Legislature(2001 - 2002)

04/27/2001 01:37 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                                                                   
                          April 27, 2001                                                                                        
                              1:37 pm                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Lyda Green, Chair                                                                                                       
Senator Loren Leman, Vice Chair                                                                                                 
Senator Gary Wilken                                                                                                             
Senator Jerry Ward                                                                                                              
Senator Bettye Davis                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All Members Present                                                                                                             
                                                                                                                              
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE JOINT RESOLUTION NO. 28                                                                                                  
Urging dissemination  of  information about  the costs of  long-term                                                            
care services  and the availability of long-term care  insurance for                                                            
individuals.                                                                                                                    
                                                                                                                                
     MOVED CSSJR 28(HES) OUT OF COMMITTEE                                                                                       
                                                                                                                                
CS FOR SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 76(FIN)                                                                            
"An Act providing  for and relating to the issuance  of certificates                                                            
of participation  to finance  construction of  a new facility  to be                                                            
known  as the Alaska  Psychiatric  Institute; giving  notice of  and                                                            
approving  the  entry  into  and the  issuance  of  certificates  of                                                            
participation  in a lease-purchase  agreement for construction  of a                                                            
new  facility  to be  known  as the  Alaska  Psychiatric  Institute;                                                            
giving  notice  of the  intent  and approval  to  retain  investment                                                            
income from  pertinent appropriations  to be applied to the  cost of                                                            
construction   of  a  new  facility  to  be  known   as  the  Alaska                                                            
Psychiatric  Institute; relating to  the construction of  a facility                                                            
to be known as  the Alaska Psychiatric Institute;  and providing for                                                            
an effective date."                                                                                                             
                                                                                                                                
     MOVED CSSSHB 76(FIN) OUT OF COMMITTEE                                                                                      
                                                                                                                                
SENATE CS FOR CS FOR HOUSE BILL NO. 101(HES)                                                                                    
"An Act relating to charter  schools; and providing for an effective                                                            
date."                                                                                                                          
                                                                                                                                
     MOVED SCS CSHB 101(HES) OUT OF COMMITTEE                                                                                   
                                                                                                                                
CS FOR HOUSE BILL NO. 203(FIN)                                                                                                  
"An Act  making an appropriation  to the  Legislative Council  for a                                                            
study  of  school  district  cost  factors;  and  providing  for  an                                                            
effective date."                                                                                                                
                                                                                                                                
     MOVED SCS CSHB 203(FIN) OUT OF COMMITTEE                                                                                   
                                                                                                                                
SENATE CONCURRENT RESOLUTION NO. 13                                                                                             
Suspending Rules  24(c), 35, 41(b), and 42(e), Uniform  Rules of the                                                            
Alaska State Legislature,  concerning House Bill No.  203, making an                                                            
appropriation for a study of school district cost factors.                                                                      
                                                                                                                                
     MOVED SCR 13 OUT OF COMMITTEE                                                                                              
                                                                                                                                
CS FOR HOUSE BILL NO. 115(HES)                                                                                                  
"An Act relating  to the definition of 'mental health  professional'                                                            
for certain  mental health proceedings  and treatments; relating  to                                                            
the services of  certain medical professionals in  civil proceedings                                                            
for  the commitment  of  certain  intoxicated  persons;  allowing  a                                                            
physician assistant  or advanced nurse  practitioner to certify  the                                                            
need  for emergency  treatment  as  a result  of  intoxication;  and                                                            
providing for an effective date."                                                                                               
                                                                                                                                
          HEARD AND HELD                                                                                                        
                                                                                                                                
SENATE BILL NO. 11                                                                                                              
"An  Act  relating  to the  legal  age  for  attending  school;  and                                                            
providing for an effective date."                                                                                               
                                                                                                                                
     MOVED SB 11 OUT OF COMMITTEE                                                                                               
                                                                                                                                
SENATE BILL NO. 40                                                                                                              
"An Act relating to the  education of children with disabilities and                                                            
of  gifted   children;  relating   to  the  Governor's  Council   on                                                            
Disabilities  and Special Education;  making conforming amendments;                                                             
and providing for an effective date."                                                                                           
                                                                                                                                
     MOVED CSSB 40(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
SJR 28 - No previous action to consider.                                                                                        
                                                                                                                                
HB 76 - No previous action to consider.                                                                                         
                                                                                                                                
HB 101 - No previous action to consider.                                                                                        
                                                                                                                                
HB 203 - See HESS minutes dated 4/20/01.                                                                                        
                                                                                                                                
SCR 13 - No previous action to record.                                                                                          
                                                                                                                                
HB 115 - No previous action to consider.                                                                                        
                                                                                                                                
SB 11 - See HESS minutes dated 2/5/01 and 4/20/01.                                                                              
                                                                                                                                
SB 40 - See HESS minutes dated 2/7/01.                                                                                          
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
Mr. John Sherwood                                                                                                               
Division of Medical Assistance                                                                                                  
Department of Health and Social Services                                                                                        
P.O. Box 110660                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Commented on SJR 28.                                                                                      
                                                                                                                                
Ms. Janet Clark, Director                                                                                                       
Division of Administrative Services                                                                                             
Department of Health and Social Services                                                                                        
P.O. Box 110650                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Commented on status report letter to the                                                                  
Finance Committees on Medicaid Program.                                                                                         
                                                                                                                                
Mr. Bob Labbe, Director                                                                                                         
Division of Medical Assistance                                                                                                  
Department of Health and Social Services                                                                                        
P.O. Box 110660                                                                                                                 
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Commented on status report letter to the                                                                  
Finance Committees on Medicaid Program.                                                                                         
                                                                                                                                
Ms. Janet Seitz                                                                                                                 
Staff to Representative Rokeberg                                                                                                
State Capitol Bldg.                                                                                                             
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Commented on HB 76.                                                                                       
                                                                                                                                
Mr. Randall Burns, CEO                                                                                                          
Alaska Psychiatric Institute                                                                                                    
Department of Health and Social Services                                                                                        
2900 Providence Ave.                                                                                                            
Anchorage AK 99508                                                                                                              
POSITION STATEMENT: Commented on HB 76.                                                                                       
                                                                                                                                
Mr. Kurt Parkan, Deputy Commissioner                                                                                            
Department of Transportation &                                                                                                  
  Public Facilities                                                                                                             
3132 Channel Dr.                                                                                                                
Juneau, AK  99801-7898                                                                                                          
POSITION STATEMENT: Commented on HB 76.                                                                                       
                                                                                                                                
Mr. Jeff Jessee, Executive Director                                                                                             
Alaska Mental Health Trust Authority                                                                                            
Department of Revenue                                                                                                           
550 W 7th Ave., Ste. 1820                                                                                                       
Anchorage AK 99501                                                                                                              
POSITION STATEMENT: Commented on HB 76.                                                                                       
                                                                                                                                
Ms. Suzanne Price, Executive Director                                                                                           
Fairbanks Community Mental Health Center                                                                                        
Fairbanks AK                                                                                                                    
POSITION STATEMENT: Supported HB 76.                                                                                          
                                                                                                                                
Representative Fred Dyson                                                                                                       
Alaska State Capitol                                                                                                            
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Sponsor of HB 101.                                                                                        
                                                                                                                                
Representative Peggy Wilson                                                                                                     
Alaska State Capitol                                                                                                            
Juneau AK 99811                                                                                                                 
POSITION STATEMENT: Sponsor of HB 203.                                                                                        
                                                                                                                                
Mr. Eddy Jeans, Manager                                                                                                         
School Finance and Facilities Section                                                                                           
Department of Education & Early Development                                                                                     
801 W 10th St., Ste 200                                                                                                         
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Commented on HB 203.                                                                                      
                                                                                                                                
Mr. Darroll Hargraves, Executive Director                                                                                       
Alaska Council of School Administrators                                                                                         
326 4th St., Ste 404                                                                                                            
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported on HB 203.                                                                                      
                                                                                                                                
Ms. Pam Watts, Director                                                                                                         
Governor's Advisory Board on Alcoholism and Drug Abuse                                                                          
Department of Health and Social Services                                                                                        
P.O. Box 110608                                                                                                                 
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported HB 115.                                                                                         
                                                                                                                                
