  who is not  required. She                                                              
     The  bill also  provides  provisions  that the  assisted                                                                   
     living industry  has been very interested  in obtaining.                                                                   
     The  bill  sets  out  the  conditions   under  which  an                                                                   
     assisted  living provider could  terminate a  resident's                                                                   
     contract.  Often  times,  the  smaller  assisted  living                                                                   
     homes  are  not  capable  of   managing  every  type  of                                                                   
     behavior   or  medical  condition   and  they   need  an                                                                   
     opportunity when  an individual progresses  beyond their                                                                   
     capability  to handle,  and  subsequently,  then, is  at                                                                   
     risk,  or  has  a  behavioral   issue  that  puts  other                                                                   
     residents  at risk.  They need a  process through  which                                                                   
     they  can terminate  the contract  of  the resident  and                                                                   
     find more suitable placement.                                                                                              
     The  primary  mechanism  through  which  this  would  be                                                                   
     addressed is contained in Section  4 and would allow for                                                                   
     a 30-day  process for  these determination  proceedings.                                                                   
     It lays out specific activities  that would generate the                                                                   
     assisted  living   providers  right  to   terminate  the                                                                   
     Section  5   essentially  continues  this   process  for                                                                   
     termination  and it  lays out the  residents' rights  to                                                                   
     have  a conference  with  the assisted  living  provider                                                                   
     along with  any advocates or  family members  to contest                                                                   
     that  determination  and  show  why  that  determination                                                                   
     should not occur.                                                                                                          
     There are  occasions where  an emergency termination  of                                                                   
     contract may  be necessary and  Section 7 addresses  the                                                                   
     emergency  termination of  contract and  again lays  out                                                                   
     what would constitute the emergency  and sets out a much                                                                   
     shorter   time  frame   than   the  normal   involuntary                                                                   
     The  bill  also  includes  in   Section  8  an  immunity                                                                   
     provision  for liability  for acts  or omissions in  the                                                                   
     licensing,  monitoring  or  supervision  of  a  licensed                                                                   
     Section  9 addresses the  situation, which has  occurred                                                                   
     and we  determined we did  not have the legal  authority                                                                   
     to  go in an  assisted living  environment and  actually                                                                   
     take over the  operation of the home. Where  the home is                                                                   
     not  being  operated  in a  way  that  is safe  for  the                                                                   
     residents of the home, but where  some time is needed in                                                                   
     order  to place  those individuals  in another  setting.                                                                   
     So, this addresses a real situation  that occurred a few                                                                   
     years ago in the Anchorage area  where we had two fairly                                                                   
     good-sized homes  with approximately 16  residents each,                                                                   
     both  operated  by  the  same   operator  who  ran  into                                                                   
     financial difficulties.  It was impossible to  place the                                                                   
     30-some residents  in other settings over night.  So, we                                                                   
     need  this window  of opportunity and  this is  actually                                                                   
     modeled  after a provision  that's currently in  statute                                                                   
     for nursing  homes that allows the Department  of Health                                                                   
     and  Social Services  the same  kind  of opportunity  if                                                                   
     there is a similar situation with nursing homes.                                                                           
CHAIRWOMAN GREEN asked if there was an appeal process, if                                                                       
someone's license was being revoked for unfair reasons, for                                                                     
Number 1178                                                                                                                     
MR. GARY WARD, Manager, Assisted Living Licensing Program,                                                                      
     The home  does have  an appeal  process if the  Division                                                                   
     takes  action  to  revoke  the   license  either  on  an                                                                   
     emergency   basis   or   through    routine   procedures                                                                   
     revocation.  The home  is issued a  notice of  violation                                                                   
     with the  intent to  impose an administrative  sanction.                                                                   
     That administrative sanction  would be the revocation of                                                                   
     a  license. The  home, then,  has  10 days  in which  to                                                                   
     request a hearing to appeal  the revocation. Unless it's                                                                   
     an imminent  situation, the home is allowed  to continue                                                                   
     to operate. If they submit a  request for an appeal or a                                                                   
     request for a  hearing, then a hearing officer  would be                                                                   
     assigned and  it really depends  on the schedule  of the                                                                   
     hearing  officer and then  an administrative hearing  is                                                                   
     held. That is usually down the  road several months. The                                                                   
     home,  unless  it's  an emergency  situation  where  the                                                                   
     residents  are  at  imminent  risk  of  harm,  would  be                                                                   
     allowed to  continue to operate  pending the  outcome of                                                                   
     the hearing.                                                                                                               
CHAIRWOMAN GREEN referred to the immunity in Section 8 and asked                                                                
if that was typical language.                                                                                                   
MR. WADE said he thought it was.                                                                                                
CHAIRWOMAN GREEN asked what that language was designed after.                                                                   
MS. ELGEE answered that is was language very similar to that that                                                               
protects child protection workers.                                                                                              
SENATOR LEMAN wanted clarification on how an assisted living home                                                               
was taken over if it was in imminent danger.                                                                                    
MR. WADE replied:                                                                                                               
     In  terms   of  the   court  order,  administration   of                                                                   
     receivership,  you would have  to petition the  superior                                                                   
     court  for temporary administration  or receivership  of                                                                   
     the home, in which case, the  administration of the home                                                                   
     would  be  present  at  that  hearing  to  defend  their                                                                   
     situation. So,  it's not something we can  walk right in                                                                   
     and take  over the home. We  would have to  petition the                                                                   
     court for receivership or temporary administration.                                                                        
SENATOR LEMAN asked what the timeline was for when the department                                                               
decides that needs to be done and when it actually gets done.                                                                   
MR. WADE replied that it is new language and they don't have                                                                    
experience with this procedure. Previously, the options they had                                                                
were to do an emergency revocation of the license. He said:                                                                     
     In  other words,  go in,  serve  a notice  to the  home,                                                                   
     notify  all the residents  and/or their  representatives                                                                   
     and  inform  that the  license  was being  revoke  under                                                                   
     emergency conditions.  The reason, as Ms.  Elgee stated,                                                                   
     was  that in those  situations, it's  very difficult  to                                                                   
     find especially  if you have a large home  with a fairly                                                                   
     large  number  of  residents,  it's very  hard  to  find                                                                   
     alternative places  for them on very short  notice. It's                                                                   
     very difficult  for senior citizens, elders,  anyone, to                                                                   
     make a move like that even though  it's required because                                                                   
     they  are  at  imminent  risk.  So,  the  court  ordered                                                                   
     administration would  allow us to potentially  go in and                                                                   
     take  over temporary  administration of  the home or  at                                                                   
     least allow  enough time for  the residents of  the home                                                                   
     and/or the  families and  their representatives  to look                                                                   
     for alternative placements.                                                                                                
SENATOR LEMAN  said that much of  this was patterned  after things                                                              
in child welfare and he just wanted an understanding.                                                                           
MS. ELGEE  responded that  if this language  was in effect  in the                                                              
instance she  told them  about, they would  have tried to  do some                                                              
court  receivership.  They  worked  for several  months  with  the                                                              
administrator  of the  homes to try  to correct  the problems.  It                                                              
became  obvious that  he  could not  overcome  all the  underlying                                                              
financial  difficulties.  "It's   a  last  resort  effort  and  we                                                              
wouldn't be  attempting the other kinds  of things that  we can do                                                              
in terms of working with the homes first."                                                                                      
MR. SHELBY LARSON, Administrator,  Health Facilities Licensing and                                                              
Certification,  said they  hadn't had circumstances  like  that in                                                              
the  12 years  he  had  been with  the  agency. They  didn't  have                                                              
similar language either on nursing home licensure.                                                                              
SENATOR  LEMAN  said it  seemed  like  no  one could  answer  that                                                              
question  very well  and  he then  asked Ms.  Elgee  if this  also                                                              
applies to family members who take care of their related family.                                                                
MS. ELGEE answered:                                                                                                             
     In  an assisted  living home  where  the family  resides                                                                   
     along  with the  assisted living  residents, the  family                                                                   
     members  that may not  provide direct  care, but are  in                                                                   
     the home and, therefore, have  access on an unsupervised                                                                   
     basis to the residents, would  also require a background                                                                   
     check unless they're younger than 16.                                                                                      
SENATOR LEMAN asked  about language on page 2,  line 10, referring                                                              
to a  family member  who is maybe  off at  school, but  moves back                                                              
into the  home. Would that family  member, if they were  not there                                                              
and then  moves back  into the  home, be  subject to a  background                                                              
MS.  ELGEE  replied that  the  background  checks would  apply  to                                                              
visitors, and he  could think of that family member  as a visitor,                                                              
who are residing in the home for  more than 14 days. A student who                                                              
is residing  in  a home for  the summer  would be  subject to  the                                                              
background check, as well.                                                                                                      
SENATOR LEMAN  said he thought to  think about that area  a little                                                              
bit more.                                                                                                                       
MR. ELMER LINDSTROM, Special Assistant  to the Commissioner, DHSS,                                                              
said  they  had  a  memo  to  him  from  Mr.  Larson  relating  to                                                              
background  checks in  nursing homes.  They did  not suggest  that                                                              
background  check  information  be   added  to  the  nursing  home                                                              
