Legislature(2001 - 2002)

05/05/2001 09:07 AM 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                                                                   
                            May 5, 2001                                                                                         
                             9:07 a.m.                                                                                          
                                                                                                                              
MEMBERS PRESENT                                                                                                               
Senator Lyda Green, Chair                                                                                                       
Senator Loren Leman, Vice Chair                                                                                                 
Senator Gary Wilken                                                                                                             
Senator Bettye Davis                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Jerry Ward                                                                                                              
                                                                                                                              
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
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."                                                                                               
     MOVED SCS CSHB 115(HES) OUT OF COMMITTEE                                                                                   
                                                                                                                                
CS FOR HOUSE BILL NO. 113(HES) am                                                                                               
"An Act relating  to health care insurance payments  for hospital or                                                            
medical services; and providing for an effective date."                                                                         
     MOVED SCS CSHB 113(HES) OUT OF COMMITTEE                                                                                   
                                                                                                                                
CS FOR HOUSE BILL NO. 51(FIN)                                                                                                   
"An  Act giving  notice  of and  approving the  entry  into and  the                                                            
issuance  of certificates   of participation  for  a lease-purchase                                                             
agreement  for  a  seafood  and  food safety  laboratory   facility;                                                            
relating  to  the  use of  certain  investment  income  for  certain                                                            
construction costs; and providing for an effective date."                                                                       
     MOVED CSHB 51(FIN) OUT OF COMMITTEE                                                                                        
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
HB 115 - HB 115 - See HESS minutes dated 4/28/01.                                                                               
                                                                                                                                
HB 113 - See Labor and Commerce minutes dated 4/26/01.                                                                          
                                                                                                                                
HB 51 - No previous Senate committee action.                                                                                    
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
Representative Mary Kapsner                                                                                                     
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT:  Sponsor of HB 115                                                                                        
                                                                                                                                
Representative Joe Green                                                                                                        
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT:  Sponsor of HB 113                                                                                        
                                                                                                                                
Roland Gower, M.D.                                                                                                              
Alaska Physicians and Surgeons                                                                                                  
2841 DeBarr Rd.                                                                                                                 
Anchorage, AK                                                                                                                   
POSITION STATEMENT:  Supports SCS HB113(HES)                                                                                  
                                                                                                                                
Kurt Fredriksson                                                                                                                
Deputy Commissioner                                                                                                             
Department of Environmental Conservation                                                                                        
410 Willoughby Ave. Ste. 105                                                                                                    
Juneau, AK  99801-1795                                                                                                          
POSITION STATEMENT:  Presented and answered questions about CSHB
51(FIN)                                                                                                                         
                                                                                                                                
Janice Adair, Director                                                                                                          
Division of Environmental Health                                                                                                
Department of Environmental Conservation                                                                                        
555 Cordova St.                                                                                                                 
Anchorage, AK  99501                                                                                                            
POSITION STATEMENT:  Answered questions about CSHB 51(FIN)                                                                    
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 01-44, SIDE A                                                                                                            
Number 001                                                                                                                      
                                                                                                                                
                                                                                                                                
CHAIRWOMAN LYDA  GREEN called the Senate Health, Education  & Social                                                          
Services  Committee  meeting  to order  at  9:07 a.m.  Present  were                                                            
Senators  Wilken, Davis and  Green.  Senator  Leman arrived  at 9:08                                                            
a.m. The committee took up HB 115.                                                                                              
                                                                                                                                
         HB 115-EMERGENCY COMMITMENT ORDERS AND TREATMENT                                                                   
                                                                                                                                
CHAIRWOMAN GREEN announced that a proposed committee substitute                                                                 
(CS) was before the committee that would require a concurrent                                                                   
resolution due to a title change.                                                                                               
                                                                                                                                
SENATOR WILKEN  moved to adopt Version O as the working  document of                                                            
the committee.  There being no objection, Version O was adopted.                                                                
                                                                                                                                
REPRESENTATIVE  KAPSNER,  sponsor  of  HB 115,  explained  that  the                                                            
mental  health professional  portion  of the bill  was removed  from                                                            
Version O.   Under the CS, only middle-level  practitioners  will be                                                            
able to sign  the certificates of  need for a petition to  the court                                                            
for involuntary commitment.                                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN expressed continuing  concern that in communities                                                             
that  have a  consortium  of  providers who  interact  and  exchange                                                            
information  about  people,  it  is  absolutely  critical  that  the                                                            
provider who  is authorized to do  an involuntary commitment  uphold                                                            
ethical  and professional  requirements  regarding confidentiality.                                                             
She expressed  concern  about the  network of  information that  has                                                            
been created with the one-stop shopping approach for services.                                                                  
                                                                                                                                
