Legislature(2003 - 2004)

04/14/2003 01:35 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE HEALTH, EDUCATION AND SOCIAL SERVICES                                                                        
                       STANDING COMMITTEE                                                                                     
                         April 14, 2003                                                                                         
                           1:35 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Fred Dyson, Chair                                                                                                       
Senator Lyda Green, Vice Chair                                                                                                  
Senator Gary Wilken                                                                                                             
Senator Bettye Davis                                                                                                            
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Gretchen Guess                                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
Overview: Division of Public Health - Douglas Bruce, Director,                                                                  
and John Middaugh, Chief, Epidemiology                                                                                          
                                                                                                                                
CS FOR HOUSE JOINT RESOLUTION NO. 13(HES)                                                                                       
Urging adoption of the Alaska recommendations for implementing                                                                  
the No Child Left Behind Act of 2001.                                                                                           
                                                                                                                                
     MOVED SCS CSHJR 13(HES) OUT OF COMMITTEE                                                                                   
                                                                                                                                
SENATE BILL NO. 30                                                                                                              
"An  Act  relating  to  information  and  services  available  to                                                               
pregnant women  and other persons; and  ensuring informed consent                                                               
before an abortion  may be performed, except in  cases of medical                                                               
emergency."                                                                                                                     
                                                                                                                                
     MOVED CSSB 30(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
PREVIOUS ACTION                                                                                                               
                                                                                                                              
HJR 13 - No previous action to record.                                                                                          
                                                                                                                                
SB 30 - See HESS minutes dated 3/17/03, 3/26/03, 4/3/03 and                                                                     
4/9/03.                                                                                                                       
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                              
Representative Carl Gatto                                                                                                       
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT: Sponsor of HJR 13.                                                                                        
                                                                                                                                
Mr. Cody Rice                                                                                                                   
Staff to Representative Gatto                                                                                                   
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT: Commented on HJR 13.                                                                                      
                                                                                                                                
Dr. Bob Johnson                                                                                                                 
PO Box 945                                                                                                                      
Kodiak AK 99615                                                                                                                 
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                                
Ms. Frances Cater                                                                                                               
PO Box 1472                                                                                                                     
Kodiak AK 99615                                                                                                                 
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                                
Ms. Pauline Utter                                                                                                               
13820 Jarvi Dr.                                                                                                                 
Anchorage AK 99503                                                                                                              
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                                
Ms. Robin Smith                                                                                                                 
14400 Jarvi Dr.                                                                                                                 
Anchorage AK 99503                                                                                                              
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                                
Ms. Katie Bryson                                                                                                                
7911 Hazel Ct.                                                                                                                  
Anchorage AK 99524                                                                                                              
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                                
Ms. Sophie Butigan                                                                                                              
PO Box 242134                                                                                                                   
Anchorage AK 99524                                                                                                              
POSITION STATEMENT: Opposed SB 30.                                                                                            
                                                                                                                              
ACTION NARRATIVE                                                                                                              
                                                                                                                                
TAPE 03-21, SIDE A                                                                                                            
                                                                                                                                
CHAIR FRED DYSON  called the Senate Health,  Education and Social                                                             
Services  Standing  Committee  meeting  to  order  at  1:35  p.m.                                                               
Present were  Senators Wilken, Davis  and Chair Dyson.  The first                                                               
order of  business to come  before the committee was  an overview                                                               
from the  Division of Public  Health on Severe  Acute Respiratory                                                               
Syndrome (SARS).                                                                                                                
                                                                                                                                
MR.  DOUGLAS BRUCE,  Director, Division  of  Public Health,  said                                                               
that Dr. John Middaugh would  give the background and overview of                                                               
SARS.                                                                                                                           
                                                                                                                                
DR. JOHN  MIDDAUGH, Chief of  Epidemiology, Department  of Health                                                               
and  Social Services  (DHSS), said  in late  2002, cases  of life                                                               
threatening respiratory disease with  no identifiable cause began                                                               
to be  reported from the  Quang Dong province in  China, followed                                                               
by  similar reports  of illness  from Viet  Nam, Canada  and Hong                                                               
Kong.   On  February  26,  the first  person  who was  officially                                                               
identified with  a case of  SARS came  to the attention  of Carlo                                                               
Urbani, World Health  Organization (WHO). The patient  he saw was                                                               
a  48-year old  businessman from  the U.S.  who had  stayed in  a                                                               
hotel in Hong  Kong before traveling to Hanoi on  February 24. He                                                               
became  ill   shortly  after   he  arrived   in  Hanoi   and  was                                                               
hospitalized on  February 26. His  health declined until  he died                                                               
on March 12.                                                                                                                    
                                                                                                                                