statute,  but it  has been  Mr. Larson's  intention  to adopt,  in                                                              
regulation,  the same background  check  standards that they  have                                                              
now developed  for assisted living and  in order to do  that, they                                                              
would need some statutory revisions  for the nursing home statutes                                                              
that are parallel  to those already included in  the bill relative                                                              
to assisted living homes.                                                                                                       
CHAIRWOMAN GREEN said they would continue to work on this bill.                                                                 
MR.  RON   PARKS,  Housing   Administrator,  Friendship   Services                                                              
Assisted Living, said they were a  nonprofit organization and used                                                              
volunteers.  The  fingerprint  requirements   would  add  $94  per                                                              
volunteer to  their budget,  which they  can't afford.  Every year                                                              
they have 50 - 60 volunteers come  through their establishment. He                                                              
asked them to  clarify the difference between  a regular volunteer                                                              
and  an  occasional volunteer.  In  Section  2,  line 10,  he  was                                                              
concerned specifically when volunteers  are in direct contact with                                                              
staff  and  how  that  would  work  with  church  groups  that  do                                                              
fellowship with some of his residents.  He was concerned that they                                                              
might be overprotecting  the residents and violating  their rights                                                              
if they want  to invite one of  those persons into their  rooms to                                                              
have their services.  He wanted to know when they  would come into                                                              
violation as far as a criminal background check.                                                                                
CHAIRWOMAN  GREEN asked  Ms. Elgee  and  Mr. Lindstrom  to see  if                                                              
there was a better definition and  if regulations would cover that                                                              
more clearly that the language before them.                                                                                     
MR.  PARKS said  he  had a  hard time  understanding  some of  the                                                              
terms. He asked if they could define 'contractor.'                                                                              
MR. LINDSTROM  replied  that the  exceptions in  Section 3  say it                                                              
doesn't  include a  contractor  who  comes into  the  home who  is                                                              
telephone repairman  repairing utilities.  A contractor  is really                                                              
people who  are providing services  to the residents in  the home,                                                              
not a contractor in the sense of a building repairperson.                                                                       
CHAIRWOMAN GREEN  asked if  a contractor could  be a  therapist or                                                              
someone who provided food services.                                                                                             
MR. LINDSTROM replied yes. In his  department, for instance, there                                                              
would  be other  Health  and Human  Services  providers who  would                                                              
likely be  contractors providing  services to  people in  the home                                                              
and that is what they are speaking to.                                                                                          
CHAIRWOMAN GREEN asked  if those people weren't  already under the                                                              
requirement of a background check.                                                                                              
MR.  LINDSTROM replied  that  some  of them  might  already be  by                                                              
virtue of licensure requirements,  but he couldn't say that all of                                                              
them would be.                                                                                                                  
CHAIRWOMAN GREEN asked if that helped Mr. Parks.                                                                                
MR.  PARKS replied  that helped  him  somewhat and  asked if  they                                                              
could change  "regular volunteers"  to "care providers".  He asked                                                              
since these  people are coming into  his facility, since  he can't                                                              
use other  agency's background checks  for their purposes,  does a                                                              
health care provider who comes into  a room and closes the door to                                                              
take blood for blood work need to have a background check?                                                                      
MS. ELGEE responded  that Section 3 (2) specifically  exempts from                                                              
the background  check requirement  an individual who  is providing                                                              
services  to the  resident  as an  employee  of  a care  providing                                                              
entity that is not affiliated with the assisted living home.                                                                    
CHAIRWOMAN GREEN asked if this could be an RN or a doctor.                                                                      
MS. ELGEE  said the  example of  a physical  therapist was  a good                                                              
one.  They contract  with  physical  therapists  in the  Pioneers'                                                              
Homes, but  the physical  therapist is  usually affiliated  with a                                                              
hospital or another medical practice.                                                                                           
MR. PARKS  asked if they are  already health care  providers, they                                                              
already have their own background checks.                                                                                       
MS. ELGEE  responded that  the assisted living  home would  not be                                                              
required  to  provide  a  background  check as  a  part  of  their                                                              
licensure for those individuals.                                                                                                
MR. PARKS  said the volunteer program  is very important  in their                                                              
facility  and are important  in their  socialization programs  and                                                              
getting people out. The wording in  SB 67 in regards to volunteers                                                              
would be  so restrictive that it  would cripple their  program and                                                              
he  asked  if language  could  be  put  in  that would  cover  the                                                              
background checks for their volunteers.                                                                                         
MR. WARD  responded  that Mr. Parks  had some  good questions.  He                                                              
said  there was  quite a  bit of  discussion about  them. The  key                                                              
piece in terms of  volunteer, is if the volunteer  was going to be                                                              
in direct  contact with a  resident in an unsupervised  situation.                                                              
Groups  from schools  and groups  to  provide entertainment,  etc.                                                              
would probably  be in  a public  area in  a situation where  staff                                                              
would be in  close proximity and  those would not be subject  to a                                                              
background check. They are most concerned  about an individual who                                                              
is  coming  in on  a  one on  one  basis.  He thought  the  larger                                                              
percentage of volunteers would not  be required to have background                                                              
MR. PARKS  said their senior  companion program could  be arranged                                                              
in  a public  area  where  staff is  present,  but  if a  resident                                                              
invites someone  they have befriended  into their room  where they                                                              
have the right  to close the door  if they wish, this  is the main                                                              
gray area of his concern.                                                                                                       
CHAIRWOMAN GREEN said there was nothing  in their fiscal note that                                                              
would cover the cost of background checks.                                                                                      
MS.  ELGEE   said  that   was  right.   The  individuals,   before                                                              
employment, are asked  to get the name check and  they cover those                                                              
costs. They cover the costs for people in the Pioneer Homes.                                                                    
MR. PARKS  agreed that they do  cover the cost for  employees, but                                                              
criminal background checks are very  restrictive. Just fingerprint                                                              
checks are $94 and he doesn't have that in the budget.                                                                          
CHAIRWOMAN  GREEN said  she  hoped they  could  work through  this                                                              
problem  and not  have it  burdensome  to the  people who  provide                                                              
services and set SB 67 aside.                                                                                                   
CHAIRWOMAN GREEN said  that SB 86 would not be heard  today at the                                                              
request of the Chair.                                                                                                           
                    SB  94-EDUCATION FUNDING                                                                                
CHAIRWOMAN GREEN announced  SB 97 to be up for  consideration. She                                                              
announced a brief at ease.                                                                                                      
TAPE 01-23, SIDE B                                                                                                            
SENATOR TAYLOR, sponsor, said he  first filed aspects of this bill                                                              
as  amendments submitted  by Ron  Larson in  1986 and  87 as  they                                                              
tried to change  an inequitable formula for funding  education. It                                                              
was  his intention  that all  residents  of Alaska  who pay  taxes                                                              
towards  education would  share the  same  level of  pain and  the                                                              
funds would be  distributed throughout the state  and every school                                                              
district would receive benefit.                                                                                                 
He said  in Wrangell,  they pay  almost 9  mils of local  property                                                              
taxes to support education and he  considered this a low level. He                                                              
didn't think that  there were any nurses in his  schools and there                                                              
weren't coaches  in his  elementary schools.  There were  no music                                                              
programs  or  art programs.  This  is  because of  an  inequitable                                                              
formula that  grants area cost  differentials to  school districts                                                              
across  the  state,  but  basically   leaves  all  of  the  school                                                              
districts  in Southeast  Alaska, with  a very  small exception  in                                                              
Juneau, at the same funding base that Anchorage receives money.                                                                 
Anchorage  has  almost half  of  the  children  in the  state,  so                                                              
through   volumes   of  scale   their   school   board  can   make                                                              
discretionary   appropriations  to   other  activities   in  their                                                              
community  from their school  district budget.  His school  boards                                                              
wrestle with the  question of maintaining the one  or two janitors                                                              
they have when  they used to have  five or six or do  they have to                                                              
"can"  another one  of  them. He  said  they are  receiving  about                                                              
$7,000 per student  in Wrangell. The North Slope  Borough receives                                                              
$21,000 per  student and has a student  teacher ratio of  10 to 1.                                                              
He has about 18 to 1.                                                                                                           
He explained that  under the bill before them, every  child in the                                                              
North Slope Borough  will receive an increase in  funding, so will                                                              
every  child in  Wrangell.  Anchorage  would receive  the  largest                                                              
increase in funding. Senator Taylor explained:                                                                                  
     This  bill   increases  funding  across  the   board  to                                                                   
     education  by  over  $47 million.  It  carries  a  state                                                                   
     fiscal  note  against  the general  fund  of  about  $29                                                                   
     million,  maybe $27 million.  There is  no bill that  is                                                                   
     before you or  that has been submitted so  far that will                                                                   
     cost the general fund less money  than this one does nor                                                                   
     is there  any bill that  will distribute this  amount of                                                                   
     money to the  children of Alaska. How do we  do that? We                                                                   
     do  that by  expecting every  citizen in  the state  who                                                                   
     lives in  a tax-based district  to pay the  same minimum                                                                   
     amount.  Forty-eight  school  districts  in  this  state                                                                   
     today either have full support  or provide local support                                                                   
     themselves.  They provide that  support up to  a minimum                                                                   
     of 4 mils.  Each of you three members live  in tax-based                                                                   
     communities where you are paying  a minimum of 4 mils on                                                                   
     your home  or other  property you own  in your town  and                                                                   
     that  4 mils has  to be  dedicated by  the community  of                                                                   
     Anchorage,  the community  of Palmer,  the community  of                                                                   
     Wasilla, the  community of Wrangell, we all  have to pay                                                                   
     a minimum of  4 mils before we receive one  thin dime of                                                                   