SENATOR LEMAN moved to  report SCS CSHB 115(HES) from committee with                                                            
individual  recommendations with accompanying  fiscal notes.   There                                                            
being no objection, the motion carried.                                                                                         
                                                                                                                                
SENATOR LEMAN  moved the accompanying  Senate concurrent  resolution                                                            
(22 LS/C), which pertains  to the title change of SCS CSHB 115(HES).                                                            
 There being no objection, the motion carried.                                                                                  
                                                                                                                                
The committee then took up HB 113.                                                                                              
                                                                                                                                
               HB 113-HEALTH CARE INSURANCE PAYMENTS                                                                        
                                                                                                                                
CHAIRWOMAN  GREEN thanked  the sponsor and  all parties involved  in                                                            
this legislation.   She noted this  piece of legislation  is not one                                                            
that needed to be hammered  out at the committee table.  Instead, it                                                            
was  better  for all  parties  involved  to  come  to some  kind  of                                                            
workable agreement that  would solve the problems for physicians and                                                            
take into consideration  problems  faced by insurers when  trying to                                                            
deal with multi-state functions.                                                                                                
                                                                                                                                
REPRESENTATIVE  JOE GREEN, sponsor of HB 113, explained  that HB 113                                                            
is a  simple measure.   He believes  the modifications  made  by the                                                            
Senate HESS Committee  have improved the bill.  HB  113 ensures that                                                            
insurers of medical  practices, either hospitals or  physicians, pay                                                            
claims in  a timely fashion.   Insurance  companies must pay  claims                                                            
within 30  days of submittal  of a "clean"  claim. If, on the  other                                                            
hand, a submitted claim  is problematic, the insurer must notify the                                                            
medical  provider  as  to  what  is  needed.    Once  the  necessary                                                            
information is  provided, the insurer must pay that  claim within 15                                                            
calendar  days. This same  terminology is used  in 39 other  states.                                                            
The insurance  companies found this procedure to be  acceptable with                                                            
a  few exceptions  that  have  been  corrected  by the  Senate  HESS                                                            
Committee.   Interest   will  accrue   after  either   the  30   day                                                            
reimbursement  period  for a  clean  claim or  the extended  15  day                                                            
period for a problematic  claim beginning July 1 of  2002.  The bill                                                            
becomes effective on January  1 of 2002.  The six-month delay of the                                                            
interest  provision  will  ensure  that  the programs  used  by  the                                                            
insurance companies  are adequately  modified so that, for  example,                                                            
electronic claims can be  processed in a timely fashion.  The second                                                            
change is that  interest in the amount  of $1 or less will  not have                                                            
to be paid.                                                                                                                     
                                                                                                                                
Number 872                                                                                                                      
                                                                                                                                
CHAIRWOMAN  GREEN  asked  if  this bill  addresses  claims  for  new                                                            
procedures  for which rates  have not been  set and whether  non- or                                                            
delayed payment  for those  procedures would  be considered to  be a                                                            
legitimate dispute.                                                                                                             
                                                                                                                                
REPRESENTATIVE   GREEN   said  that   is  not   addressed  by   this                                                            
legislation.  That matter would be addressed as it is now.                                                                      
                                                                                                                                
CHAIRWOMAN GREEN took public testimony.                                                                                         
                                                                                                                                
DR.  ROLAND GOWER,  president  of Alaska  Physicians  and  Surgeons,                                                            
which represents about  180 specialists and primary care physicians,                                                            
stated support for SCS  HB 113(HES).  This bill will help physicians                                                            
stabilize  cash   flow  and  is  long  overdue.    Members   of  his                                                            
organization  understand the need  to delay the implementation  date                                                            
of the bill and the $1 minimum on interest.                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN said had time permitted,  she would have  liked to                                                            
look into the fact that  some physicians and vendors will not do the                                                            
second  filing for  patients with  secondary insurance.   She  urged                                                            
physicians to do that.                                                                                                          
                                                                                                                                