Ms. Anne Henry, Project Coordinator                                                                                             
Division of Mental Health and Developmental Disabilities                                                                        
Department of Health and Social Services                                                                                        
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Supported 115.                                                                                            
                                                                                                                                
Ms. Kathleen Wedemeyer                                                                                                          
307 Minnie St.                                                                                                                  
Fairbanks AK 99701                                                                                                              
POSITION STATEMENT: Opposed HB 115.                                                                                           
                                                                                                                                
Ms. Barbara Craver                                                                                                              
Juneau AK 99801                                                                                                                 
POSITION STATEMENT: Supported HB 115.                                                                                         
                                                                                                                                
Dr. Bruce Johnson, Deputy Commissioner                                                                                          
Department of Education &                                                                                                       
 Early Development                                                                                                              
        th                                                                                                                      
801 W 10 St.                                                                                                                    
Juneau, AK  99801-1894                                                                                                          
POSITION STATEMENT: Supported SB 40.                                                                                          
                                                                                                                              
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 01-39, SIDE A                                                                                                            
Number 001                                                                                                                      
            SJR 28-INFO ABOUT LONG-TERM CARE INSURANCE                                                                      
                                                                                                                              
CHAIRWOMAN  LYDA  GREEN  called the  Senate  Health,  Education  and                                                          
Social  Services  Committee  meeting  to  order  at  1:37  p.m.  and                                                            
announced SJR 28 to be up for consideration.                                                                                    
                                                                                                                                
SENATOR WILKEN,  sponsor of  SJR 28, said  the resolution has  to do                                                            
with the dissemination  of long-term care insurance  information and                                                            
encourages  Alaskans and Americans  to consider it. This  resolution                                                            
was  proposed  by  the  Alzheimer's  Association  and  the  American                                                            
Legislative  Conference,  but this  is an  effort that  is going  on                                                            
nationwide. He read the sponsor statement as follows:                                                                           
                                                                                                                                
     SJR 28 directs  appropriate state and federal  agencies to                                                                 
     inform  the public about the  high cost of long-term  care                                                                 
     services and the need for  families to plan in advance for                                                                 
     their   long-term   care  needs.   The   fastest  growing                                                                  
     population in Alaska is  people who are 65 years or older.                                                                 
     The senior  community is growing about 5 percent  annually                                                                 
     while the rest of the population  is growing at a slight 2                                                                 
     percent. This growth rate  can almost triple to 12 percent                                                                 
     by 2018.  In less than 20 years,  seniors will comprise  a                                                                 
     significant  portion of Alaska's  total population.  These                                                                 
     rapid  growth  rates are  coupled with  the  high cost  of                                                                 
     providing long-term care  in Alaska. At an average of over                                                                 
     $210 per day, Alaska's nursing  home costs rank number one                                                                 
     nationwide, twice the national average.                                                                                    
                                                                                                                                
     This incredible  expense can  have a disastrous effect  on                                                                 
     families  wiping  out a  lifetime  of savings  before  the                                                                 
     elder  becomes eligible  for Medicaid.  Widespread use  of                                                                 
     private  long-term  care insurance  has the  potential  to                                                                 
     protect families from the  catastrophic costs of long-term                                                                 
     care services  while at the same time reducing  the burden                                                                 
     on Medicaid as Alaska ages.  Most Americans, 76 percent in                                                                 
     fact,  cannot believe they will  ever need long-term  and,                                                                 
     therefore, do not explore  the option of obtaining private                                                                 
     long-term care insurance.                                                                                                  
                                                                                                                                
     SJR 28  directs the beginning  of an educational campaign                                                                  
     to inform  Alaskans about the  realities of aging and  how                                                                 
     individuals can protect themselves for the future.                                                                         
                                                                                                                                
SENATOR WILKEN  referred to  the Long-Term  Care Task Force  report,                                                            
published  in  January  1999,   and  said  item  29  addresses  this                                                            
particular  issue.  He  said  the  Long-Term   Care  and  Retirement                                                            
Security  Act  of 2001,  HR  831 and  SB 627,  are  currently  under                                                            
consideration in our U.S. Congress.                                                                                             
                                                                                                                                
CHAIRWOMAN GREEN said she  appreciated the work the committee did on                                                            
this.                                                                                                                           
                                                                                                                                
SENATOR WILKEN  moved to adopt amendment 1, which  adds two names to                                                            
the distribution  list, Honorable  Tommy Thompson, the Secretary  of                                                            
Health  and Human  Services and  Jane P. Demmert,  Director,  Alaska                                                            
Commission on Aging, and  asked for unanimous consent. There were no                                                            
objections and it was so ordered.                                                                                               
                                                                                                                                
SENATOR  WILKEN moved  amendment  2 on page  2, line  21, to  delete                                                            
"still" and asked for unanimous  consent. He explained that they are                                                            
trying  to determine  to  what  extent tax  rules  may discriminate                                                             
against the buyers of long-term  care insurance policies. There were                                                            
no objections and it was so ordered.                                                                                            
                                                                                                                                
Number 616                                                                                                                      
                                                                                                                                
MR. JOHN  SHERWOOD, Division  of Medical  Assistance, Department  of                                                            
Health and  Social Services (DHSS)  said he works with the  Medicaid                                                            
Program in the area of  long-term care and that currently in Alaska,                                                            
the  Medicaid  Program  pays for  long  term  care for  about  2,000                                                            
people, in  either nursing  facilities or  other home or  community-                                                            
based settings.                                                                                                                 
                                                                                                                                
He said that very often  people contact his division and they aren't                                                            
prepared for  the eventuality. He  said it has a profound  impact on                                                            
their financial  and emotional situation.  He supported any  efforts                                                            
to make the  public aware of the need  to plan and take appropriate                                                             
action.                                                                                                                         
                                                                                                                                
SENATOR WILKEN  moved to pass SJR 28 from committee  with individual                                                            
recommendations. There were no objections and it was so ordered.                                                                
                                                                                                                                
CHAIRWOMAN GREEN asked  Ms. Janet Clarke of DHSS to explain a letter                                                            
dated April 5, 2001.                                                                                                            
                                                                                                                                
MS. JANET  CLARKE, Director,  Division of  Administrative  Services,                                                            
DHSS, explained  that the letter was intended to be  a status report                                                            
to   the    Finance   Committees    on    the   Medicaid    Program.                                                            
The Division  could run out of spending  authority in early  May but                                                            
it is  very close  to meeting its  projections.  The letter  asks if                                                            
it's at all possible to  have a supplemental appropriation passed on                                                            
Monday,  May 7, rather  than waiting  one day, the  last day  of the                                                            
session,  because there  is a check-write  done  on Tuesdays,  which                                                            
would be May 8.                                                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN asked  if this fell into the proshare investment by                                                            
a certain date.                                                                                                                 
                                                                                                                                
MS.  CLARKE  replied that  last  year  they worked  very  hard  with                                                            
Senators  Parnell, Therriault  and  Kelly on  the proshare  program.                                                            
Their 2001 budget is a  very economical one and they did the work to                                                            
gain the proshare  money, $11.4 million, in the state  general fund.                                                            
"...It's all in the bank,  but we need your authority to spend those                                                            
funds before  we can spend  them. That is  part of the supplemental                                                             
request."                                                                                                                       
                                                                                                                                
She  explained  that  the supplemental   request  is $9  million  of                                                            
general funds  and $77.6 million total funds. "So  the general funds                                                            
are a small part of the  supplemental request. We tried to make that                                                            
as small as possible."                                                                                                          
                                                                                                                                
CHAIRWOMAN GREEN asked if the other $77 million was federal.                                                                    
                                                                                                                                
MS.  CLARKE  answered  that  it  was  federal  and  other  statutory                                                            
designated receipts from proshare.                                                                                              
                                                                                                                                
MR. BOB LABBE,  Director, Division of Medical Assistance,  clarified                                                            
that they made  the proshare payment,  because it had to  be made by                                                            
March 13 or they would  loose the opportunity to gain the additional                                                            
funding.                                                                                                                        
                                                                                                                                
CHAIRWOMAN GREEN asked  if the information on the prescription drugs                                                            
and  the increase  in  the waivers  and  increased activity  on  the                                                            
claims is new information or just a reiteration.                                                                                
                                                                                                                                
MS. CLARKE answered that it was reiteration.                                                                                    
                                                                                                                                