On  March  12, the  World  Health  Organization issued  a  global                                                               
alert, which resulted in worldwide  surveillance for persons with                                                               
SARS. By  April 1,  2003 there  were over  1,800 reports  of SARS                                                               
from over 15 countries; 62 of  those cases resulted in death. Dr.                                                               
Urbani, himself, died from SARS during that period.                                                                             
                                                                                                                                
On March  12, following the  WHO global alert, the  United States                                                               
Centers for  Disease Control and  Prevention in Atlanta  issued a                                                               
health alert  to all  public health officials  in all  50 states.                                                               
Immediately,  Alaska began  enhanced surveillance.  As of  today,                                                               
3,169  cases have  been  reported worldwide,  with  144 deaths  -                                                               
about 4.5% of  the cases. Twenty-one countries have  had cases of                                                               
SARS; Toronto, Canada  has reported 100 cases with  13 deaths. In                                                               
the  United States  as of  April 10,  there were  166 SARS  cases                                                               
reported  in 31  states with  no deaths.  No health  workers have                                                               
been  infected  in  the  United  States and  there  has  been  no                                                               
evidence  of  person-to-person transmission  within  communities.                                                               
California has reported  35 cases among its 34  million people, 4                                                               
million of whom are Asians.                                                                                                     
                                                                                                                                
The  disease has  an incubation  period of  2 to  10 days  with a                                                               
median of around  5 days. The virus has been  isolated, but until                                                               
a definitive epidemiologic  agent is identified, the  virus has a                                                               
syndrome  and case  definition.  A  SARS victim  has  a fever  of                                                               
greater  than 100.4  degrees, headache,  discomfort, body  aches,                                                               
muscle stiffness,  loss of appetite, malaise,  rash and diarrhea;                                                               
and  after 2  to 7  days,  the person  develops a  dry cough  and                                                               
trouble  breathing.  The  definition also  includes  exposure  to                                                               
Southeast Asian countries or to cases exposed to them.                                                                          
                                                                                                                                
The   concern  about   bio-terrorism  has   attracted  government                                                               
resources for public health  surveillance, communication links to                                                               
hospitals  and  hospital   administrators,  and  emergency  first                                                               
responders  to   physicians  in  emergency  rooms.   Health  care                                                               
providers  are continually  being updated.  The agent  might have                                                               
been identified as  a corona virus, which is a  family of viruses                                                               
that heretofore  was known to  cause the common cold.  Until this                                                               
outbreak,  this  virus  family  was not  known  to  cause  severe                                                               
illness  in humans.  The corona  virus family  does cause  severe                                                               
illness in  certain animals' feces,  like swine, birds  and other                                                               
ruminants. This  virus was  isolated from  patients who  had SARS                                                               
and  was  identified under  a  microscope,  which identified  its                                                               
characteristic appearance.  Nucleotide sequence  tests identified                                                               
400  base pairs  in the  virus  isolates from  patients in  eight                                                               
separate  countries. In  control  patients who  are healthy,  the                                                               
virus  has not  been found  at all.  Evidence suggests  that this                                                               
virus is a  new member of the corona virus  family and shares new                                                               
characteristics of  being able to  cause severe illness  and even                                                               
death among humans.                                                                                                             
                                                                                                                                
At this point,  China has allowed teams of  epidemiologists in to                                                               
do  much more  research  and define  more  information about  the                                                               
characteristics of  SARS and SARS infection.  When Dr. Middaugh's                                                               
department got the alert, he  immediately contacted public health                                                               
experts,   such  as   the  Alaska   Native  Medial   Center,  the                                                               
Southcentral   Foundation,   the    Municipality   of   Anchorage                                                               
Department of  Health and Human  Services, experts  at Providence                                                               
Hospital  and  the  Alaska  Regional   Hospital  and  the  Arctic                                                               
Investigations  Program,  a  unit  of  the  Centers  for  Disease                                                               
Control  (CDC) run  by Dr.  Jay Butler  in Anchorage.  Physicians                                                               
throughout the  state have been  receiving the CDC  health alerts                                                               
and updates by email, fax, and first class mail.                                                                                
                                                                                                                                