     money  from the  state of  Alaska. So,  that's the  rule                                                                   
     under which all of us have to play.                                                                                        
     If you're  a wealthy  district and you  have a tax  base                                                                   
     that is  just extraordinary, you  don't have to  play by                                                                   
     that  rule. You  get to play  by a  different rule.  You                                                                   
     only have  to pay  45 percent of  the cost of  educating                                                                   
     your children.  You don't have  to pay 4 mils.  All this                                                                   
     bill does is it asks that everyone  in the state play on                                                                   
     the same playing  field - that everybody pays  4 mils on                                                                   
     their  house towards  education. It  doesn't seem to  me                                                                   
     like a lot to ask.                                                                                                         
     What  does that  do to  your formula?  That allows  you,                                                                   
     because you would not be subsidizing  with state general                                                                   
     fund  money the  North  Slope Borough  and  a couple  of                                                                   
     other school  districts in this state fully.  They would                                                                   
     be paying  their own  cost of  education and they  don't                                                                   
     even come near 4 mils….                                                                                                    
SENATOR  TAYLOR  explained  that  Section 1  modifies  the  Public                                                              
School  Account that  is  already set  up  by including  municipal                                                              
contributions within  it. It would  be a contribution  returned to                                                              
the  state by  a municipality  that had  so much  money left  over                                                              
after paying  the minimum amount that  each of you pay,  that that                                                              
money would be redistributed back  through this formula for poorer                                                              
tax-based districts.                                                                                                            
Section  2  says the  state  of  Alaska  will receive  credit  for                                                              
federal impact  aid funds that are  received by REAAs.  Today they                                                              
receive  100 percent  of the  money  that comes  from the  federal                                                              
government,  but the  state is  requiring  them to  only count  90                                                              
percent of  it. "So,  basically, they receive  a 10 percent  slush                                                              
fund from the feds over and above  the amount of money we're going                                                              
to send to them."                                                                                                               
SENATOR TAYLOR  said that the only  thing he has asked  is for all                                                              
the dollars to be  counted 90 - 100 percent. The  other numbers in                                                              
the section  would provide for  both vocational education  special                                                              
needs funding. At the bottom of the  second section the words "not                                                              
to exceed  45 percent  of" [a district's  cost of education]  from                                                              
the existing formula. This provides  then for the full amount of 4                                                              
mils to be redistributed back across the state.                                                                                 
He said the next section provides  for the money that is left over                                                              
or excess to come back into this  formula that will distributed as                                                              
indicated in Section 3.                                                                                                         
SENATOR TAYLOR  said he  had heard  concerns expressed  across the                                                              
state  by  educators   and  others  especially   in  the  business                                                              
community,  that  the state  isn't  spending  very much  money  on                                                              
vocational  education. He said  that the  state isn't spending  it                                                              
because  when SB  36 passed,  they  provided 20  percent over  and                                                              
above what people get in the regular  formula for gifted children,                                                              
young children  that are challenged  or having some  difficulties,                                                              
bi-lingual programs and voc-ed. They  were all rolled into one and                                                              
the districts had to figure out how to spend it.                                                                                
     Because of federal mandates,  the legislation where they                                                                   
     are required  to provider certain levels of  funding and                                                                   
     certain  types  of  programs   for  those  of  our  most                                                                   
     challenged  students, the  vast majority  of this  money                                                                   
     gets eaten  up for those programs.  A little bit  may be                                                                   
     there for bi-lingual  and what's left over  may be there                                                                   
     available for  a voc-ed program. As a  consequence, what                                                                   
     I've done  here is  I have provided  a specific  funding                                                                   
     level  for voc-ed at  3 percent.  These numbers, by  the                                                                   
     way, Madame  Chair, are just  ideas thrown out  for you.                                                                   
     Some are  very fearful  of categorically funding  voc-ed                                                                   
     because they  say every other  program, then,  will want                                                                   
     to come  in and  have a specific  funding category  just                                                                   
     like  voc-ed does  and that  we should  not fund  voc-ed                                                                   
     because somebody  else might come  and ask for  the same                                                                   
     thing. I think  if it's justifiable, maybe  we should be                                                                   
     specifically  and categorically  funding or else  you're                                                                   
     never going to get it.                                                                                                     
     An amendment  that I  wish to offer  as this bill  moves                                                                   
     through is  to also add  categorical funding  for school                                                                   
     nurses. That's  the only way I believe I can  ever get a                                                                   
     school  nurse  back  into any  district  school  that  I                                                                   
He said  he would  probably add  that back  into Section  4, which                                                              
provides  for voc-ed  funding. Section  5 is  just cleanup  adding                                                              
that  new  section.  Section  6   brings  the  formula  back  into                                                              
compliance with the numbers that have been provided for voc-ed.                                                                 
     Section   8  is  what   we  call   the  declining   fund                                                                   
     adjustment. For  the last five or six years  across this                                                                   
     state, we  have seen declining enrollments  occurring in                                                                   
     various  communities. For  the first  time, I think,  in                                                                   
     several years,  we're now seeing an overall  increase in                                                                   
     student  population  estimates and  that's  why for  the                                                                   
     first time  in several years we're seeing  an indication                                                                   
     that the  formula will actually  have to go up  by about                                                                   
     $10 million  next year  just to fund  at the same  basic                                                                   
     level  that you  currently have  that  formula set.  For                                                                   
     those  schools,   however,  that  are   still  suffering                                                                   
     declining enrollments, under  this formula - you are all                                                                   
     familiar with the Wrangell Petersburg  problem - because                                                                   
     of student declines causing  major shifts in the way the                                                                   
     funding levels  are applied,  it can have a  devastating                                                                   
     impact on a district to just  loose a very few students.                                                                   
SENATOR  TAYLOR said  he decided  to submit  a bill  that said  it                                                              
doesn't matter what the decline is,  whether it's only one student                                                              
or 10  students, it  shouldn't make any  difference. It's  still a                                                              
loss of funding for that next year. He explained further:                                                                       
     So rather than have a school  district fall off a cliff,                                                                   
     what we've  provided for here  is that even  though that                                                                   
     child wasn't  there the next  year, the school  district                                                                   
     would still receive 75 percent  funding for that phantom                                                                   
     child. The next year after that  it would be 50 percent,                                                                   
     the next  year 25 percent and  then zero. That  would at                                                                   
     least  allow school  boards  the opportunity  to  adjust                                                                   
     those budgets on a much gentler slope…"                                                                                    
He said that Sitka lost 140 students  last year and the impacts on                                                              
their budget are so severe that they're  contemplating terminating                                                              
14 - 17 staff people.                                                                                                           
He said that  Section 9 is the  most expensive part of  this bill.                                                              
He went with  $4,150 to apply to  all students across the  state -                                                              
an  increase  of  $210.  Section  10  provides  for  the  Wrangell                                                              
Petersburg "fix" and  drops the number from 750 to  400 on student                                                              
count for a school  funding formula for three  funding schools. In                                                              
Wrangell and Petersburg,  he said, they have three  buildings, but                                                              
are under  a funding formula mechanism  that funds them  for as if                                                              
they were only two.                                                                                                             
Section 11  repeals the  40 percent  penalty provision,  where new                                                              
students  moving  into  a  rural school  district,  which  as  its                                                              
enrollment increased would only receive  60 percent of the funding                                                              
that student would have brought under the old formula.                                                                          
     I  believe  that  provision   is  illegal.  I  think  it                                                                   
     violates equal  protection and I think sooner  or later,                                                                   
     we in  the legislature  are going to  be sued over  that                                                                   
     one and when we do I don't think  we have a leg to stand                                                                   
CHAIRWOMAN  GREEN said  she  had vaguely  remembered  some of  the                                                              
rationale and had also voted against SB 36.                                                                                     
Number 1584                                                                                                                     
SENATOR WARD asked how this bill affected charter schools.                                                                      
SENATOR  TAYLOR  replied  that  it doesn't  affect  them,  but  it                                                              
provides  additional  funding. He  added  that he  was  frustrated                                                              
because the old formula contains  an area cost differential, which                                                              
was based  upon studies done  of what it  cost to live  in various                                                              
areas  of the  state.  He does  not want  to  provide for  another                                                              
study,  but  he  wanted  to  tell   the  Department  of  Education                                                              
professionals  who actually  audit  every  single school  district                                                              
every year to go out and use consumer  price indexing and give the                                                              
legislature  an objective  report of  what it  truly costs  in the                                                              
various   regions  and   communities   and   adjust  the   formula                                                              
accordingly. He said this had never  been done. This would be done                                                              
every two years.                                                                                                                
He recollected that  rationale for the 40 percent  concept came up                                                              
because  no one could  understand  how the numbers  had gotten  so                                                              
distorted that  some school districts  were receiving  $20,000 per                                                              
student and others were receiving  $6,000. "When you actually look                                                              
at  the  formula,   much  of  it  is  driven  by   the  area  cost                                                              
differential that  everything is multiplied against at  the end of                                                              
the formula."                                                                                                                   
SENATOR TAYLOR said that this redistributes  and appropriates over                                                              
$47 million for  kids. "I know that is a huge  amount, but it also                                                              
the lowest amount  from the general fund of any of  the bills that                                                              
you'll be presented with this year…."                                                                                           