CHAIRWOMAN GREEN said that was what confused them.                                                                              
                                                                                                                                
MR. LABBE said  they feel they are  in pretty good shape  with their                                                            
projections. "If all the  supplementals come through, we feel pretty                                                            
good about  getting through the year  without any interruption,  but                                                            
we do have this  little blip concern for the next  couple of weeks."                                                            
                                                                                                                                
CHAIRWOMAN GREEN asked them to go over the forecast scenario.                                                                   
                                                                                                                                
MS. CLARKE responded:                                                                                                           
                                                                                                                                
     As  we have testified  in  the Finance  Committee and  the                                                                 
     subcommittees on the budget,  the budget that the Governor                                                                 
     submitted  is  a  low  case  scenario  for  the  Medicaid                                                                  
     Program. The  Office of Management and Budget  asked us to                                                                 
     develop  a mid-case scenario.  So we did go back and  look                                                                 
     at  our projections  and made  changes in  population  and                                                                 
     have  provided some  information  to you  that a mid-case                                                                  
     scenario would  be higher than what we submitted  as a low                                                                 
     case  primarily  due  to  increased  number   of disabled                                                                  
     individuals  coming onto the program. I think,  as you can                                                                 
     see,  we  are actually  estimating  a  reduced  cost  from                                                                 
     children.  Adults and the elderly  costs they project  are                                                                 
     holding  their own,  but we  underestimated  based on  our                                                                 
     current numbers,  a number of disabled individuals  on the                                                                 
     Medicaid Program.  Based on a mid-case scenario,  we would                                                                 
     increase   that.  We   also  wanted   to  make  sure   the                                                                 
     legislature  knew  that this  wonderful  proshare program                                                                  
     that  we've gotten into,  the federal  government has  cut                                                                 
     that  back starting October  1, 2001  and that would  have                                                                 
     had a slight  change in our general fund request.  So this                                                                 
     is just  a request of  OMB [the Office  of Management  and                                                                 
     Budget]   to   give  the   legislature   some  additional                                                                  
     information.                                                                                                               
                                                                                                                                
Number 1144                                                                                                                     
                                                                                                                                
MR. LABBE added  that they worked diligently to manage  the budgeted                                                            
scenario.                                                                                                                       
                                                                                                                                
CHAIRWOMAN  GREEN asked  if  there was  any other  information  they                                                            
should know.                                                                                                                    
                                                                                                                                
MS. CLARKE  responded that  the only other  items were the  unknowns                                                            
from the federal process.  There are changes in federal funding that                                                            
come through  the  Medicaid Program  that they  can't predict.  They                                                            
know  a little  bit about  the Medicaid  percentage.  Their  current                                                            
budget for FY02 is based on a 59.8%.                                                                                            
                                                                                                                                
CHAIRWOMAN GREEN asked what the range for that was.                                                                             
                                                                                                                                
MR. LABBE  answered  that the  full range  can be 50  to 83  percent                                                            
under statute. "We're at  60.13 percent in the current, but it drops                                                            
next year unless we work  on getting this fixed with the delegation,                                                            
which  we have  been working  on. It's  scheduled to  drop to  57.16                                                            
percent.  We believe that  we're on track to  not see that  level of                                                            
reduction, but there may  be some reduction. The 59.8 percent is not                                                            
a bad place to be at in our budgeting."                                                                                         
                                                                                                                                
CHAIRWOMAN GREEN asked if that was a floating number.                                                                           
                                                                                                                                
MR. LABBE answered  that it's recalculated  every year effective  in                                                            
October and  is based on  the comparison of  the state's per  capita                                                            
income to the  national average per capita income.  When the federal                                                            
government  does the calculation,  they look  back to '95,  '96, and                                                            
'97 to  calculate 2000. This  year they changed  how they  calculate                                                            
per capita  income and he has been  spending time trying  to explain                                                            
the impact of the statistical change to folks in Alaska.                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN  indicated there  were  no further  questions  and                                                            
thanked everyone for their testimony.                                                                                           
                                                                                                                                
                   HB  76-NEW FACILITIES FOR API                                                                            
                                                                                                                              
CHAIRWOMAN GREEN announced HB 76 to be up for consideration.                                                                    
                                                                                                                                
MS. JANET SEITZ, staff to Representative Rokeberg, said:                                                                        
                                                                                                                                
     HB  76   provides  replacement   for  Alaska  Psychiatric                                                                  
     Institution  (API) to go forward  with a mixture of  funds                                                                 
     including   already  appropriated  money,  proceeds   from                                                                 
     certificates  of participation  to be issued by the  state                                                                 
     bond  committees,  money  from the  Alaska  Mental Health                                                                  
     Trust   Authority  and  estimated   interest  income.   In                                                                 
     addition,  the Alaska  Mental Health  Trust Authority  has                                                                 
     granted  land for the  project and  it's anticipated  that                                                                 
     funds for  the demolition of the old API may come  through                                                                 
     some federal road funds.                                                                                                   
                                                                                                                                
She said that  documents in their  packets set forth the  memorandum                                                            
of understanding,  signed  April 2001, by  the Alaska Mental  Health                                                            
Trust Authority, DHSS,  the University of Alaska (UA) and Providence                                                            
Alaska  Medical Center.  It sets forth  the framework  for the  land                                                            
exchanges   and  other   commitments   that  will   facilitate   the                                                            
replacement  of API. She said that  basically the bill sets  out the                                                            
funding structure.                                                                                                              
                                                                                                                                
SENATOR DAVIS said she was glad to see this bill.                                                                               
                                                                                                                                
SENATOR WILKEN  said they had this before them a few  months ago and                                                            
the  discussion revolved  around  the  design itself,  which  wasn't                                                            
really "Alaskan,"  and that the facility cost $40  million and would                                                            
be over capacity  as soon as it opened  the doors. The question  was                                                            
should they  step back from  the design that  is six or seven  years                                                            
old and  look at something  that was a better  use of the  money and                                                            
build  a facility  that  has some  room to  grow.  He remembered  50                                                            
standard  beds  and 16  or 18  others.  He asked  if  that had  been                                                            
discussed in the memorandum of agreement.                                                                                       
                                                                                                                                
MS. SEITZ  pointed  out that  a document  called  "A Shared  Vision"                                                            
shows that there is a design  change on the last page. She said that                                                            
the contract was a design/build contract.                                                                                       
                                                                                                                                
MR.  RANDALL BURNS,  CEO,  Alaska Psychiatric  Institute,  said  the                                                            
facility  project is now  going to  be design/build  and has  a much                                                            
smaller  footprint. "It  will be constructed  for  72 beds, which  I                                                            
believe will  be sufficient. Generally,  the highest we ever  are is                                                            
somewhere around 74 beds.  By the time this building is constructed,                                                            
Providence  Hospital has entered  into an  agreement to provide  the                                                            
single point of  entry services that will eliminate  some of the bed                                                            
capacity that we currently  use. As a result, that will take some of                                                            
the census pressure off  of us and make the 72 beds very practical."                                                            
                                                                                                                                
CHAIRWOMAN  GREEN asked if  a single point  of entry is the  same as                                                            
designated evaluation and treatment (DET).                                                                                      
                                                                                                                                
MR. BURNS explained  that the single  point of entry is part  of the                                                            
community implementation  project the department has been developing                                                            
with Providence Alaska  Medical Center. It will be a place where law                                                            
enforcement,  family members  or any  other individual  can bring  a                                                            
person experiencing  a mental  health crisis.  It's attached  to the                                                            
emergency  room  at Providence  as  a triage  center  for  decisions                                                            
regarding the  appropriate referral  for that person.  It  will be a                                                            
24-hour facility.                                                                                                               
                                                                                                                                
CHAIRWOMAN GREEN asked if API would be doing initial intake.                                                                    
                                                                                                                                
MR. BURNS replied  no, that Providence  would do that. API  would be                                                            
the facility  of referral. He said  that 12 beds will be  supplanted                                                            
by Providence.                                                                                                                  
                                                                                                                                
CHAIRWOMAN GREEN  asked if this would also be augmented  by the DET.                                                            
                                                                                                                                
MR. BURNS said  that is correct. Fairbanks  Memorial Hospital  has a                                                            
number of DET beds, which helps reduce the pressure on API.                                                                     
                                                                                                                                
