Legislature(2005 - 2006)BUTROVICH 205

04/20/2005 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 185 POSTSECONDARY STUDENT IMMUNIZATION TELECONFERENCED
Moved CSHB 185(FIN) Out of Committee
*+ SB 162 REPORT STUDENT HEALTH/DISCIPLINE/SAFETY TELECONFERENCED
Heard & Held
*+ SB 177 PRACTICE OF PSYCHOLOGY TELECONFERENCED
Scheduled But Not Heard
+ Bills Previously Heard/Scheduled TELECONFERENCED
                          ALASKA STATE LEGISLATURE                                                                            
      SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                         
                               April 20, 2005                                                                                   
                                 1:38 p.m.                                                                                      
                                                                                                                                
     MEMBERS PRESENT                                                                                                          
                                                                                                                                
     Senator Fred Dyson, Chair                                                                                                  
     Senator Gary Wilken, Vice Chair                                                                                            
     Senator Lyda Green                                                                                                         
     Senator Kim Elton                                                                                                          
     Senator Donny Olson                                                                                                        
                                                                                                                                
     MEMBERS ABSENT                                                                                                           
                                                                                                                                
     All members present                                                                                                        
                                                                                                                                
     COMMITTEE CALENDAR                                                                                                       
                                                                                                                              
     CS FOR HOUSE BILL NO. 185 (FIN)                                                                                            
     "An Act  relating to immunization  of postsecondary  students for                                                          
     meningitis; and providing for an effective date."                                                                          
          MOVED CSHB 185(FIN) OUT OF COMMITTEE                                                                                  
                                                                                                                                
     SENATE BILL NO. 162                                                                                                        
     "An  Act   relating  to  monitoring  and   reporting  of  student                                                          
     discipline and  safety, of student  health pertaining  to height,                                                          
     nutrition,  and  physical  activity,  of the  percentage  of  the                                                          
     legislative body  with a body  mass index that exceeds  25.0, and                                                          
     of state  capitol vending machine  profits; requiring  schools to                                                          
     report  school  health  status  and  policy,  the  percentage  of                                                          
     students that  are overweight  and at  risk of  being overweight,                                                          
     and profits  from vending machines; and  requiring the evaluation                                                          
     of health education  programs on the basis of  health reports and                                                          
     screening."                                                                                                                
          HEARD AND HELD                                                                                                        
                                                                                                                                
     SENATE BILL NO. 177                                                                                                        
     "An Act eliminating the requirement  that persons using titles or                                                          
     descriptions   of    services   that   incorporate    the   terms                                                          
     'psychotherapy,'  'psychotherapeutic,'  or  'psychotherapist'  be                                                          
     licensed  by   the  Board   of  Psychologist   and  Psychological                                                          
     Associate Examiners."                                                                                                      
          SCHEDULED BUT NOT HEARD                                                                                               
                                                                                                                                
     PREVIOUS COMMITTEE ACTION                                                                                                
                                                                                                                                
BILL: HB 185                                                                                                                  
SHORT TITLE: POSTSECONDARY STUDENT IMMUNIZATION                                                                                 
SPONSOR(s): REPRESENTATIVE(s) CHENAULT                                                                                          
                                                                                                                                
02/28/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/28/05       (H)       HES, FIN                                                                                               
03/17/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
03/17/05       (H)       Moved Out of Committee                                                                                 
03/17/05       (H)       MINUTE(HES)                                                                                            
03/18/05       (H)       HES RPT 3DP 1DNP 3NR                                                                                   
03/18/05       (H)       DP: ANDERSON, MCGUIRE, WILSON;                                                                         
03/18/05       (H)       DNP: GARDNER;                                                                                          
03/18/05       (H)       NR: CISSNA, KOHRING, SEATON                                                                            
03/31/05       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
03/31/05       (H)       <Bill Hearing Postponed to 4/1/05 9 AM>                                                                
04/01/05       (H)       FIN AT 9:00 AM HOUSE FINANCE 519                                                                       
04/01/05       (H)       Moved CSHB 185(FIN) Out of Committee                                                                   
04/01/05       (H)       MINUTE(FIN)                                                                                            
04/04/05       (H)       FIN RPT CS(FIN) 4DP 5NR                                                                                
04/04/05       (H)       DP: HOLM, FOSTER, MEYER, CHENAULT;                                                                     
04/04/05       (H)       NR: HAWKER, CROFT, STOLTZE, MOSES,                                                                     
                         KELLY                                                                                                  
04/07/05       (H)       TRANSMITTED TO (S)                                                                                     
04/07/05       (H)       VERSION: CSHB 185(FIN)                                                                                 
04/08/05       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/08/05       (S)       HES                                                                                                    
04/20/05       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
04/20/05       (S)       Moved CSHB 185(FIN) Out of Committee                                                                   
04/20/05       (S)       MINUTE(HES)                                                                                            
04/21/05       (S)       HES RPT 2DP 1NR                                                                                        
04/21/05       (S)       DP: DYSON, ELTON                                                                                       
04/21/05       (S)       NR: GREEN                                                                                              
04/22/05       (S)       RETURN TO (H), TRANSMIT TO GOV NEXT                                                                    
04/22/05       (S)       VERSION: CSHB 185(FIN)                                                                                 
                                                                                                                                
BILL: SB 162                                                                                                                  
SHORT TITLE: REPORT STUDENT HEALTH/DISCIPLINE/SAFETY                                                                            
SPONSOR(s): SENATOR(s) DYSON                                                                                                    
                                                                                                                                