He said that the poorer communities  of California were faced with                                                              
the same  problem about 12  years ago. Poor agricultural  families                                                              
used  the  equal  protection  argument  and asked  why  they  were                                                              
getting  paid a certain  amount for  education,  but the ones  who                                                              
were rich in Hollywood were getting  paid more. The judge couldn't                                                              
find a  good reason for  it other than  power politics.  "The same                                                              
thing has happened to us…."                                                                                                     
MR. CARL  ROSE, Executive Director,  Association of  Alaska School                                                              
Boards, opposed  SB 94. They do  not positioned to scaling  back a                                                              
system  of education  for  some to  provide  more  for others.  He                                                              
thought that repealing the funding  floor was a critical issue. He                                                              
     My recollection  of SB 35 is similar in some  cases, but                                                                   
     different in  others. As I recall the  discussion behind                                                                   
     SB  36 was  to  first provide  equity  across the  state                                                                   
     through  a  distribution  of  funds and  once  that  was                                                                   
     accomplished,  we would address  adequacy. I'm  not sure                                                                   
     that equity was accomplished,  but nonetheless, that was                                                                   
     the reason  for the  passage of that  bill and we  still                                                                   
     struggle  with adequacy.  The  issue back  then was  the                                                                   
     redistribution  of state  funds.  The issue  with SB  94                                                                   
     once again is a redistribution of funds…                                                                                   
He said  he served on  a task force  that dealt with  the adequacy                                                              
that was  required under  SB 36.  He was  concerned that  they had                                                              
never recognized  that PL874  dollars were in  lieu of  taxes, but                                                              
now they are  being told that 100  percent of that money  will now                                                              
be withheld  in lieu  of taxes.  He didn't  know why people  would                                                              
file for that money if they get no  benefit from it, other than to                                                              
create a huge  hole in the foundation formula if  those monies are                                                              
not generated.                                                                                                                  
MR. ROSE did not recommend that as  a strategy, because they loose                                                              
on both ends  of that argument. The reason people  will eventually                                                              
apply for this money  is because they get some credit  for it as a                                                              
result of the 90 percent deduct.  He said there is a long-standing                                                              
state policy  that said that four  school districts -  North Slope                                                              
Borough, Valdez, Unalaska and Skagway  - were an anomaly. "We were                                                              
trying to  create a  foundation formula for  the entire  state and                                                              
didn't know  how to  deal with  the anomaly  of wealth divided  by                                                              
In the case of Skagway, when the  railroad shut down in 1983, they                                                              
were left  in an  economic disaster,  but they  created a  tourism                                                              
corridor and  as a result  of that effort  they have a  deep water                                                              
port, an ore  terminal, hotels, a railroad and  a thriving tourism                                                              
economy. Six-hundred  people live in Skagway full-time  and if you                                                              
take all  of that  wealth and divide  it by 600  and it  puts them                                                              
into a different  category. They mayor of Skagway  was there under                                                              
the SB 36 discussion and said that  back then they were paying the                                                              
in excess of  53 percent of the school district  budget. He didn't                                                              
know what  the current figures were,  but he guaranteed  them that                                                              
the 45 percent figure they are under  is being exceeded. They have                                                              
the ability  to pay more and  they have. "These  school districts,                                                              
though this provision is a long standing  public policy, this is a                                                              
radical change and a redistribution  and I don't think many people                                                              
have had a chance to really think about it."                                                                                    
MR. ROSE  said he supports  vocational education. That  was talked                                                              
about  in the  20 percent  categorical funding  that was  provided                                                              
under  SB 36  for  special  education, bi-lingual  and  vocational                                                              
     An argument  can be made  equally well, if  you're going                                                                   
     to take vocational education  out and fund that, we have                                                                   
     tremendous  special education  needs  that aren't  being                                                                   
     met. The money that goes to  special education is coming                                                                   
     directly  out of  regular instruction  dollars. So,  the                                                                   
     issue  of the 20  percent, to  begin with,  is a  larger                                                                   
     issue  than  just  the  vocational  education.  I  don't                                                                   
     begrudge vocational education  being treated separately,                                                                   
     but special ed and bi-lingual  education are also paying                                                                   
     a price as well.                                                                                                           
MR. ROSE  said has  seen many  foundation rewrites  and he  agrees                                                              
with some of the  studies. SB 36 was based on a  study, but it was                                                              
based largely on expenditure data  from 1996 and to his knowledge,                                                              
school districts were  getting and spending all that  they had and                                                              
it was inadequate.  "To take that snapshot and  project it forward                                                              
into a new foundation formula left us further behind."                                                                          
The funding  task force  recognized that  they actually  need good                                                              
empirical data  so they can  make changes. They  specifically said                                                              
they  would  not  encourage  any   more  changes  to  the  current                                                              
foundation formula  until they had  the empirical data  that would                                                              
underwrite  those decisions.  To turn  over to  the Department  of                                                              
Education and  Early Development  the responsibility of  coming up                                                              
with  an appropriate  cost factor  without anything  to hang  that                                                              
decision on subjects them to quite a bit of lobbying.                                                                           
     My main concern  in all this is we're talking  about all                                                                   
     the things  we didn't agree with  SB 36 and we  tried to                                                                   
     deal with  it then  and we couldn't  get there.  I think                                                                   
     what SB  94 does is brings  all that back to  the table,                                                                   
     again, but  it's not doing it  in an open  fashion. What                                                                   
     we're talking  about is  redistribution of wealth  here.                                                                   
     And so, I  do have some concerns and I'm  also sensitive                                                                   
     to the  concerns that have  been expressed for  Wrangell                                                                   
     and Petersburg  and I agree  with these. In  fact, these                                                                   
     were part of the discussion  under SB 36 that didn't get                                                                   
     through. I don't  think I come before you to  say I just                                                                   
     want to trash  on this bill. That's not the  case. But I                                                                   
     think  what we're  doing is  we're  changing some  long-                                                                   
     standing  policies  in  this   state  in  how  we  treat                                                                   
     districts  that are a  fiscal anomaly  with the rest  of                                                                   
     our districts. We're going to  change that policy in one                                                                   
     fell swoop and redistribute that money.                                                                                    
     Without   the  recapture  clause   that  would   require                                                                   
     districts to pay  back, you don't have the  money to pay                                                                   
     for this bill.  So, I would just want to  talk about the                                                                   
     recapture. The  way you get  the money for this  bill is                                                                   
     take from those who are struggling  right now and I know                                                                   
     you will  say that  the North Slope  has a lot  of money                                                                   
     along with  Valdez, Unalaska  and Skagway, but  it's the                                                                   
     plight  that  they  have  and  they  are  struggling  to                                                                   
     provide  an education  as it  right now.  To alter  that                                                                   
     ability   for   those   school   districts   simply   to                                                                   
     redistribute  the money, what we  need is a  increase of                                                                   
     funding  for  the  purpose  of  educating  our  children                                                                   
     state-wide.  So,  any time  that  we  start to  look  at                                                                   
     increasing funding for education  to try and imbed these                                                                   
     standards that we're trying  to do, it requires an awful                                                                   
     lot of need  that needs to be addressed.  The suggestion                                                                   
     comes to me  that we're just throwing more  money at the                                                                   
     problem. I  don't believe that. We've never  invested in                                                                   
     the  cure. There  is  a solution  and  it  was going  to                                                                   
     require  us   to  align  our  systems  to   provide  the                                                                   
     professional  development that we  need and assist  kids                                                                   
     with  intervention to  help them  take and  successfully                                                                   
     pass  their exam.  We've done  all this  and we  haven't                                                                   
     made the investment.                                                                                                       
MR. ROSE  said they  would  like to work  on a  funding bill  that                                                              
meets the needs of all Alaska's students.                                                                                       
Number 655                                                                                                                      
SENATOR DAVIS  asked him to elaborate  on why those  districts are                                                              
struggling to pay for education.                                                                                                
MR. ROSE replied that he could speak in the case of Skagway:                                                                    
     The amount of  money that they receive in  Skagway, even                                                                   
     under  this   bill,  they  would  loose   an  additional                                                                   
     $65,000.  I  think  that  their   budget  right  now  is                                                                   
     somewhere in  the area of $1.3 million and  they receive                                                                   
     about  $800,000 from the  state. So,  a good portion  of                                                                   
     that money already comes locally.  Local contribution is                                                                   
     severe,  but they have  the money  and they readily  put                                                                   
     forward what they  can. It's not that they  have an open                                                                   
     checkbook;   they   are  limited   to   what  they   can                                                                   
CHAIRWOMAN GREEN said they would  look this year at how they could                                                              
make improvements in education funding. She set the bill aside.                                                                 
          SB  91-ABORTION: INFORMED CONSENT;INFORMATION                                                                     
CHAIRWOMAN GREEN announced SB 91 to be up for consideration.                                                                    
MS. SANDY ALTLAND, staff to Senator  Ward, sponsor, explained that                                                              
SB 91 provides  more information to people who  are considering an                                                              
abortion. It asks  the Department of Health to  prepare a handbook                                                              
with the  information that is  needed. Some people  have emotional                                                              
problems after a  procedure and more information  in the beginning                                                              
might help them.                                                                                                                
MS. NANCY DAVIS, Acting Director,  Division of Public Health, said                                                              
she  was  presenting  the prepared  testimony  of  Karen  Pearson,                                                              
Director as follows:                                                                                                            
     The Division  of Public Health supports what  appears to                                                                   
     be  the intent  of  this bill  insuring  that all  women                                                                   