SENATOR WILKEN said it went from ranch style to dormitory style.                                                                
                                                                                                                                
MR. BURNS said that is correct.                                                                                                 
                                                                                                                                
SENATOR WILKEN  asked if  they had done a  growth analysis  to where                                                            
they think 72 beds will be adequate for the next 20 years.                                                                      
                                                                                                                                
MR. BURNS responded  that a number of studies were  done in the late                                                            
'90s  taking  population  into  account  and estimated  if  all  the                                                            
community  services   that  are  being  developed   right  now  were                                                            
completed  that API  could work  with 54  - 72 beds.  "That has  not                                                            
changed and that is still the plan we are functioning under."                                                                   
                                                                                                                                
SENATOR WILKEN  asked for the graphs they had before  when this gets                                                            
to Finance.  He  expressed  concern about  spending  $50 million  to                                                            
build  a building  that could  be full the  first day  it opens.  He                                                            
asked if $9  million for demolition  of the old building  was passed                                                            
to the state and is shed from this proposal's budget.                                                                           
                                                                                                                                
MR. BURNS replied  that the demolition  funds were removed  entirely                                                            
from  the  bill.  The  intent,  which   is  mentioned  in  both  the                                                            
legislation  and the  agreement, is  to approach  the Congressional                                                             
delegation for  federal funds for the demolition,  which has already                                                            
been done.  He explained that a road  is planned on the site  of the                                                            
old building  and they would  seek demolition  funds that way.   The                                                            
building is the state's responsibility until it is torn down.                                                                   
                                                                                                                                
CHAIRWOMAN GREEN  asked if there is going to be a  public hearing on                                                            
the proposal for that road.                                                                                                     
                                                                                                                                
MR. BURNS replied  that they are only  plans. The entire  area would                                                            
have to go through  municipal planning and zoning,  platting and all                                                            
of those processes.                                                                                                             
MR. KURT PARKAN,  Deputy Commissioner, Department  of Transportation                                                            
and Public  Facilities (DOTPF), said  regarding the road,  the whole                                                            
AMHTA process  would have to be followed before it's  approved. That                                                            
includes conformance with  the long-range transportation plan, AMHTA                                                            
policy, and borough and municipal concurrence.                                                                                  
                                                                                                                                
CHAIRWOMAN GREEN  commented that this could happen  in 2010 or 2020.                                                            
She asked if the  level of participation by the AMHTA  had undergone                                                            
any changes that she hasn't noticed.                                                                                            
                                                                                                                                
MR.  JEFF JESSE,  Executive  Director,  Alaska Mental  Health  Trust                                                            
Authority, replied  that beginning July 1 income from  $2 million of                                                            
the Trust  fund will  be allocated  to the project;  and in  July of                                                            
2002, another  $1 million. The income  from those funds will  now be                                                            
dedicated to projects increasing their participation.                                                                           
                                                                                                                                
MS. SUZANNE  PRICE, Executive Director,  Fairbanks Community  Mental                                                            
Health Center, supported  HB 76. She said that if community services                                                            
are funded appropriately,  a larger structure won't  be needed. Many                                                            
in Fairbanks  don't want  a large hospital  in Anchorage; they  want                                                            
people  treated  in  the  community.    But  everyone   knows  API's                                                            
expertise and services are needed.                                                                                              
                                                                                                                                
SENATOR LEMAN  moved to pass  CSSSHB 76(FIN)  and fiscal notes  from                                                            
committee with individual  recommendations. There were no objections                                                            
and it was so ordered.                                                                                                          
                                                                                                                                
                      HB 101-CHARTER SCHOOLS                                                                                
                                                                                                                                
CHAIRWOMAN GREEN announced HB 101 to be up for consideration.                                                                   
                                                                                                                                
REPRESENTATIVE  DYSON, sponsor of HB 101, said he  has worked on the                                                            
charter school issue for  four and half years. This bill extends the                                                            
contract  period for  charter  schools from  five to  ten years,  it                                                            
removes the geographical  limitations; it does away  with the sunset                                                            
date; it  allows the charter  schools to  use public buildings  that                                                            
may not  meet school safety  codes, but have  been agreed to  by the                                                            
local building  inspector and the superintendent (such  as churches,                                                            
public halls, and other  public spaces). It makes it very clear that                                                            
charter school  students are subject  the graduate competency  test.                                                            
                                                                                                                                
HB  101  does  three  things  financially.  It  adds  staff  to  the                                                            
Department of Education  and Early Development to do a better job of                                                            
overseeing  the charter  schools  and helping  them;  it gives  them                                                            
start-up money,  and it reduces the  threshold from 200 to  150 that                                                            
the school needs in order  to not be counted with the largest school                                                            
in the  district.  It also  increases the  allowable  number in  the                                                            
state from  30 to 60. These schools  are all under the local  school                                                            
district and  can only be started  after a contractual agreement  is                                                            
reached with the  school district and under strict  supervision from                                                            
the local school district.                                                                                                      
                                                                                                                                
SENATOR WILKEN  asked if  we are lowering  the safety standards  for                                                            
these schools, even though they are acceptable.                                                                                 
                                                                                                                                
REPRESENTATIVE DYSON answered  yes. He said that quite a few charter                                                            
schools have moved  into a business or a mall. Malls  don't have the                                                            
same safety  standards as  schools, but they  certainly meet  public                                                            
safety standards.  He cited an example  of one charter school  at an                                                            
airport  where the  students are  learning aircraft  technology  and                                                            
graduating with a pilot's license as AMPs.                                                                                      
                                                                                                                                
SENATOR DAVIS  said she was  glad to see  this bill and appreciates                                                             
all the work that has been done on it.                                                                                          
                                                                                                                                
REPRESENTATIVE DYSON responded  that due to Senator Green's efforts,                                                            
the Mat-Su  school district supplies  about $1,000 more per  charter                                                            
school student than most other districts.                                                                                       
                                                                                                                                
TAPE 01-39, SIDE B                                                                                                            
                                                                                                                                
CHAIRWOMAN GREEN explained  a proposed amendment on page 3, line 23,                                                            
to the charter school grant  program language saying, "If the amount                                                            
appropriated  in a fiscal year is  insufficient to meet the  amounts                                                            
authorized  under (a) of this section,  the department shall  reduce                                                            
pro rata each pupil's grant  by the necessary percentages determined                                                            
by the  partner."  The amendment  would  say, "If  a charter  school                                                            
grant  is reduced  under this  subsection,  the charter  school  may                                                            
apply to the department  in a subsequent fiscal year for the balance                                                            
of the grant."                                                                                                                  
                                                                                                                                
SENATOR DAVIS moved amendment 1.                                                                                                
                                                                                                                                
SENATOR  LEMAN explained  he  did not have  a problem  with  charter                                                            
schools applying as long  as it's understood that it's not mandatory                                                            
that they will  receive that grant, which would still  be subject to                                                            
legislative appropriation.                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN  announced   that  there  were  no  objections  to                                                            
amendment #1 and it was adopted.                                                                                                
                                                                                                                                
SENATOR  DAVIS moved  to pass SCS  CSHB 101(HES)  with the  attached                                                            
fiscal  note   with  individual  recommendations.   There   were  no                                                            
objections and it was so ordered.                                                                                               
                                                                                                                                
         HB 203-SPECIAL APPROP: SCHOOL DIST. COST FACTORS                                                                   
                                                                                                                                
CHAIRWOMAN GREEN announced HB 203 to be up for consideration.                                                                   
                                                                                                                                
SENATOR  WILKEN  moved  to  adopt  the  SCS  CSHB  203(HES)  version                                                            
O/Cramer/4/26/01.  There were no objections  and it was so  ordered.                                                            
                                                                                                                                
SENATOR WILKEN said that  he and Representative Wilson had gone over                                                            
this bill and agreed on all items but one.                                                                                      
                                                                                                                                
REPRESENTATIVE  PEGGY WILSON, sponsor of HB 203, explained  that the                                                            
study is on school  district cost factors. She said  she didn't have                                                            
a problem with  Legislative Budget  and Audit overseeing  the study.                                                            
She said that section 1  was the same, although the wording has been                                                            
changed.                                                                                                                        
                                                                                                                                