DR. MIDDAUGH explained  that links are posted  on DHSS's Internet                                                               
site  so   that  individuals  could  immediately   access  direct                                                               
information   from  the   CDC  and   WHO  computer   sites.  This                                                               
continually updated  information is interfaced with  the Meet and                                                               
Greet program  for the international passenger  flights coming in                                                               
from Hong Kong  or Korea. Information about the  symptoms of SARS                                                               
and a  contact number in  case a passenger develops  any symptoms                                                               
in  the next  10  days is  provided.  The CDC  and  WHO are  also                                                               
working to provide information to  the crews of cargo vessels and                                                               
planes. He  has collaborated with  the Municipality  of Anchorage                                                               
health department,  Providence and Alaska Regional  Hospitals and                                                               
the Alaska Native Medical Center  to develop a plan to transport,                                                               
evaluate,  and appropriately  monitor an  ill crew  or passengers                                                               
who could  be possible SARS  cases from an  international flight.                                                               
His  department  has  worked  with  all  three  of  the  civilian                                                               
hospitals in Anchorage  to develop a plan to  accept, isolate and                                                               
treat  an ill  crew member,  passenger or  any other  patient who                                                               
presents with an illness that meets the SARS case definition.                                                                   
                                                                                                                                
The   department  has   prepared   collection   kits  to   obtain                                                               
appropriate diagnostic  specimens as  recommended by the  CDC and                                                               
worked with the state lab  on handling and shipping procedures to                                                               
the  CDC. DHSS  staff has  been trained  on how  to follow  up an                                                               
investigation of a potential case.                                                                                              
                                                                                                                                
DR. MIDDAUGH  said that  finally, state  laws on  procedures were                                                               
reviewed for  isolating and  quarantining individuals.  They have                                                               
given  numerous media  interviews to  reporters around  the state                                                               
about SARS and  have also had follow up meetings  with their team                                                               
of experts  and other physicians  around the state.  One possible                                                               
case  had  been  detected  of  an  airline  pilot  who  developed                                                               
symptoms and that allowed them to  have a test run of procedures.                                                               
The pilot  had the flu,  but it  showed that their  system worked                                                               
very well.                                                                                                                      
                                                                                                                                
DR.  MIDDAUGH said  DHSS still  needs  to provide  more and  more                                                               
information to  the public and  statewide medical  care providers                                                               
and is  planned to have  teleconference meetings  with colleagues                                                               
in  Washington,  British  Columbia  and the  Yukon  Territory  in                                                               
anticipation of the tourist season.  The cruise ship industry, in                                                               
particular, is  working with  the CDC  and it's  anticipated that                                                               
the CDC  will come out  with formal written  guidelines regarding                                                               
handling  SARS within  the  week.  AS of  this  morning, the  CDC                                                               
thought it would  have the entire genome of  this virus sequenced                                                               
out and  it is working on  a rapid laboratory test  kit, which it                                                               
expects to  be operational at the  end of the week.  The CDC will                                                               
send  out  materials  as  soon  as  they  are  developed  to  the                                                               
different states to enable the labs to effectively use them.                                                                    
                                                                                                                                
He is  working with  the CDC to  develop specific  guidelines for                                                               
rural clinics in  remote areas as the major initial  focus was on                                                               
the large hospitals related to  handling patients and appropriate                                                               
respiratory   isolation.  Those   physical  facilities   are  not                                                               
available in smaller areas.                                                                                                     
                                                                                                                                
SENATOR WILKEN  asked if  passengers can  disembark when  a jumbo                                                               
jet lands at the Anchorage International Airport.                                                                               
                                                                                                                                
DR. MIDDAUGH  answered that passengers  are allowed  to disembark                                                               
within  the international  component of  the terminal.  Those who                                                               
are not ending their journey go  back on the aircraft. All of the                                                               
international  flights fall  under federal  quarantine authority.                                                               
The minute a  person clears U.S. Customs that  person falls under                                                               
state authority.                                                                                                                
                                                                                                                                