     seeking a  abortion are fully informed prior  to signing                                                                   
     consent  for the  procedure to  be done.  Since this  is                                                                   
     currently  required  to  any  surgical  procedure  being                                                                   
     performed  and is  considered essential  by the  medical                                                                   
     provider and  the advocate communities, we  question the                                                                   
     need for a law specific to the abortion procedure.                                                                         
     I believe  we are in  agreement that each  woman seeking                                                                   
     an  abortion  needs  information   about  the  physical,                                                                   
     emotional, psychological and  medical risks and benefits                                                                   
     of  the procedure  them personally.  This bill seeks  to                                                                   
     address this need by requiring  each women be provided a                                                                   
     detailed   and   lengthy  informational   document   and                                                                   
     requiring  that the  provider  have the  patient sign  a                                                                   
     form  indicating  she  has   read  and  understands  the                                                                   
     information in the document and its relevance to her.                                                                      
     Some  women would  find such  material information,  but                                                                   
     many who  are of  low literacy,  illiterate or for  whom                                                                   
     English is  a second language  would not be  served well                                                                   
     by  this  process.  Many individuals  who  have  reading                                                                   
     problems are very skilled at  hiding those problems from                                                                   
     those with  whom they interact.  Thus, it could  be very                                                                   
     difficult  for a provider  to ascertain  surely or  with                                                                   
     any  degree  of  certainty  that  a woman  to  whom  the                                                                   
     written  materials were  provided was  actually able  to                                                                   
     read and comprehend the information.                                                                                       
     Providers  are  accustomed   to  explaining  procedures,                                                                   
     risks,  and  benefits relative  to  medication  options,                                                                   
     treatment options of all kinds  and being able to follow                                                                   
     up on  questions and  concerns as  they arise. They  are                                                                   
     used  to tailoring  the information  given  to meet  the                                                                   
     specific  needs of  the patient  being  seen. There  are                                                                   
     many  individual  health issues  that  a physician  must                                                                   
     address with  each patient no matter what  the procedure                                                                   
     that will be performed. These  needs are not well served                                                                   
     when large  volumes of written  information that  may or                                                                   
     may  not be  relevant to  that  individual are  required                                                                   
     first in order to verify that  a person is informed. The                                                                   
     language,  culture, age  and other  relevant factors  of                                                                   
     the  woman  must  be considered  when  deciding  how  to                                                                   
     provide information  in the most usable form  and manner                                                                   
     and  only  the provider  working  with the  patient  can                                                                   
     determine those individual needs.  There are substantial                                                                   
     costs  as reflected in  the fiscal  note related to  the                                                                   
     Department   of  Health   and   Social  Services   staff                                                                   
     compiling  and  keeping  current   lists  of  providers,                                                                   
     agencies  and  organizations   in  each  community  that                                                                   
     provides  support,  aid  or  other  services  for  women                                                                   
     contemplating  parenting,  adoption or  abortion.  Local                                                                   
     communities are  well-versed in local resources  and are                                                                   
     better   able  to  keep   the  information  current   at                                                                   
     significantly  lower costs. Thus,  if these booklets  do                                                                   
     not significantly  improve the process of  informing the                                                                   
     patient, and  we believe they will not, then  this money                                                                   
     could  perhaps be  used to  fund needed  services or  to                                                                   
     educate  women  about  avoiding  unintended  pregnancies                                                                   
     and, thus, avoiding contemplating having an abortion.                                                                      
TAPE 01-24, SIDE A                                                                                                            
CHAIRWOMAN  GREEN  asked  if  they generally  refer  people  to  a                                                              
physician, if possible.                                                                                                         
MS.  DAVIS  answered  that the  Public  Health  Division,  through                                                              
several different divisions, encounters  women who are pregnant or                                                              
seeking a  pregnancy test.  Through some  of their grantees,  that                                                              
encounter is  made through public  health nurses in  public health                                                              
centers  at the  local level.  They  do not  provide any  abortion                                                              
services at public health centers  or by public health staff. They                                                              
refer clients  to whatever  services they need  or seek.  She said                                                              
further that  public health services  are primarily  preventive in                                                              
nature and for on-going prenatal  care or other things, they refer                                                              
them to an on-going provider.                                                                                                   
MS. IDA  BARNICK, Alaskans  for Life, Inc.,  supported SB  91. She                                                              
said, "Medical  and scientific  fact have  proven that  human life                                                              
begins at conception."                                                                                                          
This is extremely  important for a woman who is  contemplating the                                                              
life of her unborn child to understand what she is doing.                                                                       
     Therefore,  she  deserves to  know  the age,  the  fetal                                                                   
     development of her unborn child,  possible psychological                                                                   
     effects that  she might experience if she  ends the life                                                                   
     of  this child  and she  needs  to know  what the  other                                                                   
     options  to abortion  or other  community services  that                                                                   
     can  help her if  she decides  to let  her unborn  child                                                                   
     live.  She  should  never  be  coerced  into  having  an                                                                   
     abortion.  She should  be required  to sign a  statement                                                                   
     that she was given the information…                                                                                        
MS. BARNICK said  this is the same procedure she  would have to go                                                              
through  if she  were  going  to have  any  other major  or  minor                                                              
medical procedure.  If English is  the second language,  she would                                                              
usually  have  an  interpreter  with  her  who  will  explain  the                                                              
information.  She also  didn't think  it was unusual  for a  state                                                              
agency  to have to  provide brochures  to the  public for  various                                                              
things and she didn't believe it would cost that much.                                                                          
Number 460                                                                                                                      
MS.  KAREN VOSBURGH,  Executive Director,  Alaska  Right to  Life,                                                              
said she didn't  understand the opposition by  pro-abortion forces                                                              
to allow  women to have full  and informed consent. She  has found                                                              
that  when women  are considering  abortion,  very little  factual                                                              
information  is  actually  given.  She  said there  are  over  100                                                              
potential  physical complications  associated  with abortion.  She                                                              
presented some  abortion statistics for Great Britain  saying that                                                              
she new women were not aware of these.  She said that many studies                                                              
have connected breast cancer and  abortion and have also connected                                                              
it with the pill.                                                                                                               
     According   to  Calinborn  (ph),   based  on  the   most                                                                   
     comprehensive   medical  evidence   available,   induced                                                                   
     abortion   and  the   birth   control   pill  are   both                                                                   
     independent  root  factors  for  development  of  breast                                                                   
     cancer. This risk is especially  great if the women have                                                                   
     participated in either of these  factors at a young age…                                                                   
She said  that despite  evidence of the  dangers of breast  cancer                                                              
from abortions  and contraceptive use, "abortion  clinics continue                                                              
to  promote  abortion  on  demand."  She  said  that  evidence  of                                                              
psychological damage from having abortion is overwhelming.                                                                      
Number 825                                                                                                                      
MR.  BOB  LYNN,  President,  Alaskans  Right to  Life,  said  that                                                              
passing a statute mandating informed  consent is not about whether                                                              
abortion should or should not be  legal or available or who should                                                              
pay  for it.  "My concern  today is  nothing more  than a  woman's                                                              
right to know  the facts about any medical procedure  including an                                                              
abortion procedure before consenting to it."                                                                                    
He said that  informed consent is  routine. If women knew  some of                                                              
the  risks of  abortion,  she might  not  consent.  He noted  that                                                              
abortion providers only get paid when a woman decides to abort.                                                                 
MR. LYNN  said that  he sells  real estate  and that everyone  who                                                              
sells a house must provide a disclosure statement to buyers.                                                                    
     Likewise, Alaska  Right to Life  thinks that  anyone who                                                                   
     sells  an  abortion should  provide  the buyer  of  that                                                                   
     abortion with  a full disclosure of facts.  So there was                                                                   
     informed consent  before the woman buys the  abortion. I                                                                   
     hope the legislature  thinks that the health  of a woman                                                                   
     is more important than the health of a house.                                                                              
DR. COLLEN MURHPY,  Anchorage Obstetric Gynecologist,  said she is                                                              
Board certified  by the American  College of OBGYN. She  wanted to                                                              
reassure the audience and said:                                                                                                 
     The  standard  procedure  for  medical  practice  is  to                                                                   
     provide  informed  consent.   It  currently  constitutes                                                                   
     excellent patient care. It is  currently required by all                                                                   
     professional  organizations under  all circumstances  be                                                                   
     it for a medical or a surgical  procedure of any nature.                                                                   
     Likewise, our professional ethical  standards require it                                                                   
     and  furthermore  the  lawyers  demand it.  I  will  say                                                                   
     repeatedly  again   and  again,  that   this  particular                                                                   
     attempt at informed consent  is not required under state                                                                   
     law. This  is something that  is done in the  privacy of                                                                   
     the  office  with  an  individual   patient  and  client                                                                   
     talking about  the serious nature  of a condition  be it                                                                   
     related to  abortion, a hysterectomy, a colposcopy  or a                                                                   
     gall  bladder surgery.  For the legislature  to step  in                                                                   
     between  the  privacy  of  a patient  and  a  doctor  is                                                                   
     inappropriate. We are practicing  medicine and this does                                                                   
     not need to be legislated.                                                                                                 
DR. MURPHY disagreed with the preceding  scientific information by                                                              