She said she called Mr.  David Cottrell, a school auditor, and asked                                                            
him if the  study could be  done in the stated  amount of time.   He                                                            
thought it  could. A McDowell Group  spokesman said the study  could                                                            
be done  and Senator Therriault,  Chairman  of the Budget and  Audit                                                            
Committee, said  he knew everyone wanted this study  and it would be                                                            
something the auditors could get to right away.                                                                                 
                                                                                                                                
REPRESENTATIVE  WILSON  recommended that  the committee  change  the                                                            
date back to next year  and say that a preliminary report be done by                                                            
January 30, with a final report due April 1.                                                                                    
                                                                                                                                
SENATOR LEMAN moved to  adopt those dates and an immediate effective                                                            
date on page 1, line 9.                                                                                                         
                                                                                                                                
SENATOR WILKEN objected  saying that this study is really important.                                                            
It affects how schools  get funded across the state. He thought they                                                            
needed to sort  some things out first.  In 1998, the McDowell  Group                                                            
found that the  53 school districts didn't even have  a common chart                                                            
of accounts.  This will  be the  third year that  two auditors  have                                                            
been out trying  to get the accounts aligned, so people  can compare                                                            
costs between  districts. He  felt the chart  of accounts should  be                                                            
aligned across the state and working as they should be.                                                                         
                                                                                                                                
He explained when they  get some cost comparisons, they boil it down                                                            
to a model  that projects numbers  that are valid for the  53 school                                                            
districts.  Then it has to get tested  to see how real data  reacts.                                                            
He didn't think  that they wanted the preliminary  report next year,                                                            
an election  year, where  it will  get bogged  down in politics.  He                                                            
said that this  would definitely shift some money  around and no one                                                            
knew where it would go.                                                                                                         
                                                                                                                                
SENATOR WILKEN concluded  saying, "First of all we need to make sure                                                            
the system  is in  place to measure  and, secondly,  that the  model                                                            
works and that  it's valid and we  have confidence in it.  When that                                                            
happens,  then  in '03  we  can go  ahead  and  work this  into  the                                                            
foundation formula ...."                                                                                                        
                                                                                                                                
CHAIRWOMAN GREEN asked  if he was assuming that the information that                                                            
comes in will somehow be part of an every other year correction.                                                                
                                                                                                                                
SENATOR WILKEN answered in his mind he thought so.                                                                              
                                                                                                                                
MR. EDDY JEANS,  School Finance and  Facilities Section,  Department                                                            
of Education  and Early  Development (DOEED),  commented that  SB 36                                                            
requires  DOEED to review  and update the  cost differentials  every                                                            
other  year and to  make recommendations  to  the legislature.  This                                                            
year, DOEED's  report used  the McDowell methodology  (in SB  36) to                                                            
update the cost  differentials, but DOEED found the  methodology was                                                            
flawed. DOEED  took revised calculations back to the  McDowell Group                                                            
and asked them  to review them.  The McDowell Group  agreed that the                                                            
methodology  can no longer  be used.  Subsequently,  the  Governor's                                                            
Education Funding  Task Force has recommended that  a new cost study                                                            
be done.                                                                                                                        
                                                                                                                                
SENATOR  WILKEN asked  which  year he was  comfortable  using for  a                                                            
report date.                                                                                                                    
                                                                                                                                
MR. JEANS replied  January 15, 2003. He thought that  studies in the                                                            
past had  been hurried projects,  which has  led to questions  about                                                            
the validity of  the differentials. He didn't expect  the cost study                                                            
to be based  on audited expenditures  as previous studies  had done.                                                            
He envisioned  the study to be based on other types  of indices that                                                            
demonstrate the variance  in cost of delivering education around the                                                            
state.                                                                                                                          
                                                                                                                                
CHAIRWOMAN GREEN announced a brief at-ease.                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN  called  the  meeting  back  to  order  and  asked                                                            
Representative Wilson if she wanted to comment on the amendment.                                                                
                                                                                                                                
REPRESENTATIVE  WILSON said she talked  to Senator Therriault  about                                                            
the Request  for Proposal  process and is  ready to work at  getting                                                            
the education community on board when session is over.                                                                          
                                                                                                                                
SENATOR LEMAN  said he thought the amendment provided  adequate time                                                            
or he wouldn't have offered it.                                                                                                 
                                                                                                                                
CHAIRWOMAN  GREEN called for a roll  call vote. SENATOR LEMAN  voted                                                            
yes; SENATORS  WILKEN, DAVIS, and GREEN voted no;  and the amendment                                                            
failed.                                                                                                                         
                                                                                                                                
MR.  DARROLL  HARGRAVES,  Executive   Director,  Council  of  School                                                            
Administrators,  said SB  203 has  support and looks  like an  issue                                                            
they can  look forward to  working with in  the next few months.  He                                                            
said the Council supports  this bill. "I do know that there are very                                                            
few states  in the Union  who have attempted  to take a snapshot  of                                                            
what's  actually  happening  in  schools  to  set  this  kind  of  a                                                            
differential.   Theoretically,  charts   of  accounts  are   current                                                            
expenditures  and  should  have  nothing  to do  with  setting  cost                                                            
differentials.  It  should be  based  on what  is happening  in  the                                                            
communities' economy."                                                                                                          
                                                                                                                                
He said  that in the early  '80s, they hired  the Stanford  Group to                                                            
do the foundation  funding study for us. It collapsed  under its own                                                            
weight as it did in other  places. They attempted to describe school                                                            
districts in terms  of money. He cautioned that the  language in the                                                            
bill will set  the philosophy for the direction of  the study and is                                                            
extremely critical to the results they are going to get.                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN asked what  language he  thought was important  to                                                            
get.                                                                                                                            
                                                                                                                                
MR. HARGRAVES  replied, "These  terms reflect  what you're  going to                                                            
spend to  keep your  household going….  I look at  what the  cost of                                                            
those items are to get things into the community…."                                                                             
                                                                                                                                
CHAIRWOMAN  GREEN asked  him to  look at  line 10 to  see if  that's                                                            
improved language.                                                                                                              
                                                                                                                                
MR. HARGRAVES said he thought it was an improvement.                                                                            
                                                                                                                                
CHAIRWOMAN GREEN  said she didn't understand what  he was advocating                                                            
for.                                                                                                                            
                                                                                                                                
MR. HARGRAVES  summed it  up by saying, "Don't  look at the  audited                                                            
budgets of school districts to set cost differentials."                                                                         
                                                                                                                                
CHAIRWOMAN  GREEN  asked  if that  was  the issue  that  caused  the                                                            
McDowell study to be called into question.                                                                                      
                                                                                                                                
SENATOR WILKEN  answered that it was a matter of opinion.  It wasn't                                                            
perfect, but  it was a quantum leap  over the report from  1982.  He                                                            
agreed with  Mr. Hargraves.  "It's not a question  of what  we spend                                                            
today, but  what should we spend.  I think that's addressed  in line                                                            
10  when  it  says, 'Should   be based  on  the  cost  providing  an                                                            
education in each school district."                                                                                             
                                                                                                                                
SENATOR WILKEN  said he wasn't  sure they  could do this report.  He                                                            
was  concerned  that they  were  imposing  what the  schools  boards                                                            
should be doing  from the top down.   He didn't think that  meant it                                                            
shouldn't be started.                                                                                                           
                                                                                                                                
MR. HARGRAVES  said he thought the  language was O.K. as  long as it                                                            
has the  right philosophy  behind it. He  repeated his major  point,                                                            
"The chart  of accounts  and audited budgets  really shouldn't  have                                                            
much play in setting a cost differential."                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN said she  didn't know how  they could avoid  that.                                                            
                                                                                                                                
SENATOR  WILKEN said  he thought  it was  part of  the equation.  He                                                            
agreed  with Mr. Hargraves  that the  study shouldn't  be driven  by                                                            
what is being spent, but on what should be spent.                                                                               
                                                                                                                                
CHAIRWOMAN GREEN  said she didn't think the language  expressed what                                                            
he  way  saying.  She  asked  everyone  for  suggestion  for  better                                                            
language.                                                                                                                       
                                                                                                                                