SENATOR WILKEN remarked that Alaska  is just as vulnerable as any                                                               
other  large transportation  center because  of its  proximity to                                                               
the Asian countries.                                                                                                            
                                                                                                                                
DR.  MIDDAUGH agreed  and said  the WHO  suggested that  all non-                                                               
essential  travel to  Hong  Kong,  China and  North  Viet Nam  be                                                               
suspended  and  yet  the  virus  has  been  identified  in  eight                                                               
countries  and   patients  from   21  countries  meet   the  case                                                               
definition.  China wasn't  providing information  to the  rest of                                                               
the world  about the extent of  the illness and it  appears to be                                                               
more  widespread. Having  a rapid  reliable laboratory  test will                                                               
really help  in containment efforts.  Experts are looking  at how                                                               
quickly a vaccine for this virus could be developed.                                                                            
                                                                                                                                
SENATOR WILKEN  asked if they are  working on a vaccination  or a                                                               
pill.                                                                                                                           
                                                                                                                                
DR. MIDDAUGH replied that neither  effective pills nor anti-viral                                                               
agents are  available for any  viral infection. There is  a great                                                               
deal to  be learned about  the clinical risk factors  whereby one                                                               
person gets  a very mild  infection and another person  dies from                                                               
it. Most  of the  people who  have died are  elderly or  have had                                                               
severe underlying  diseases, such  as diabetes. The  experts also                                                               
know that tobacco use in China  and Viet Nam is horrific and that                                                               
tobacco may  well prove to be  a risk factor for  someone exposed                                                               
to this virus.  They have to wait  and see if that  pans out with                                                               
the epidemiologic research.                                                                                                     
                                                                                                                                
He suspects that the experts  will look at whether our technology                                                               
can develop an  effective vaccine and how would it  be tested and                                                               
approved. If the  vaccine is safe and effective  he thought there                                                               
might be a global vaccination program.                                                                                          
                                                                                                                                
SENATOR WILKEN asked how the virus is transmitted.                                                                              
                                                                                                                                
DR. MIDDAUGH replied that SARS  is definitely transmitted through                                                               
an airborne  route, as  are all the  corona family  viruses. It's                                                               
possible  that  infected  sputum droplets  could  be  potentially                                                               
passed through  other objects and  the virus has  been identified                                                               
in feces. One  of the symptoms associated with  SARS is diarrhea,                                                               
but the  level of virus in  that is low. The  primary risk factor                                                               
is very  close contact and there  has been no evidence  of casual                                                               
transmission as  in a  hotel or large  settings. In  addition, no                                                               
community transmission has occurred.                                                                                            
                                                                                                                                
SENATOR DAVIS  asked how long  it will  take to get  something to                                                               
help a patient.                                                                                                                 
                                                                                                                                
DR. MIDDAUGH  replied that it would  take many months to  a year,                                                               
depending on the  characteristics of the virus  and their ability                                                               
to  engineer a  vaccine. It  might be  possible to  get expedited                                                               
review for use by people who meet the SARS case definition.                                                                     
                                                                                                                                
SENATOR DAVIS  asked how long it  took to establish that  the one                                                               
case in Alaska was not SARS, but the flu.                                                                                       
                                                                                                                                
DR.  MIDDAUGH replied  that it  took a  matter of  hours for  the                                                               
positive flu identification to come  back. The system worked very                                                               
well.                                                                                                                           
                                                                                                                                
CHAIR DYSON asked  if the disease has attacked  anyone other than                                                               
the ones mentioned.                                                                                                             
                                                                                                                                
DR. MIDDAUGH said  those are possibly the only  group of factors,                                                               
but data hadn't been made widely available.                                                                                     
                                                                                                                                
CHAIR  DYSON  asked  how  to   protect  people  against  airborne                                                               
transmission.                                                                                                                   
                                                                                                                                
DR.   MIDDAUGH  replied   that  standard   respiratory  isolation                                                               
procedures used  for suspected cases  of TB or  other respiratory                                                               
illnesses work  very well for  SARS -  face masks with  a certain                                                               
level of HEPA  filter individually fitted. Hand  washing helps as                                                               
the virus  doesn't live in the  environment for more than  3 or 4                                                               
hours.  So far,  there  has been  no transmission  of  SARS to  a                                                               
health care worker in the United States.                                                                                        
                                                                                                                                