someone describing breast cancer.  That is not scientific fact and                                                              
is a subjective  evaluation. She also wanted to  discuss what they                                                              
could do about the tragedy of unintended pregnancy in Alaska.                                                                   
     Currently, 60  percent of pregnancies are  unintended in                                                                   
     Alaska. It  is estimated that half of  those pregnancies                                                                   
     will go to termination of pregnancy.  The other half may                                                                   
     miscarry or become  live born. Some women  will elect to                                                                   
     adopt them  out. If we truly  want to decrease  the need                                                                   
     or the request  for abortion, we should be  directly our                                                                   
     attention  towards  decreasing  the  reasons  unintended                                                                   
     pregnancy occurs  in Alaska. Rather than  fighting about                                                                   
     informed  consent,  which  is  something  that  is  done                                                                   
     privately  between  a trained  medical  provider when  a                                                                   
     surgical condition  is being considered with  a patient.                                                                   
     I would suggest that we direct  our attention, just like                                                                   
     the World  Health Organization has suggested  elsewhere.                                                                   
     The best  way to  decrease the  need for termination  of                                                                   
     pregnancy   is   to   increase   the   availability   of                                                                   
     contraception. I would challenge  this committee to look                                                                   
     at a  bill that has  currently been proposed  by Senator                                                                   
     Johnny Ellis,  SB 15,  called the prescriptive  fairness                                                                   
     act.  This is  a step  in the  right  direction that  is                                                                   
     concrete, that  everyone can agree  on - that  women who                                                                   
     use contraception  that is reliable and approved  by the                                                                   
     FDA - have a lower risk of unintended  pregnancy and the                                                                   
     need for termination.                                                                                                      
DR. MURHPY said they should spend time doing something that they                                                                
know works rather  than putting women and providers  in additional                                                              
difficulties and expense based on the proposals in this bill.                                                                   
CHAIRWOMAN GREEN said  she had a question from someone  who had to                                                              
leave  earlier,  but  they  refer  to  the term  in  the  bill  of                                                              
"gestational  age",  which is  neither  a medical  nor  scientific                                                              
concept and asked if there was better phrasing.                                                                                 
DR. MURPHY replied that gestational age varies. She explained:                                                                  
     There is  something called Migel's  Rule. It's  when you                                                                   
     find out when the woman's last  menstrual period is. You                                                                   
     add  nine months  plus one  calendar week  and it's  the                                                                   
     estimated date  of confinement. From that,  we calculate                                                                   
     the  supposed  gestational age.  The  average  pregnancy                                                                   
     will  be approximately  40 weeks in  duration. A  normal                                                                   
     term pregnancy will deliver  between 37 and 42 weeks. To                                                                   
     make   a  long   story   short,  menstrual   dating   is                                                                   
     notoriously    inaccurate.   If    you   go   ahead    a                                                                   
     retrospectively  date a  pregnancy based  on the  baby's                                                                   
     size and weight  and appearance at birth,  25 percent of                                                                   
     menstrual  dates  are inaccurate  for  gestational  aged                                                                   
     dating. In  modern obstetrics,  we will often  alter the                                                                   
     dating  of  the  pregnancy   based  on  ultrasonigraphic                                                                   
     findings  in which  we might  go ahead  and measure  the                                                                   
     gestational  sack  size.  We  might  measure  the  crown                                                                   
     growth  points, the fetal  fold, different  measurements                                                                   
     of the  skull or the femur  length. This will  alter the                                                                   
     gestational age such that we  no longer rely on the last                                                                   
     menstrual  period  because a  bleeding  episode did  not                                                                   
     occur  exactly  two  weeks  prior  before  the  egg  was                                                                   
     released from the ovary.                                                                                                   
CHAIRWOMAN GREEN asked if the method  of computing the gestational                                                              
age has been refined through time.                                                                                              
DR. MURPHY  responded that  it no longer  relies on just  the last                                                              
menstrual    period.    "It's   invariably    complemented    with                                                              
ultrasonigraphic and physical exam."                                                                                            
CHAIRWOMAN GREEN asked  if using those methods, was  there a range                                                              
in  which she  could identify  at  what point  of development  the                                                              
unborn child is.                                                                                                                
DR. MURHPY  replied, "I  don't know what  an unborn child  is. I'm                                                              
not familiar  with the term unborn  child. She is a  physician and                                                              
medically trained  and has  never come across  unborn child  in my                                                              
medical training."                                                                                                              
CHAIRWOMAN GREEN  asked what phrase  would she use for  the before                                                              
delivery time.                                                                                                                  
DR. MURHPY said they don't use that phraseology. She explained:                                                                 
     When  a  fertilized  egg  divides,  it  changes  into  a                                                                   
     blastocyst and then it will  implant into the uterus and                                                                   
     be called  an embryo until  eight weeks gestation.  From                                                                   
     eight weeks gestation until  the time of delivery, it is                                                                   
     called a fetus.  There is no such thing as  unborn child                                                                   
     in medical literature.                                                                                                     
CHAIRWOMAN GREEN asked  how she identified the number  of weeks or                                                              
what the  stage of  development is.  She asked,  "If when  you are                                                              
making those assumptions,  are you basing that on  a range of time                                                              
versus this is  a specific day in the development  versus it could                                                              
be within two weeks."                                                                                                           
DR. MURHPY replied:                                                                                                             
     It  gets  pretty  interesting.  If  you  look  at  first                                                                   
     trimester,  which  according  the  American  College  of                                                                   
     OBGYN  is up  to 14  weeks in  pregnancy,  and then  the                                                                   
     second  trimester is  14  weeks to  28  weeks and  third                                                                   
     trimester is  28 weeks to  birth. Basically, we  know if                                                                   
     we do ultrasound  measurements of the fetus,  that world                                                                   
     wide based  on large statistical studies  [indisc.] that                                                                   
     fetuses pretty  much grow at a very similar  rate in the                                                                   
     first trimester,  through 14 weeks  - such that  you can                                                                   
     date  the  pregnancy within  several  days  to about  10                                                                   
     days. Between  14 weeks [and  28 weeks] we start  to get                                                                   
     such  variation  that  it's two  weeks  difference.  So,                                                                   
     we're not accurate. I think  a lot of lay people give us                                                                   
     too  much  credit for  being  terribly accurate  and  we                                                                   
     really aren't. We guess pretty well.                                                                                       
Number 1486                                                                                                                     
MS. SHERRY  GOLL, Alaska  Pro Choice  Alliance, Haines,  said they                                                              
are  a state  wide coalition  of  diverse nonprofit  organizations                                                              
with a  mission of protecting  reproductive rights and  to promote                                                              
reproductive  health  services  through  education,  advocacy  and                                                              
community   organizing.   Although   the  group   promoting   this                                                              
legislation think it is informational,  her organization thinks it                                                              
is trying to intimidate and harass  women who are choosing to have                                                              
an abortion. She said:                                                                                                          
     Apparently, people  are under the impression  that women                                                                   
     take this  kind of decision lightly instead  of thinking                                                                   
     about it  and dealing  with it in  the privacy of  their                                                                   
     own lives, making their own  constitutionally protected,                                                                   
     private pregnancy decision with  their physician. As Dr.                                                                   
     Murphy   just  stated,  physicians   for  all   surgical                                                                   
     procedures  provide informed  consent.  To suggest  that                                                                   
     women  in  this particular  instance  have  to be  shown                                                                   
     photographs -  I mean photographs of a  developing fetus                                                                   
     would  be more  appropriate to  show to a  woman who  is                                                                   
     planning to  have a pregnancy  and there are  many books                                                                   
     in the library to help you understand  child development                                                                   
     if you're going to have a baby.                                                                                            
     If  a  man  needs  to  have  a  cyst  removed  from  his                                                                   
     testicles,  do you  think it would  appropriate for  the                                                                   
     legislature to put in law that  this man should be shown                                                                   
     pictures of  how that cyst would  grow over a  period of                                                                   
     time if he fails to remove it.                                                                                             
     I think the bill is flawed in  ways using terms that are                                                                   
     so charged,  like unborn child,  when as you know  it is                                                                   
     not a medical term. If it's  meant to be educational, if                                                                   
     you want to  provide information, don't tell  women that                                                                   
     the father  of their child  will be under  obligation to                                                                   
     provide child  support unless you're also going  to tell                                                                   
     her  what the  statistics are  that  obligors pay  their                                                                   
     child  support.   I  am  very   much  opposed   to  this                                                                   
     legislation. I  think that it's just intended  to harass                                                                   
     women who  choose to  have an abortion  and it is  clear                                                                   
     that  it is  that type  of bill  by the  folks who  have                                                                   
     shown up to  testify on it. I appreciate  your taking my                                                                   
     testimony. Thank you very much.                                                                                            
Number 1620                                                                                                                     
MS. ANNA  FRANKS, Fairbanks, said  she would be  reading testimony                                                              
from Alicia  Wells, Anchorage  resident, who  was home  caring for                                                              
her children.  The letter said  preventing pregnancy  sometimes is                                                              
just based  on luck  and that a  woman can  get pregnant  using an                                                              
IUD. She said  that she was never  forced to have sex  against her                                                              
will  and that  her  parents  shared  with her  information  about                                                              
responsible sexual behavior. She read:                                                                                          
     Not  all women  are  that lucky,  however,  and for  one                                                                   
     reason or  another, many women find themselves  pregnant                                                                   
     when  they  don't  want  to be.  For  these  women,  the                                                                   
     decision  about what  to do  is  not easy.  I know  from                                                                   