There being no further  public testimony, SENATOR LEMAN moved SCS HB
113(HES)  - Version  R, as the  working document  of the  committee.                                                            
There being no objection, the motion carried.                                                                                   
                                                                                                                                
SENATOR  LEMAN  then  moved  SCS HB  113(HES)  from  committee  with                                                            
individual  recommendations and its  zero fiscal note.  There  being                                                            
no objection, the motion carried.                                                                                               
                                                                                                                                
      CSHB  51(FIN)-LEGIS APPROVAL OF SEAFOOD/FOOD SAFETY LAB                                                               
                                                                                                                                
KURT  FREDRIKSSON,   Deputy  Commissioner   of  the  Department   of                                                            
Environmental  Conservation  (DEC), explained  the  purpose of  CSHB
51(FIN) is to  grant authorization for the issuance  of certificates                                                            
of participation  for a lease-purchase  agreement for a seafood  and                                                            
food safety  laboratory.   The existing laboratory  in Palmer  is 30                                                            
years old and  DEC's lease expires December 31, 2003.   The facility                                                            
is woefully  lacking  in terms  of what  DEC  needs to  do to run  a                                                            
proper laboratory  regarding confidence in lab results  and employee                                                            
safety. He  offered to make available  a videotape of the  facility.                                                            
He noted that DEC has worked  with private consultants over the last                                                            
few years on the  possibility of moving into a more  appropriate lab                                                            
facility.    DEC has  found  a  piece  of property  and  received  a                                                            
proposal.    CSHB  51(FIN)  provides   the  funds  to  build  a  DEC                                                            
laboratory within the Anchorage area.                                                                                           
                                                                                                                                
The current lab  performs a number of functions, the  most important                                                            
being seafood  and food safety analysis; 80 percent  of the lab work                                                            
is associated with food safety.  Other functions include:                                                                       
                                                                                                                                
   · certification of in-state laboratories for microbiological                                                                 
     analysis of drinking water,                                                                                                
   · product and water sampling required by the National Shellfish                                                              
     Sanitation Program,                                                                                                        
   · routine testing of commercial bivalve shellfish for marine                                                                 
     toxins,                                                                                                                    
   · analysis of finished seafood and general food products for                                                                 
     pathogenic bacterial contamination,                                                                                        
   · analysis of fish for five toxic metals                                                                                     
   · evaluation and random sampling of finfish for chemical and                                                                 
     bacterial contaminants and parasites                                                                                       
   · testing of animals required to maintain USDA brucellosis                                                                   
     certification.                                                                                                             
                                                                                                                                
DEC currently  has 11 positions in  the Mat-Su area that  would move                                                            
to the Anchorage area if  a new lab is built.  However, 14 staff who                                                            
perform other  non-lab related  functions in  the Mat-Su area  would                                                            
remain in their current location.                                                                                               
                                                                                                                                
DEPUTY COMMISSIONER FREDRIKSSON  said DEC has had concerns about the                                                            
cost  of the facility  and  the appropriateness  of  its size.   DEC                                                            
worked with  its prime contractor,  Livingston Stone, to  assess the                                                            
appropriateness  of  the lab  design  and it  also turned  to  other                                                            
consultants with lab experience  to determine whether the lab design                                                            
is  reasonable.    The  feedback  from  the  contractors  shows  the                                                            
laboratory  proposal is  efficient, cost-effective  and reasonable,                                                             
relative  to the cost  of labs in  other parts of  the country.   He                                                            
pointed  out that  the House Finance  Committee  reduced the  amount                                                            
requested in  DEC's original proposal  by about $1 million  and 1500                                                            
square feet.   The proposal  has been pared  down to the basics  but                                                            
still provides a safe working environment and reliable data.                                                                    
                                                                                                                                
Number 1524                                                                                                                     
                                                                                                                                
SENATOR  WILKEN  asked  what  prompted   the  move  from  Palmer  to                                                            
Anchorage.                                                                                                                      
                                                                                                                                
DEPUTY COMMISSIONER FREDRIKSSON  said a number of factors: available                                                            
space  and  an  infrastructure  to  support  a  laboratory  that  is                                                            
primarily seafood-related.   The lab needs to have good access to an                                                            
airport  for receipt  of samples  to allow  processing  in a  timely                                                            
manner.  The lab processes  a lot of chemicals so it will need to be                                                            
connected  to a  sewer  system.   DEC also  looked  for state-owned                                                             
property to control costs.                                                                                                      
                                                                                                                                