CHAIR  DYSON asked  if  there  is any  evidence  that  it can  be                                                               
sexually transmitted.                                                                                                           
                                                                                                                                
DR. MIDDAUGH replied no.                                                                                                        
                                                                                                                                
CHAIR DYSON  asked what level this  type of problem would  get to                                                               
before quarantine is authorized.                                                                                                
                                                                                                                                
DR. MIDDAUGH replied that probably  has a very limited role here.                                                               
President  Bush  added  SARS  to   the  list  of  internationally                                                               
quarantinable  diseases   as  a  precaution.   For  international                                                               
travel,  all countries  have agreed  to adopt  a uniform  list of                                                               
diseases for denial  of entry, quarantine or  isolation. The list                                                               
is  very  short.  There  are   no  recommendations  to  implement                                                               
quarantine because of  the wide spread of the virus  and the very                                                               
likely probability  that there are individuals  infected who have                                                               
mild   illness  and   don't  meet   the  case   definition.  It's                                                               
conceivable that would  change with a definitive  test that would                                                               
immediately enable the medical community  to determine if someone                                                               
has the  disease. Voluntary isolation  by those who have  been in                                                               
contact has been very effective.                                                                                                
                                                                                                                                
CHAIR DYSON  asked if  the disease can  be transmitted  by people                                                               
who are asymtomatic.                                                                                                            
                                                                                                                                
DR. MIDDAUGH said  that is one of the major  focuses of the teams                                                               
that are now in China.                                                                                                          
                                                                                                                                
CHAIR DYSON asked if the symptoms are posted on a website.                                                                      
                                                                                                                                
DR. MIDDAUGH  said they are and  added that he would  provide the                                                               
committee any information  it might need. He said  the website is                                                               
updated constantly.  He added that DHSS's  capabilities have been                                                               
expanded  with  support  for  the  bio-terrorism  money  and  the                                                               
building  of infrastructure  here, but  he didn't  know what  the                                                               
demands might be  if SARS were to  break out on a  cruise ship or                                                               
in a village.                                                                                                                   
                                                                                                                                
              HJR 13-FEDERAL EDUCATION LAW OF 2001                                                                          
                                                                                                                                
CHAIR DYSON announced HJR 13 to be up for consideration.                                                                        
                                                                                                                                
REPRESENTATIVE  CARL GATTO,  sponsor, said  the state  needs some                                                               
considerations in  implementing the  No Child Left  Behind (NCLB)                                                               
mandate. A  federal government  official said  there would  be no                                                               
waivers,  but Alaska  has situations  that  do not  exist in  any                                                               
other  place in  the nation.  Alaska has  one-room school  houses                                                               
that are  not on a  road system and if  the NCLB were  applied to                                                               
the  strictest limit,  low-performing students  would have  to be                                                               
moved  to the  next available  school,  a plane  ride away.  That                                                               
would take  those students  out of  their homes.  This resolution                                                               
asks  for  the  widest  possible consideration  for  Alaska  only                                                               
because it is truly unique.                                                                                                     
                                                                                                                                
SENATOR   WILKEN  asked   for   a  description   of  the   Alaska                                                               
consolidated    state   application    accountability   workbook,                                                               
mentioned on page 2, line 16.                                                                                                   
                                                                                                                                
MR. CODY RICE, staff to  Representative Gatto, explained that the                                                               
state  consolidated workbook  is the  state's application  to the                                                               
federal officials  for how  we are planning  on meeting  the NCLB                                                               
requirements.                                                                                                                   
                                                                                                                                
SENATOR WILKEN asked if every state has a workbook like that.                                                                   
                                                                                                                                
MR. RICE answered yes.                                                                                                          
                                                                                                                                
SENATOR GREEN arrived at 2:20 p.m.                                                                                              
                                                                                                                                
SENATOR WILKEN asked if endorsing  this resolution means they are                                                               
condoning  the  fact  that  some  school  districts  don't  teach                                                               
English as a first language.                                                                                                    
                                                                                                                                