     having  counseled  several friends  with  this  decision                                                                   
     that it is  not one that any woman takes  lightly. Women                                                                   
     who are  in this situation  need access to  good quality                                                                   
     information  and  supportive  non-judgmental  counseling                                                                   
     about their actions.                                                                                                       
She read further that:                                                                                                          
     SB  91 masquerades  as something  that  will help  women                                                                   
     make a  decision at this  critical time in  their lives,                                                                   
     its main  purpose is to  intimidate women and  make them                                                                   
     feel guilty  for exercising their right to  make choices                                                                   
     about  their  bodies and  their  lives. In  addition  to                                                                   
     being a blatant anti-choice  attempt to restrict women's                                                                   
     rights, there are several major  problems with the bill.                                                                   
     First, the  legislature has no business  telling doctors                                                                   
     the specifics of  what they can and should  be saying to                                                                   
     their  patients.  Doctors  are   already  bound  by  the                                                                   
     standards of  practice which include providing  complete                                                                   
     and unbiased  information and  counseling about  medical                                                                   
     procedures  as well  as  insuring that  a  woman or  any                                                                   
     patient  freely  consents  to  the  procedure  she  will                                                                   
     undergo.  These  systems  are  already  established  and                                                                   
     working.  There  is  not need  for  special  information                                                                   
     consent forms just for abortion.                                                                                           
     Second,   the   purposed  intent   of   this   so-called                                                                   
     counseling  material is clearly  biased and intended  to                                                                   
     dissuade women.                                                                                                            
     Third, the proposed content  of the so-called counseling                                                                   
     materials  related  to  the   psychological  affects  of                                                                   
     abortion   is  simply   not   supported  by   scientific                                                                   
     Finally,  SB 91 shows  a lack of  respect for women.  It                                                                   
     assumes  that  women  will not  make  the  right  choice                                                                   
     without an  extra push in  the right direction  from the                                                                   
     state.  Well, as  a  woman myself  and  someone who  has                                                                   
     talked to  many women,  I can assure  you that women  do                                                                   
     have the ability to make thoughtful  and moral decisions                                                                   
     about their lives.  We need to respect that  ability and                                                                   
     provide women  with quality information and  services so                                                                   
     that they  may have the  best possible outcome  whatever                                                                   
     their  choice. I  urge you  to  vote against  SB 91  and                                                                   
     allow  women  to  make  their  own  decisions  with  the                                                                   
     assistance and medical expertise of their own doctors.                                                                     
MS. JENNIFER RUDINGER, Executive  Director, Alaska Civil Liberties                                                              
Union  (ACLU), opposed  SB  91. She  asked  if  the committee  had                                                              
received testimony from  Dr. Sharon Smith, Dr. Cathy  Todd and Dr.                                                              
Jan Whitefield regarding this bill.                                                                                             
CHAIRWOMAN GREEN replied that they did receive it.                                                                              
MS. RUDINGER summarized her testimony:                                                                                          
     I want to  first of all point out something  that hasn't                                                                   
     been mentioned  yet and that's that SB 91  requires that                                                                   
     the physician, him or herself,  be the person delivering                                                                   
     these extraneous lectures to  the patient. This is going                                                                   
     to have the  effect of not only forcing doctors  to give                                                                   
     information that may not be  relevant to that particular                                                                   
     patient's circumstances, but  also by using the doctor's                                                                   
     time  to do  this, is  making access  to quality  health                                                                   
     care more difficult  and more expensive. SB  91 will not                                                                   
     allow  a trained counselor,  a nurse  or another  health                                                                   
     care  practitioner  to  provide  the  state's  mandatory                                                                   
     lecture to  the patient and  there are very  few doctors                                                                   
     already  available. There's a  shortage of doctors  able                                                                   
     to  help women  in these  circumstances.  By taking  the                                                                   
     doctors time and forcing them  to deliver these lectures                                                                   
     when  other  healthcare  practitioners  could do  it  is                                                                   
     going  to  drive up  the  cost  of healthcare  and  make                                                                   
     access more difficult.                                                                                                     
     Finally,  I just  want to  address some  of the  medical                                                                   
     misinformation,   actually,  that's  been  put   on  the                                                                   
     record, to kind  of correct the record. SB  91 refers to                                                                   
     possible   psychological   affects    that   have   been                                                                   
     associated  with having  an abortion  and as Dr.  Murphy                                                                   
     testified,  this is really  substituting lay people  and                                                                   
     politician's  judgment for that  of doctors.  Practicing                                                                   
     medicine is something  that should be left  up to people                                                                   
     with  a  medical license.  This  reference  to  possible                                                                   
     psychological  effects  is misleading  because  no  such                                                                   
     psychological  harms have  been proved  to exist and  in                                                                   
     fact  to  corroborate  that,   according  to  a  1987-88                                                                   
     investigation  by  former  Surgeon  General  C.  Everett                                                                   
     Coup, who  is of course no  champion of choice,  as well                                                                   
     as  another  study  by the  World  Health  Organization,                                                                   
     there  is  no  medical  evidence  that  abortion  causes                                                                   
     psychological  injury. On  the contrary,  relief is  the                                                                   
     most  common reaction  to a  voluntary abortion  whereas                                                                   
     women who  are forced  to continue unwanted  pregnancies                                                                   
     suffer  adverse   and  sometimes  severe   psychological                                                                   
     consequences. So, again this  is where it should be left                                                                   
     to  doctors  to  decide  based  on  their  best  medical                                                                   
     judgment, based on the specifics  of their patient, what                                                                   
     risks and  benefits are relevant  to that patient,  what                                                                   
     medical information is scientifically sound.                                                                               
     And finally,  I hadn't  planned to  discuss this,  but I                                                                   
     must just  briefly rebut the  allegation that  there's a                                                                   
     link  shown  between  abortion and  breast  cancer.  The                                                                   
     latest scare  tactic initiated by anti-choice  groups is                                                                   
     to link abortion with breast  cancer. Ceasing upon scant                                                                   
     evidence in a  1994 research study, they  have mounted a                                                                   
     bigger   advertising   and  legislative   campaigns   to                                                                   
     convince the public that having  an abortion increases a                                                                   
     woman's  chance of contracting  breast cancer.  In fact,                                                                   
     this  study  they  are referring  to  published  in  the                                                                   
     Journal  of the  National  Cancer Institute  reported  a                                                                   
     small  statistical   connection  between   abortion  and                                                                   
     breast  cancer. Although  cancer  research experts  have                                                                   
     characterized    this   study   as   inconclusive    and                                                                   
     methodolically   problematic,    anti-choice   activists                                                                   
     eagerly  wield it  as a new  way to  frighten women  and                                                                   
     restrict  their   choices.  Opponents  of   choice  have                                                                   
     persuaded  legislators in several  states that  there is                                                                   
     this link,  that this  is part  of the information  that                                                                   
     needs  to be  conveyed. It's  not clear  from this  bill                                                                   
     whether,  in fact,  that's the  case, but  if anyone  is                                                                   
     under the impression that there  is such a link and that                                                                   
     this  information is  needed for  informed consent,  I'd                                                                   
     like to  mention, and  I can get  this for you  later, a                                                                   
     couple  points that  illustrate just  the opposite.  The                                                                   
     Natural Cancer Institute has  charged that the study has                                                                   
     been   interpreted  inaccurately   and,  "There  is   no                                                                   
     evidence of a direct relationship  between breast cancer                                                                   
     and either induced or spontaneous abortion."                                                                               
     Second, the American Cancer  Society has concluded, "The                                                                   
     inconsistencies  of  existing  research  do  not  permit                                                                   
     definitive scientific conclusions."                                                                                        
     Third, on the day this study  was published, the Journal                                                                   
     of National  Cancer Institute, the source of  the study,                                                                   
     printed an editorial stating  that, "The overall results                                                                   
     of the  study as  well as the  particulars are far  from                                                                   
     conclusive and  it's difficult to  see how they  will be                                                                   
     informative to the public.                                                                                                 
     The  study was  particularly criticized  because of  the                                                                   
     methodological problem of possible  inaccurate reporting                                                                   
     of a history of abortion by participants.                                                                                  
     Fourth,  four  recent reviews  published  in  scientific                                                                   
     journals  have   assessed  more  than  30   studies  and                                                                   
     concluded  that the available  data on the  relationship                                                                   
     between  induced  or  spontaneous   abortion  in  breast                                                                   
     cancer  are  inconclusive.  Fifth,  a  1995  article  in                                                                   
     Cancer  Causes  and  Controls  reported  in  an  article                                                                   
     entitled  Abortion  and Breast  Cancer  Causes in  Seven                                                                 
     Countries  the study of  these countries concluded,  "In                                                                 
     Summary,  these data suggest  that any overall  relation                                                                   
     between abortion and risk of  breast cancer is likely to                                                                   
     be weak at the most."                                                                                                      
     This list goes on and on and  finally, one more point, a                                                                   
     widely noted  1997 study of more than 1.5  million women                                                                   
     in Denmark where abortion histories  are corroborated by                                                                   
     a government  sponsored medical registry, so  there's no                                                                   
     chance  of  reporting  bias,  concluded  that,  "Induced                                                                   
     abortions have  no overall affect on the  risk of breast                                                                   
     In  a  New  England Journal  of  Medicine  editorial,  a                                                                   
     company  in  the  Danish research  I  just  quoted,  Dr.                                                                   