CHAIRWOMAN GREEN asked about the square footage of the facility.                                                                
                                                                                                                                
DEPUTY COMMISSIONER FREDRIKSSON  said the total gross square footage                                                            
of the current  facility is approximately  10,000 square  feet.  The                                                            
proposed facility is double  that.  The increase in space is not for                                                            
staff  space,  it will  be  used to  provide  secure rooms  for  gas                                                            
cylinders and for the ventilation system.                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN noted  the proposed facility is 20,500 square feet.                                                            
                                                                                                                                
DEPUTY COMMISSIONER  FREDRIKSSON clarified  that number was  reduced                                                            
by  1500 square  feet  in the  House  so that  the  proposed  square                                                            
footage is now 19,141 square feet.                                                                                              
                                                                                                                                
CHAIRWOMAN  GREEN asked what the cost  of the new facility  will be.                                                            
                                                                                                                                
DEPUTY COMMISSIONER  FREDRIKSSON said the latest proposal  will cost                                                            
$12,788,000.                                                                                                                    
                                                                                                                                
SENATOR  WILKEN questioned  whether DEC believes  that reduction  is                                                            
wise.                                                                                                                           
                                                                                                                                
DEPUTY COMMISSIONER  FREDRIKSSON  said he and  Ms. Adair believe  it                                                            
will provide  a "bottom line" operating  facility.  He informed  the                                                            
committee that  John Wickersham, who has 19 years  of lab experience                                                            
with the USDA,  reviewed the proposal and felt the  Livingston Stone                                                            
proposal was on target.                                                                                                         
                                                                                                                                
CHAIRWOMAN GREEN  agreed that a new lab is necessary  but she is not                                                            
sure the state needs a lab that will cost $676 per square foot.                                                                 
                                                                                                                                
SENATOR DAVIS pointed out that a lab is a specialized facility.                                                                 
                                                                                                                                
DEPUTY COMMISSIONER FREDRIKSSON  said a laboratory consumes a lot of                                                            
space to prevent  cross-contamination.   Secure rooms are  necessary                                                            
for gas cylinders;  space must be dedicated to clean  glassware; and                                                            
separate  space must be provided  for laboratory  mice.  He  pointed                                                            
out the construction cost is $400 per square foot.                                                                              
                                                                                                                                
Number 1895                                                                                                                     
                                                                                                                                
SENATOR LEMAN  asked if the proposed  site at Boniface and  Tudor is                                                            
the best location.                                                                                                              
                                                                                                                                
DEPUTY  COMMISSIONER  FREDRIKSSON  said  DEC  has  looked  at  every                                                            
suggested  area and determined  that location  to be the best.   Its                                                            
proximity to the  DHSS lab will be an added benefit.   DEC turned to                                                            
Livingston Stone and Northern Economics for expert advice.                                                                      
                                                                                                                                
CHAIRWOMAN GREEN asked what part Livingston Stone played.                                                                       
                                                                                                                                
DEPUTY COMMISSIONER FREDRIKSSON  said they did the conceptual design                                                            
and looked  at available  space.   He added  DEC will  not choose  a                                                            
design firm until this project is authorized.                                                                                   
                                                                                                                                
CHAIRWOMAN  GREEN asked Deputy Commissioner  Fredriksson  to provide                                                            
the  committee  with  the  guidelines  or  parameters  DEC  gave  to                                                            
Livingston Stone.  She  also asked about the financing procedure for                                                            
this project.                                                                                                                   
                                                                                                                                
MS.  JANICE  ADAIR,  Director  of  the  Division  of  Environmental                                                             
Quality, informed  the committee the  certificates of participation                                                             
will be sold by the bond  bank; the money will be available 60 to 90                                                            
days later.                                                                                                                     
                                                                                                                                
CHAIRWOMAN  GREEN asked for clarification  of when the debt  will be                                                            
incurred and when it will be repaid.                                                                                            
                                                                                                                                
SENATOR WILKEN  pointed out  that, according  to fiscal note  3, DEC                                                            
will have a 20 year lease at 6.1 percent interest.                                                                              
                                                                                                                                
DEPUTY  COMMISSIONER  FREDRICKSSON   asked Ms.  Adair  to  give  the                                                            
committee  a  brief  description  of the  directions  given  to  the                                                            
contractors.                                                                                                                    
                                                                                                                                