Number 1169                                                                                                                     
                                                                                                                                
MR.  JEANS  said   that  he  didn't  think  more  wordsmithing   was                                                            
necessary.  It provides a  little guidance  highlighting some  areas                                                            
that need  to be  looked at when  considering  the indices for  cost                                                            
differentials.   He  thought  cooperative   effort  was   needed  in                                                            
developing  the RFP  to ensure  that it  does what  they want  it to                                                            
before it hits the street.                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN asked  if the  language  in section  1 gave  DOEED                                                            
authority to work with the study.                                                                                               
                                                                                                                                
MR.  JEANS  said he  thought  it did  and  that  item 1  gives  them                                                            
additional  guidance.   He thought   they  shouldn't  get  any  more                                                            
prescriptive.                                                                                                                   
                                                                                                                                
CHAIRWOMAN GREEN  asked what language allowed them  to work with the                                                            
different school districts.                                                                                                     
                                                                                                                                
MR.  JEANS  replied  that  he  intended   to  do  that  through  the                                                            
Department of Education and that was in the intent language.                                                                    
                                                                                                                                
SENATOR WILKEN  moved amendment #2 on page 1, line  6, to delete "to                                                            
prepare and contract for  the preparation" and to insert "enter into                                                            
a contract for"  and, on page 2, to delete line 4  to conform with a                                                            
Department of Law concern.                                                                                                      
                                                                                                                                
SENATOR  LEMAN suggested  deleting "and"  on page  2, line 4  and to                                                            
insert "and" on  line 1 and change the semicolon into  a period. The                                                            
committee indicated approval of the change in wording.                                                                          
                                                                                                                                
CHAIRWOMAN GREEN  asked if there were any further  objections. There                                                            
were no further objections and amendment #2 was adopted.                                                                        
                                                                                                                                
SENATOR  LEMAN moved  amendment  #3 on  page  1, line  14 to  delete                                                            
"between" and  insert "among" and do the same thing  on page 2, line                                                            
3.  He  also  asked  on  page  1, line  12,  if  there  was  a  cost                                                            
differential for the shipping of school materials and supplies.                                                                 
                                                                                                                                
REPRESENTATIVE  WILSON replied  that it depends  on several  things,                                                            
but if you run  out of something and have to run to  the local store                                                            
to get it, it will cost more in some areas than in others.                                                                      
                                                                                                                                
SENATOR LEMAN said he wanted  to compare costs in more than a lineal                                                            
way.  He wanted  to  compare more  than  Anchorage to  Wrangell;  he                                                            
wanted to  compare Wrangell  to Petersberg  and Barrow to  Ketchikan                                                            
and Bethel.                                                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN asked  if there  was opposition  to amendment  #3.                                                            
There were no objections and it was adopted.                                                                                    
                                                                                                                                
CHAIRWOMAN GREEN  asked on page 1, line 10, if specifically  saying,                                                            
"the cost of shipping  school materials and supplies,"  implies that                                                            
that's the only  extraordinary cost you would consider?  She thought                                                            
it would make much more  sense to say, "the cost of the school lunch                                                            
program,  the  cost of  school  materials  and  supplies,  shipping,                                                            
transportation costs."                                                                                                          
                                                                                                                                
She would have  preceded that with a phrase "such  as" so they don't                                                            
get so narrow in meaning.                                                                                                       
                                                                                                                                
REPRESENTATIVE  WILSON replied that the language at  the end of line                                                            
12,  "other  costs  that  relate  directly   or  indirectly  to  the                                                            
operation of the school," covers a multitude of things.                                                                         
                                                                                                                                
MR.  JEANS said  he  thought  the language  allowed  them  a lot  of                                                            
flexibility.                                                                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN  said  she  wanted  it on  the  record  that  this                                                            
language was meant to be very, very inclusive.                                                                                  
                                                                                                                                
SENATOR LEMAN  moved amendment  #4 to delete  "shipping" on  page 1,                                                            
line 12. There were no objections and it was so ordered.                                                                        
                                                                                                                                
              SCR 13-SUSPEND UNIFORM RULES FOR HB 203                                                                       
                                                                                                                                
SENATOR WILKEN asked if SCR 13 needs to travel with the bill.                                                                   
                                                                                                                                
CHAIRWOMAN GREEN indicated that is correct.                                                                                     
                                                                                                                                
SENATOR WILKEN  moved that SCR 13 pass from committee  and asked for                                                            
unanimous consent. There were no objections.                                                                                    
                                                                                                                                
SENATOR WILKEN  moved to pass SCS CSHB 203(HES) from  committee with                                                            
attached fiscal notes and  individual recommendations. There were no                                                            
objections and it was so ordered.                                                                                               
                                                                                                                                
         HB 115-EMERGENCY COMMITMENT ORDERS AND TREATMENT                                                                   
                                                                                                                                
CHAIRWOMAN GREEN announced HB 115 to be up for consideration.                                                                   
                                                                                                                                
REPRESENTATIVE  MARY KAPSNER,  sponsor, said  she wanted someone  to                                                            
offer an  amendment  on page 3,  line 4 following  "physician's"  to                                                            
insert, "physician assistants or advanced nurse practitioner".                                                                  
                                                                                                                                
SENATOR LEMAN  moved amendment #1.  There were no objections  and it                                                            
was so ordered.                                                                                                                 
                                                                                                                                
REPRESENTATIVE  KAPSNER explained  that HB  115 does two things:  it                                                            
expands  the definition  of mental  health professional  to  include                                                            
three people, a licensed  clinical social worker, a licensed marital                                                            
and family therapist and  a licensed professional counselor. It adds                                                            
these  people to  the pool  of clinicians  who are  able to  perform                                                            
mental health evaluations.                                                                                                      
                                                                                                                                
Second,  HB  115 allows  physician  assistants  and  advanced  nurse                                                            
practitioners   to  sign  medical  certificates  of   necessity  for                                                            
treatment  of individuals  for  alcohol  and drug  dependency  under                                                            
Title 47.                                                                                                                       
                                                                                                                                
SENATOR LEMAN said he received  a number of messages opposed to this                                                            
bill because  it expands into areas  that it shouldn't go.  He asked                                                            
if there was some kind of turf battle.                                                                                          
                                                                                                                                
REPRESENTATIVE  KAPSNER said  she only received  one e-mail  in that                                                            
regard. The reason  for this legislation is that right  now when one                                                            
person  feels that  another  person  needs to  get alcohol  or  drug                                                            
treatment, only a doctor  can sign the petition that is presented to                                                            
a judge to  make the final decision.  In some areas, there  are very                                                            
few or no physicians.                                                                                                           
                                                                                                                                
She  said  that a  lot  of  doctors are  wary  of  prescribing  that                                                            
treatment without seeing the patient.                                                                                           
                                                                                                                                
TAPE 01-40, SIDE A                                                                                                            
                                                                                                                              
REPRESENTATIVE  KAPSNER said  she didn't know  where the  resistance                                                            
was coming from.                                                                                                                
                                                                                                                                
SENATOR  LEMAN  said   his  messages  weren't  well  documented   or                                                            
supported from what he remembers.                                                                                               
                                                                                                                                
REPRESENTATIVE  KAPSNER  said  she  thought  some  people  might  be                                                            
confused, because  they are afraid that someone could  involuntarily                                                            
commit someone. She said  that all the cases have to be presented to                                                            
a judge and he makes the  final decision regardless of who signs the                                                            
petition  for the  certificate of  necessity for  treatment. To  her                                                            
knowledge,  no physicians have  been opposed  to this and no  one in                                                            
the mid-level practitioner field has opposed the bill.                                                                          
                                                                                                                                
MS.  PAM WATTS,  Director,  Advisory Board  on Alcoholism  and  Drug                                                            
Abuse,  said  that   any  opposition  has  been  primarily   due  to                                                            
misinformation  and inaccurate views about what this  bill would do.                                                            
She was testifying regarding only the alcohol section.                                                                          
                                                                                                                                
She  said   the  legislation  addresses   two  different   kinds  of                                                            
commitments. One is an  emergency commitment for up to 48 hours. The                                                            
involuntary commitment in sections 4 and 5 is up to 30 days.                                                                    
                                                                                                                                
MS. WATTS explained that  an emergency under current statute is when                                                            
a physician examines the  individual and determines that they are in                                                            
need of emergency medical  care and monitoring. There is a provision                                                            
for an extension up to  five days if it's determined they need to be                                                            
monitored longer.                                                                                                               
                                                                                                                                