REPRESENTATIVE  GATTO  responded  that  Anchorage  has  immersion                                                               
programs, but  unfortunately some children from  villages will be                                                               
taught by a Yupik teacher  and won't know English. Those students                                                               
would be tested in their  native language through the third grade                                                               
and then the requirement would shift to English.                                                                                
                                                                                                                                
SENATOR WILKEN asked who would test them.                                                                                       
                                                                                                                                
REPRESENTATIVE  GATTO said  he  thought  the schoolteacher  would                                                               
prepare the test.  Some accommodations would be made  so that the                                                               
teacher would read  the questions and have the  student write the                                                               
answers down,  until the student  reaches the fourth  grade. That                                                               
is required in the standards and to meet the NCLB.                                                                              
                                                                                                                                
SENATOR  WILKEN said  he  wanted  it on  the  record  that he  is                                                               
troubled that we endorse it in some school districts.                                                                           
                                                                                                                                
REPRESENTATIVE   GATTO  responded   that  philosophically,   when                                                               
dealing with  rural communities, if  there are children  who have                                                               
no intention  of ever  leaving their  villages, that's  an issue;                                                               
but most of those children will  some day want to move to another                                                               
city, get  a job,  make a change,  understand English,  etc. They                                                               
need  to be  prepared long  before  they graduate.  And, if  they                                                               
don't want to move, having the  knowledge base to be able to move                                                               
will not  hurt them.  He doesn't  want to condemn  them to  be in                                                               
that village forever, like it or not.                                                                                           
                                                                                                                                
CHAIR DYSON  referred to  the language  on page  1, line  14, and                                                               
asked  what he  meant by  "39 school  districts each  enroll less                                                               
than 1 percent of the student body."                                                                                            
                                                                                                                                
REPRESENTATIVE GATTO replied if you  take the student body of the                                                               
state as whole,  the schools are so small that  only 1 percent of                                                               
the student body is spread over 39 districts.                                                                                   
                                                                                                                                
CHAIR DYSON said that could be stated clearer.                                                                                  
                                                                                                                                
SENATOR WILKEN moved  to adopt a conceptual amendment  to page 1,                                                               
line 13, to delete "the" and  on line 14 to delete "student body"                                                               
and  insert "Alaska's  students."  There were  no objections  and                                                               
Amendment 1 was adopted.                                                                                                        
                                                                                                                                
TAPE 03-21, SIDE B                                                                                                            
                                                                                                                                
SENATOR WILKEN moved  to pass SCSHJR 13(HES)  from committee with                                                               
individual recommendations.  There were no objections  and it was                                                               
so ordered.                                                                                                                     
                                                                                                                                
         SB  30-ABORTION: INFORMED CONSENT; INFORMATION                                                                     
                                                                                                                                
CHAIR FRED DYSON announced SB 30 to be up for consideration.                                                                    
                                                                                                                                
SENATOR LYDA GREEN  moved to adopt the  committee substitute (CS)                                                               
to SB  30, version LS0193\S,  Lauterbach, 4/11/03. There  were no                                                               
objections and it was so ordered.                                                                                               
                                                                                                                                
CHAIR DYSON explained  that the CS adopts the  Division of Public                                                               
Health's  suggestion  to  put  updated  information  on  informed                                                               
consent  on a  website where  it can  be easily  downloaded. That                                                               
will  make  it easier  for  the  department  to keep  up  current                                                               
addresses of support groups and  providers and greatly reduce the                                                               
cost. That  is the  main change.  The bill  puts in  statute that                                                               
which  is already  in regulation  requiring informed  consent and                                                               
gives the option, but does not  demand, that the provider put the                                                               
website information in his own pamphlet.                                                                                        
                                                                                                                                