MS. ADAIR  said DEC  first contracted  with  Livingston Stone  three                                                            
years ago.  DEC  asked Livingston Stone to analyze  the work done at                                                            
the laboratory  and to design a conceptual replacement  plan that is                                                            
cost effective  and would provide the safest and most  efficient use                                                            
of the space.  DEC did  not provide a dollar limit but it did stress                                                            
that it must be cost effective.                                                                                                 
                                                                                                                                
CHAIRWOMAN  GREEN again asked for  copies of that documentation  and                                                            
whether employees in Palmer would have to move.                                                                                 
                                                                                                                                
MS. ADAIR said  even though the bulk of the functions  are statewide                                                            
functions, DEC does not plan to move those employees.                                                                           
                                                                                                                                
CHAIRWOMAN GREEN asked  if they will be located in the Mat-Su Valley                                                            
80 percent  of the time or  whether they will  be expected  to spend                                                            
more time in Anchorage.                                                                                                         
                                                                                                                                
MS. ADAIR explained  that some staff  will travel all over,  such as                                                            
the  state veterinarian,  the  dairy  sanitarian and  the  pesticide                                                            
staff.   Those positions  have  statewide responsibilities  but  the                                                            
bulk  of their  work is done  between  the Mat-Su  Valley and  Delta                                                            
Junction.                                                                                                                       
                                                                                                                                
CHAIRWOMAN GREEN asked  if the work done by those positions overlaps                                                            
with the Division of Agriculture.                                                                                               
                                                                                                                                
MS. ADAIR said Dr. Gore  [the state veterinarian] works very closely                                                            
with  the Division  of Agriculture  staff.   The  pesticide  program                                                            
issues permits  that the Division  of Agriculture applies  for.  The                                                            
dairy  sanitarian inspects  dairy  farms.  DEC  provides  regulatory                                                            
oversight  for things  owned by the  Division of  Agriculture.   She                                                            
explained the Division  of Agriculture inspectors look at quality or                                                            
grading of  eggs and agriculture crops.   DEC only gets involved  in                                                            
inspecting  those products  when  they get  into the  food chain  so                                                            
there is no duplication of services.                                                                                            
                                                                                                                                
CHAIRWOMAN  GREEN said she has heard  a great deal of concern  about                                                            
moving the non-laboratory positions out of Palmer.                                                                              
                                                                                                                                
Tape 01-45, SIDE B                                                                                                              
                                                                                                                                
SENATOR LEMAN  asked for  clarification of  who will manage  and own                                                            
the project.                                                                                                                    
                                                                                                                                
MS.  ADAIR explained  the  facility  will  be state-owned  from  the                                                            
start.  A design  Request for Proposal (RFP) will  be issued and the                                                            
lowest  responsible  bid  will  be  accepted.    The  Department  of                                                            
Transportation  and  Public Facilities  (DOTPF)  will  then issue  a                                                            
construction RFP.                                                                                                               
                                                                                                                                
SENATOR  LEMAN asked  if the  state will  use its  normal  selection                                                            
process according to the procurement code.                                                                                      
                                                                                                                                
MS. ADAIR said it will.                                                                                                         
                                                                                                                                
CHAIRWOMAN  GREEN announced  the committee  would take a recess  and                                                            
reconvene at a call of the Chair.                                                                                               
                                                                                                                                
[NO RECORDING AVAILABLE]                                                                                                        
                                                                                                                                
At 3:22 p.m.,  CHAIRWOMAN GREEN called the Senate  Health, Education                                                            
and  Social Services  Committee  back to  order.   Senators  Wilken,                                                            
Leman, Davis and Green were present.                                                                                            
                                                                                                                                
CHAIRWOMAN  GREEN announced  her intention  to move CSHB 51(FIN)  to                                                            
the Senate Finance  Committee so that it can be reviewed  within the                                                            
scope  of the entire  budget.   She also  announced  that it is  her                                                            
intention  that  the  DEC  positions  in  the  Mat-Su  Borough,  not                                                            
connected with this project, remain in the Mat-Su Borough.                                                                      
                                                                                                                                
SENATOR  LEMAN moved  CSHB 51(FIN)  from committee  with  individual                                                            
recommendations  and  its  accompanying  fiscal  notes.  The  motion                                                            
carried with no objections.                                                                                                     
                                                                                                                                
CHAIRWOMAN GREEN  then announced a recess to the call  of the chair.                                                            

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