The involuntary  commitment is for  up to 30 days with an  extension                                                            
provision for  up to 180 days, if they go back to  court for another                                                            
examination.  The only  thing  this bill  asks is  when the  medical                                                            
examination is  done, it need not be done by a physician.  Physician                                                            
assistants  or  advanced   nurse  practitioners  who   currently  do                                                            
physical  examinations around  the state, would  legally be  able to                                                            
examine  a  patient.  She didn't  think  there  was  any  difference                                                            
between a physician  assistant, a  nurse practitioner, or  a medical                                                            
doctor's  ability  to make  that determination,  although  it  might                                                            
require some training.  The physician's certificate  is a small part                                                            
of what is required for a 30 day involuntary commitment.                                                                        
                                                                                                                                
Number 513                                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN said that some people  from one area of  the state                                                            
came in with  concerns. In one case,  a woman was in the  process of                                                            
adopting and  she went to local medical  provider because  she had a                                                            
lot of headaches because  of stress from taking care of the children                                                            
she already  had. That  health care  provider went  to the  adoption                                                            
agency and told  them that she was way too stressed  and to stop the                                                            
adoption. The woman was  devastated. This was in an area where there                                                            
weren't   enough   health   care   providers   and   an   abuse   of                                                            
confidentiality.   She  asked  if   there  are  any  assurances   of                                                            
confidentiality.                                                                                                                
                                                                                                                                
MS.  ANNE  HENRY,  Division  of  Mental  Health  and  Developmental                                                             
Disabilities,  said one thing they think will be helpful  about this                                                            
bill is that people  who are licensed are required  to follow a code                                                            
of ethics.  If they violate someone's  confidentiality, they  can be                                                            
sanctioned.                                                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN said she  appreciated that  and the woman  she was                                                            
talking about  didn't have anyone in her community  to talk to about                                                            
her situation.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  KAPSNER said that they couldn't prevent  people from                                                            
talking, but  this bill would provide  more people who can  sign for                                                            
the petition to go to the judge.                                                                                                
                                                                                                                                
SENATOR  WARD  asked   if  a  physician's  assistant   can  practice                                                            
currently without a contract with a physician.                                                                                  
                                                                                                                                
MS. HENRY answered yes.                                                                                                         
                                                                                                                                
SENATOR  WARD  asked   if  a  person  could  practice   as  a  nurse                                                            
practitioner without being contracted with a physician.                                                                         
                                                                                                                                
MS. HENRY answered yes.                                                                                                         
                                                                                                                                
SENATOR  DAVIS said  she thought  30 days  was much  too long  for a                                                            
nurse practitioner  to be able to  have someone not receive  medical                                                            
attention. She thought 48 hours to five days was fine.                                                                          
                                                                                                                                
MS. HENRY said  there is confusion about the alcohol  commitment and                                                            
the mental health commitment.                                                                                                   
                                                                                                                                
CHAIRWOMAN GREEN announced a recess to move to another room.                                                                    
                                                                                                                                
CHAIRWOMAN GREEN called the meeting back to order at 3:35 pm.                                                                   
                                                                                                                                
                   SB  11-COMPULSORY SCHOOL AGE                                                                             
                                                                                                                                
SENATOR WARD  moved to pass SB 11  out of committee with  individual                                                            
recommendations.                                                                                                                
                                                                                                                                
TAPE 01-41, SIDE A                                                                                                            
                                                                                                                                
There were no objections and it was so ordered.                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN  announced HB 115 to be back before  the committee.                                                            
                                                                                                                                
MS. KATHLEEN  WEDEMEYER, Fairbanks  resident, said she didn't  think                                                            
an individual needed to  work in a particular field in order to have                                                            
a  balanced  opinion  and make  an  informed  decision  about  these                                                            
situations.  She thought  provisions in this  bill would  ultimately                                                            
cause more  harm than good. She felt  it would take away  a person's                                                            
individual  freedom,  which  is a  weighty  decision,  whether  that                                                            
person has alcohol problems  or not. She thought taking the decision                                                            
out of  highly trained  professional hands  increased the  potential                                                            
for abuses of individual rights and lawsuits.                                                                                   
                                                                                                                                
SENATOR WARD  said he understands  that it's a small segment  of the                                                            
population  and that taking away someone's  rights and locking  them                                                            
up for no good  reason is a concern,  but some people have  lost the                                                            
ability to  take care of themselves.   He asked if we didn't  have a                                                            
responsibility  to take care of them and there simply  aren't enough                                                            
physicians to get these people into some type of program.                                                                       
                                                                                                                                
MS. WEDEMEYER said that  some doctors are concerned that there could                                                            
be an  underlying  physical reason  for  a person's  action and  she                                                            
thought there  needed to  be every account  taken to make sure  it's                                                            
not one of those  cases. She also thought the bill  was too general.                                                            
                                                                                                                                
CHAIRWOMAN GREEN thanked her for her testimony.                                                                                 
                                                                                                                                
MS. BARBARA  CRAVER, Alaska Bar Association,  said she used  to work                                                            
for the  City and Borough  of Juneau for  10 years. She represented                                                             
the  Juneau  Recovery   Hospital  in  involuntary  commitments   and                                                            
emergency procedures for  that time. She thought that sections 4 and                                                            
5 were  the more important  sections, because  they have to  do with                                                            
when a court can  order a 30 day involuntary commitment.  Those same                                                            
standards  would   apply  if  a  person  were  to  petition   for  a                                                            
recommitment  of up to 180  days. These are  significant periods  of                                                            
time.  She thought  it would  be helpful  to think  about it from  a                                                            
lawyer's  point  of  view.   She  pointed  out that  these  are  the                                                            
standards that  allow a court to accept  certain kinds of  testimony                                                            
to prove incapacity.                                                                                                            
                                                                                                                                
Section 4 deals  with the type of  evidence that the Superior  Court                                                            
can use for ordering  an involuntary commitment. She  said that it's                                                            
easy to misunderstand  that the person who makes the  decision about                                                            
whether there's  sufficient evidence to commit a person  is a judge.                                                            
The standards  of  the statute  currently restrict  evidence  that's                                                            
provided for a medical evaluation to that of a physician.                                                                       
                                                                                                                                
Language in HB  115 would expand that to a physician  assistant's or                                                            
an  advanced nurse  practitioner's  evidence  being  allowed by  the                                                            
judge. None of  the proposed sections touch the fact  that the court                                                            
must clearly  find that  the grounds for  an involuntary  commitment                                                            
have been established.  Communities have found it  very difficult to                                                            
get the  medical evidence  because  of the lack  of physicians.  She                                                            
emphasized  that other  kinds of evidence  have  nothing to do  with                                                            
this, like what  kind of drinking habits that person  has, what kind                                                            
of care  they can  give themselves.  This  kind of  evidence can  be                                                            
given by a whole lot of other people, because it's not medical.                                                                 
                                                                                                                                
MS. CRAVER emphasized:                                                                                                          
                                                                                                                                
     I want  to try and  reassure you that  the protections  of                                                                 
     the  court,   the  protections   of  a  jury  trial,   the                                                                 
     protections  of a court  appointed lawyer  continue to  be                                                                 
     there for  the person who is considered the respondent  in                                                                 
     these  actions. The  only thing these  two sections  would                                                                 
     change  would be that  the court could  even consider  and                                                                 
     accept  as evidence the examination  of a person who  is a                                                                 
     physician  assistant  or an advanced  nurse practitioner.                                                                  
     Right now  the court would not be able to consider  those.                                                                 
     Nothing   says   that   there  can't   be   more  medical                                                                  
     professionals  there to  give an opinion.  For example,  a                                                                 
     defense  attorney for  the respondent  might say, "I  just                                                                 
     don't  think  that  this  person  who  gave  the  initial                                                                  
     petition certificate had  enough information. I'm going to                                                                 
     have the  respondent examined  by my own physician at  the                                                                 
     court's  expense." You can do  that. You can have as  much                                                                 
     evidence  as  you need  if  you think  there's  a genuine                                                                  
     dispute.                                                                                                                   
                                                                                                                                