     Patricia  Harkey (ph) of  the National Cancer  Institute                                                                   
     said, "It  provides important new evidence  to resolve a                                                                   
     controversy  that  previous   investigations  have  been                                                                   
     unable  to settle."  In short,  a woman  need not  worry                                                                   
     about  the  risk  of  breast   cancer  when  facing  the                                                                   
     difficult decision of whether  to terminate a pregnancy.                                                                   
MS. GOLL said she appreciated the opportunity to read these                                                                     
articles into the record and offered to provide them with further                                                               
information they might find helpful.                                                                                            
MS. DIETRICK SITLER, Anchorage resident, opposed SB 91. She                                                                     
wanted to share with them why a bill like this could be very                                                                    
detrimental to many women like her as follows:                                                                                  
     At  the age of  14 I  was diagnosed  with hemophilia,  a                                                                   
     disease  affecting  the  blood.  As  a  result  of  this                                                                   
     condition, it  is medically dangerous for me  to carry a                                                                   
     pregnancy  to term,  because  the loss  of blood  during                                                                   
     delivery  could be potentially  fatal to  me. I am  in a                                                                   
     long-term  committed relationship and  my partner  and I                                                                   
     are  very careful,  but as you  know, no  form of  birth                                                                   
     control  is  100 percent  effective.  Were  I to  become                                                                   
     accidentally  pregnant, it would  be in my best  medical                                                                   
     interests to  terminate the pregnancy rather  than carry                                                                   
     the  pregnancy  to  term.  I strongly  feel  this  is  a                                                                   
     decision between  my partner and  I with the  advice and                                                                   
     consultation of my doctor. The  government I feel has no                                                                   
     place in this personal painful  choice that I would have                                                                   
     to make.  Furthermore, my  partner and  I would find  it                                                                   
     very  painful   to  have  to  listen  to   a  litany  of                                                                   
     alternatives to abortion - alternatives  that are not in                                                                   
     our best  interest and that  could actually  threaten my                                                                   
     life before we would be deemed  capable of consenting to                                                                   
     an abortion.                                                                                                               
     My  greatest  objection  is  in  your  definition  of  a                                                                   
     medical emergency.  I would  not fall under  the medical                                                                   
     necessity  exception  to  SB   91,  because  having  the                                                                   
     abortion  at that very  moment would  probably not  be a                                                                   
     life   saving  measure   or   an  emergency   situation.                                                                   
     Therefore, I  would be subject to this  extra counseling                                                                   
     which  would  be  wholly  irrelevant  in  my  individual                                                                   
     circumstances.  I have  also  heard a  lot of  testimony                                                                   
     today stating  that if many women knew more  facts about                                                                   
     abortion, they  would probably  choose not to  have this                                                                   
     procedure. This  is not entirely true, especially  in my                                                                   
     situation.  Not every woman  that is having  an abortion                                                                   
     is having this  procedure just because they  do not want                                                                   
     to have  the child. What about  women like me?  There is                                                                   
     no exception for women like  me. I would remind you that                                                                   
     this decision  would already be very painful  for me and                                                                   
     I would  be terminating  this pregnancy  to save my  own                                                                   
     life. Why  should these extra  hurdles be placed  on me,                                                                   
     especially  when they  are not placed  before any  other                                                                   
     patient  seeking any  other medical  treatment. We  urge                                                                   
     you  to oppose  this bill and  thank you  very much  for                                                                   
     your time.                                                                                                                 
Number 2224                                                                                                                     
MS. MARY DYE, citizen of Alaska, supported SB 91 and read a                                                                     
definition of informed consent that she got off the Internet:                                                                   
     In medicine  a patient's written  consent to  a surgical                                                                   
     or medical procedure or other  course of treatment given                                                                   
     after  the physician  has told  the patient  all of  the                                                                   
     potential benefits, risks and alternatives involved.                                                                       
She used an analogy  of deciding whether or not to  put gutters on                                                              
her home and gathering all the information  available and deciding                                                              
if  it  was the  thing  to  do.  She  said they  could  offer  the                                                              
information to women and do the best you can.                                                                                   
MR. SID HEIDERSDORF, Juneau resident, supported SB 91.                                                                          
TAPE 01-24, SIDE B                                                                                                            
He said  that informed  consent is  needed to  protect women  from                                                              
unscrupulous  abortion practices.  He pointed  out this bill  does                                                              
not attempt to outlaw abortion or  place restrictions on a woman's                                                              
right to  an abortion. He said,  "Abortion is not an  honorable or                                                              
an innocent medical  procedure and those who are  involved with it                                                              
are not  likely to  be very  open and  free about the  information                                                              
when they are talking to their patient."                                                                                        
MR. HEIDERSDORF asked, "Why is abortion  the only invasive medical                                                              
procedure  for which  full information  is not  given? It is  well                                                              
known that abortion counseling is a sham."                                                                                      
Further he said:                                                                                                                
     If biased information results  in an attitude of viewing                                                                   
     it  as being anti  abortion, I  think there's  something                                                                   
     there to look  at. The fact is that  scientific unbiased                                                                   
     information, which is required  by this legislation, may                                                                   
     in fact  speak against  abortion and  that's the way  it                                                                   
     is. It's  true if the  child in  the womb, which  is the                                                                   
     crux  of the  issue, is  what's  discussed. That's  what                                                                   
     women really must know.                                                                                                    
     We hear a  lot said about RU486. In August  of this past                                                                   
     year, Serle, the company that  produces one of the drugs                                                                   
     used in the RU486 abortion procedure,  wrote a letter to                                                                   
     200,000  medical practitioners  in this country  telling                                                                   
     them,  "Don't use  cytotech  for abortions."  They  said                                                                   
     don't use  it because it's dangerous. They  didn't study                                                                   
     it  for  that purpose;  this  is  a  drug used  to  cure                                                                   
     ulcers, not to be used for producing  contractions for a                                                                   
     woman to expel a dead baby.                                                                                                
He passed out an  article to the committee on cytotech  in which a                                                              
woman died  who used  it. He  disagreed that  there wasn't  a link                                                              
between abortion  and breast  cancer. He said  there are  over two                                                              
dozen  scientific articles  that  do show  a  strong link  between                                                              
abortion and breast cancer, especially  first pregnancy abortions.                                                              
He said, "The evidence is building."                                                                                            
Specifically, SB 91 does not include  a waiting period. He thought                                                              
a 24-hour  waiting period  was critical because  a woman  needs to                                                              
get the information  and get away  from the doctor and  the clinic                                                              
personnel, because they are out to  sell an abortion. "They are in                                                              
the business of selling these abortions."                                                                                       
One final thing was on page 5, line  3. He was concerned that this                                                              
language did not  require that the woman be given  the information                                                              
produced by the Department of Health and Social Services.                                                                       
CHAIRWOMAN GREEN  said she thought  page 5, line 8,  addressed his                                                              
MR. HEIDERSDORF responded  that he was concerned  with language in                                                              
AS 18.05.032.                                                                                                                   
Number 1853                                                                                                                     
MS. MARY  HORTON, Juneau resident,  supported SB 91, because  of a                                                              
recent  experience she  had bringing  healing to  two men and  six                                                              
women who had  experienced abortion in Juneau. Their  ages were 17                                                              
-  over 50  years. She  said that  a man  begins to  deal with  an                                                              
abortion 5 - 7 years after it's happened.  She said, "When we talk                                                              
about  the abortion,  it's  not only  the  woman  who carries  the                                                              
child,  the fetus,  it's also  the grandparents,  the sisters  and                                                              
brothers  that  come  before  or  are still  there,  the  man  who                                                              
fathered the child."                                                                                                            
She said  there will  be another opportunity  for healing  that is                                                              
called  Project Rachael,  Rachael's Vineyard.  In her  experience,                                                              
she found  that women were very  surprised to hear the  other side                                                              
of the  story, that  men were  carrying the  guilt and what  could                                                              
they have done about it. "Women need  to know, but so do the men…"                                                              
She  said that  people who  can't read  can see  pictures and  can                                                              
understand clearly what's  going on. It's hard for  her to express                                                              
all the  healing that happened  and SB 91  would go a long  way in                                                              
helping people think about it a little bit more clearly.                                                                        
CHAIRWOMAN GREEN said  she was chagrined at some  of the comments.                                                              
She had undergone various surgeries  and had seen pictures of body                                                              
parts on  the doctor's office  wall and  what might be  wrong with                                                              
them and  how they could be  corrected. She received a  great deal                                                              
of information and  the consent forms and waivers  she signed were                                                              
all inclusive. She continues:                                                                                                   
     On the other  hand, I would say that those  who say that                                                                   
     government  should  not  be involved  in  this  decision                                                                   
     making  and certainly in  regulating and/or  prohibiting                                                                   
     or allowing are  the very same people who  spend a great                                                                   
     deal of  time challenging the  fact that state  Medicaid                                                                   
     money should  indeed be used to fund abortions.  So, I'm                                                                   
     a little conflicted on those.                                                                                              
SENATOR  DAVIS  asked if  there  would  be  time for  more  public                                                              
SENATOR WARD  said he had  a lot of  people who wanted  to testify                                                              
and  wanted  to  know  if  any  state  money  had  been  spent  on                                                              
psychological follow-ups or abortions; if so, how much. He was                                                                  
trying to figure out if the state is liable.                                                                                    
CHAIRWOMAN GREEN adjourned the meeting at 2:55 p.m.                                                                             

Document Name Date/Time Subjects