DR. BOB  JOHNSON, Kodiak, said he  is a retired physician  who in                                                               
his  last  10  years  of  practice performed  an  average  of  70                                                               
abortions per  year. He explained  that he scheduled  five visits                                                               
for each  patient. During the  first visit, he determined  if the                                                               
patient   had  really   investigated  other   options  and   felt                                                               
comfortable with  the decision;  the second  visit was  to inform                                                               
the patient about the procedure  and possible problems that could                                                               
arise and to  answer questions. He found  that patients expressed                                                               
many varying needs  and that each one needed to  be treated as an                                                               
individual.  He didn't  have a  set list  of information  he felt                                                               
required to give to them,  because some of them couldn't tolerate                                                               
it, some would  have been angered by it, some  didn't need it and                                                               
others had  questions that probably  wouldn't have  been included                                                               
in his list.  Dictating the requirements of what  a person should                                                               
be told  is a mistake.  The deputy commissioner pointed  out that                                                               
the department  doesn't regulate,  monitor or license  clinics or                                                               
doctors offices  and that  this might  produce a  situation where                                                               
monitoring is necessary.                                                                                                        
                                                                                                                                
CHAIR DYSON  said that  some testifiers  indicated that  having a                                                               
24-hour waiting period  would be a great  inconvenience. He asked                                                               
if he  considered it good practice  to have first contact  with a                                                               
client,  perform the  procedure and  put  the client  back on  an                                                               
airplane in one day.                                                                                                            
                                                                                                                                
DR. JOHNSON replied that he  was never faced with that situation,                                                               
because Kodiak is the end of the  line and they were all there to                                                               
begin with. He  thought most doctors would like to  have a couple                                                               
of  days with  the patient  to  explore the  decision and  answer                                                               
questions about the procedure.                                                                                                  
                                                                                                                                
CHAIR  DYSON asked  if  he  thought it  is  wise  to observe  the                                                               
patient for  some period after  the procedure to make  sure there                                                               
aren't complications.                                                                                                           
                                                                                                                                
DR. JOHNSON  replied about a half  hour is all that  is necessary                                                               
if the patient is in the same community.                                                                                        
                                                                                                                                
CHAIR  DYSON  asked  about  patients  who  fly  out  to  a  rural                                                               
community.                                                                                                                      
                                                                                                                                
DR. JOHNSON said  the complication rate is extremely  low, but he                                                               
wouldn't want anyone flying on the same day.                                                                                    
                                                                                                                                
MS. FRANCES  CATER, Kodiak,  said that SB  30 is  unnecessary and                                                               
that  any ethical  doctor would  do all  those things  anyway. It                                                               
would be very expensive for  DHSS to monitor this program instead                                                               
of doing more important things.                                                                                                 
                                                                                                                                
MS. PAULINE  UTTER, Anchorage resident,  opposed SB 30,  but said                                                               
if  it passes,  she  thinks it  should  also include  information                                                               
about how hard it is for the mother to get child support.                                                                       
                                                                                                                                
MS. ROBIN  SMITH, Anchorage  resident, said  she wants  to reduce                                                               
the number of  abortions, but thought the best way  to do that is                                                               
to  reduce   the  number  of   unintended  pregnancies.   She  is                                                               
disappointed that  the governor's budget reduced  all state money                                                               
for  family  planning.  Alaska  has  the  highest  rate  of  teen                                                               
pregnancies and rape in the country.                                                                                            
                                                                                                                                
MS. KATIE BRYSON, Anchorage resident,  also opposed SB 30 for all                                                               
the  aforementioned reasons  and added  while the  intent of  the                                                               
legislation  is  to empower  women  by  mandating choice  through                                                               
information, the  language of this  bill would make  the pamphlet                                                               
heavily  biased  rather than  objective.  She  opined, "It  would                                                               
serve to intimidate rather than inform."                                                                                        
                                                                                                                                
MS.  SOPHIE  BUTIGAN,  Anchorage  resident, opposed  SB  30.  She                                                               
personally finds the 24-hour waiting  period biased against lower                                                               
income women and women without access to affordable health care.                                                                
                                                                                                                                
SENATOR  GREEN moved  to pass  CSSB 30(HES)  from committee  with                                                               
individual recommendations and the accompanying fiscal note.                                                                    
                                                                                                                                
SENATOR DAVIS objected.                                                                                                         
                                                                                                                                
A roll  call vote  was taken. SENATORS  GREEN, WILKEN,  and DYSON                                                               
voted yea; SENATOR  DAVIS voted nay; and CSSB  30(HES) moved from                                                               
committee.                                                                                                                      
                                                                                                                                
CHAIR DYSON adjourned the meeting at approximately 3:20 p.m.                                                                    

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