     In  my  experience,  in  10  years  of doing  involuntary                                                                  
     commitment  procedures, there  has never been a competing                                                                  
     physician.  Usually the  examination by  the physician  is                                                                 
     not in  controversy. The bare  medical fact about whether                                                                  
     or not that  person is a chronic alcoholic is  usually not                                                                 
     the issue. A lot of times  the arguments come down to what                                                                 
     kind of treatment is appropriate  and where that treatment                                                                 
     should  be given. Often, the  respondent, themselves,  are                                                                 
     having a very difficult  time with accepting the fact that                                                                 
     they  need to be  forced to  do this. That's  sort of  the                                                                 
     crux of the problem, too.                                                                                                  
                                                                                                                                
     If you can look at the larger  process of the court making                                                                 
     the decision  and all the provisions and protections  that                                                                 
     are  already in the  statute and the  court procedure,  it                                                                 
     might  allow  you  to consider  that  this  broadening  of                                                                 
     evidence is  all that's involved in sections 4  and 5. Not                                                                 
     that this  would be an insignificant help. It  would allow                                                                 
     even more  cases to be brought  to a judge, but the  judge                                                                 
     would  still have to  make the decision  as to whether  or                                                                 
     not  the grounds  had been  clearly established.  I  think                                                                 
     judges  are great advocates of  civil rights, themselves,                                                                  
     and reluctant  to see anybody railroaded and subjected  to                                                                 
     the court's power without legitimate reason.                                                                               
                                                                                                                                
SENATOR  WARD  asked  what  the  definition  of  an  advanced  nurse                                                            
practitioner is.                                                                                                                
                                                                                                                                
MS. HENRY replied that  the Division of Occupational Licensing would                                                            
have it.                                                                                                                        
                                                                                                                                
SENATOR WARD asked for  the language to be brought to the committee.                                                            
                                                                                                                                
MS. HENRY said  that advanced nurse  practitioners are qualified  to                                                            
administer all kinds of drugs and narcotics.                                                                                    
                                                                                                                                
SENATOR  DAVIS asked  what  kind of  training and  guidelines  these                                                            
people would have to get.                                                                                                       
                                                                                                                                
MS. CRAVER replied  that she didn't think they needed  training, but                                                            
guidance.  Typically,  they  will not  be  the ones  initiating  the                                                            
situation.  She explained that the  certificate is very simple.  "Is                                                            
this person an  alcoholic in your opinion as a medical  professional                                                            
and are  they incapacitated?  Do they  lack the  judgment to  make a                                                            
rational decision?"                                                                                                             
                                                                                                                                
She thought  the general  definition  of an alcoholic  that all  the                                                            
professionals use is based on the DSM IV.                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN  thanked everyone for their testimony  and said she                                                            
would hold the bill for further work.                                                                                           
                                                                                                                                
            SB  40-EDUC.OF DISABLED OR GIFTED CHILDREN                                                                      
                                                                                                                              
CHAIRWOMAN GREEN announced SB 40 to be up for consideration.                                                                    
                                                                                                                                
DR. BRUCE JOHNSON, Deputy  Commissioner, Department of Education and                                                            
Early  Development,  said SB  40 was developed  with  a broad  based                                                            
constituent  group  on  the  special  education   of  children  with                                                            
disabilities  and individuals  representing  the  exceptionality  of                                                            
giftedness. They believe it is a good bill.                                                                                     
                                                                                                                                
He  said  last year  DOEED  required  school  districts  to  provide                                                            
services  for children identified  as gifted,  but left the  service                                                            
decisions up to  the local district. There is no money  at the state                                                            
level;  money is  passed through  as the  20 percent  block  grants.                                                            
Constituents wanted the state to provide oversight, however.                                                                    
                                                                                                                                
CHAIRWOMAN  GREEN  said  that currently  the  state  has  no say  in                                                            
qualifications for a gifted program for a certain district.                                                                     
                                                                                                                                
DR. JOHNSON said that is  correct. The scope of the project is up to                                                            
the school district  and DOEED receives a plan of  service from each                                                            
of them.                                                                                                                        
                                                                                                                                
CHAIRWOMAN GREEN asked if the state has an appeal process.                                                                      
                                                                                                                                
DR. JOHNSON  said  the appeals  process is  an issue  and the  state                                                            
rarely gets  involved in resolving  disputes, but the threat  of the                                                            
state getting  involved helped the districts solve  the differences.                                                            
                                                                                                                                
CHAIRWOMAN  GREEN asked if  the school districts  have a mandate  to                                                            
provide  an  appeal  process  for  all  parents   and  students  for                                                            
decisions that  a school district makes that a parent  doesn't like.                                                            
                                                                                                                                
DR. JOHNSON  replied that he didn't  know if it was in statute,  but                                                            
every  school district  has a  complaint resolution  process  that's                                                            
well founded in the board's  policies and administrative procedures.                                                            
                                                                                                                                
CHAIRWOMAN  GREEN  asked if  it  was limited  to  special  education                                                            
students.                                                                                                                       
                                                                                                                                
DR. JOHNSON  answered  that it is  open to any  parent or  community                                                            
member  that has  an  issue with  the school  district.  It  usually                                                            
involves trying  to resolve the issue  at the lowest possible  level                                                            
and moving  it forward  to the Board  of Education  and then  to the                                                            
Superior Court.                                                                                                                 
                                                                                                                                
CHAIRWOMAN GREEN asked  if there could be a mediation process if the                                                            
local school district had it in their policy.                                                                                   
                                                                                                                                
DR. JOHNSON answered, "Absolutely."                                                                                             
                                                                                                                                
CHAIRWOMAN GREEN said she  thought that the districts probably had a                                                            
variety of ways of implementing a complaint procedure.                                                                          
                                                                                                                                
DR. JOHNSON said that was correct.                                                                                              
                                                                                                                                
CHAIRWOMAN GREEN said that  there has been continued interest in the                                                            
state having  the appearance of oversight.   She explained  that the                                                            
proposed  committee   substitute   handles  the  problem   a  little                                                            
differently and  her goal was to get it passed this  year. She asked                                                            
Dr. Johnson to  explain the dilemma DOEED is in if  it doesn't pass.                                                            
                                                                                                                                
DR.  JOHNSON  responded  that   for  the  last  several  years,  the                                                            
Department  has  been  under  corrective  action  from  the  federal                                                            
government and  it had to do with the fact that the  Department some                                                            
years   ago    was   spending   federal    dollars   on    the   G/T                                                            
(Gifted/Talented)  programs around  the state, particularly  when it                                                            
came to  monitoring.  Three years  ago, a monitoring  review  by the                                                            
federal  government  said the  state  could not  do  that; that  the                                                            
federal money  was to be used for  children with disabilities,  even                                                            
though the  state had a broader definition  of exceptional  children                                                            
with an umbrella  that covered children  with disabilities  and G/T.                                                            
                                                                                                                                
DR. JOHNSON  said they have been respecting  that review  ever since                                                            
that  time and  had regulations  prepared  a year  ago giving  clear                                                            
directions.  Now, DOEED is trying  to get statutes in line  with the                                                            
federal IDEA  '97 statutes and regulations.  SB 40 is an  attempt to                                                            
do that. The  portion dealing with  children with disabilities  does                                                            
that very well.  The federal government has no voice  in identifying                                                            
children who are gifted. It's up to the local district.                                                                         
                                                                                                                                
CHAIRWOMAN GREEN said that  Congressman Jeffords was trying to get a                                                            
federal  mandate for  gifted  children and  she thought  the  timing                                                            
would be  better if Alaska  tries to get its  statute to conform  to                                                            
the federal one.                                                                                                                
                                                                                                                                
CHAIRWOMAN GREEN recessed the meeting to the call of the chair.                                                                 
                                                                                                                                
CHAIRWOMAN GREEN called  the meeting back to order at 4:37 p.m. with                                                            
all members present. She said that SB 40 was before them.                                                                       
                                                                                                                                
SENATOR WARD  moved to adopt the F  version committee substitute  of                                                            
SB 40. There were no objections and it was so ordered.                                                                          
                                                                                                                                
SENATOR  WARD moved  to pass CSSB  40(HES) from  committee with  the                                                            
accompanying  fiscal  note with  individual  recommendations.  There                                                            
were no objections and it was so ordered.                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN adjourned the meeting at 4:39 p.m.                                                                             

Document Name Date/Time Subjects