04/06/05       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/06/05       (S)       HES, FIN                                                                                               
04/20/05       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
04/20/05       (S)       Heard & Held                                                                                           
04/20/05       (S)       MINUTE(HES)                                                                                            
                                                                                                                                
BILL: SB 177                                                                                                                  
SHORT TITLE: PRACTICE OF PSYCHOLOGY                                                                                             
     SPONSOR(s): HEALTH, EDUCATION & SOCIAL SERVICES                                                                            
                                                                                                                                
     04/15/05       (S)       READ THE FIRST TIME - REFERRALS                                                                   
     04/15/05       (S)       HES, L&C                                                                                          
     04/20/05       (S)       HES AT 1:30 PM BUTROVICH 205                                                                      
     04/20/05       (S)       Heard & Held                                                                                      
     04/20/05       (S)       MINUTE(HES)                                                                                       
                                                                                                                              
     WITNESS REGISTER                                                                                                         
                                                                                                                                
     ERICH DELAND                                                                                                               
     Aide to Representative Mike Chenault                                                                                       
     Alaska State Capitol                                                                                                       
     Juneau, AK  99801-1182                                                                                                     
     POSITION STATEMENT: Introduced HB 185.                                                                                   
                                                                                                                                
     DR. RICHARD MANDSAGER, Director                                                                                            
     Department of Public Health and Social Services                                                                            
     Alaska State Capitol                                                                                                       
     Juneau, AK  99801-1182                                                                                                     
     POSITION STATEMENT: Introduced SB 162.                                                                                   
                                                                                                                                
     BARBARA TOMPSON, Director of Teaching                                                                                      
     Department of Education & Early Development                                                                                
             th                                                                                                                 
     801 W 10 St.                                                                                                               
     Juneau, AK  99801-1894                                                                                                     
     POSITION STATEMENT: Neutral on SB 162.                                                                                   
                                                                                                                                
     BEVERLY SMITH                                                                                                              
     The Christian Science Committee on Publication                                                                             
     Box 240976                                                                                                                 
     Douglas, Alaska  99824                                                                                                     
     POSITION STATEMENT: Proposed an amendment to SB 162.                                                                     
                                                                                                                                
     DR. BETH FUNK                                                                                                              
     Department of Health and Social Services                                                                                   
     Division of Public Health, Section of Epidemiology                                                                         
     Box 240249                                                                                                                 
     Anchorage, Alaska  99524-0249                                                                                              
     POSITION STATEMENT: Neutral towards SB 162.                                                                              
                                                                                                                                
     ACTION NARRATIVE                                                                                                         
                                                                                                                                
     CHAIR FRED DYSON  called the Senate Health,  Education and Social                                                        
     Services  Standing  Committee meeting  to  order  at 1:38:31  PM.                                                        
     Present were Senators  Donny Olson, Kim Elton,  Gary Wilken, Lyda                                                          
     Green and Chair Fred Dyson.                                                                                                
                                                                                                                                
                                                                                                                                
           HB 185-POSTSECONDARY STUDENT IMMUNIZATION                                                                        
                                                                                                                                
CHAIR DYSON announced HB 185 to be up for consideration.                                                                        
                                                                                                                                
ERICH DELAND, legislative aide to Representative Mike Chenault,                                                                 
introduced HB 185:                                                                                                              
                                                                                                                                
     We refer to the bill as  the Ryan Colton Bill. He was a                                                                    
     19 year-old university student who  woke up one morning                                                                    
     with what he  thought was the flu. By 3:00  AM the next                                                                    
     day he  was in the  hospital and by  5:00 AM he  was on                                                                    
     life support  and blind.  By the time  he was  flown to                                                                    
     Seattle, he was brain dead.                                                                                                
                                                                                                                                
     Meningococcal viruses and bacterial  diseases have a 15                                                                    
     percent mortality rate and when  it is not terminal, it                                                                    
     can result  in loss  of limbs, blindness,  and problems                                                                    
     with the major organs. The  bill would remove a current                                                                    
     exemption  on  post-secondary   institutions  and  thus                                                                    
     require  them to  provide information  about viral  and                                                                    
     bacterial    meningococcal     diseases    and    offer                                                                    
     immunization  options  for  students. In  addition,  it                                                                    
     would  require  them  to  have   the  students  sign  a                                                                    
     document saying they have received the information.                                                                        
                                                                                                                                
1:40:20 PM                                                                                                                    
                                                                                                                                
CHAIR DYSON asked the reason schools are not able to do the                                                                     
reasonable things proposed in the bill.                                                                                         
                                                                                                                                
MR. DELAND replied they could but they don't.                                                                                   
                                                                                                                                
CHAIR DYSON asked Dr. Mandsager whether that was true.                                                                          
                                                                                                                                
DR. RICHARD MANDSAGER, director,  Department of Public Health and                                                               
Social Services (DHSS), advised  although Alaska colleges are not                                                               
mandated  to provide  such  information,  they often  voluntarily                                                               
tell freshman they should get a meningococcal immunization.                                                                     
                                                                                                                                
CHAIR DYSON asked whether the bill would require Alaska                                                                         
institutions to do that.                                                                                                        
                                                                                                                                
DR. MANDSAGER responded that is correct.                                                                                        
                                                                                                                                
     CHAIR  DYSON  asked the  reason  the  college environment  is  so                                                          
     conducive to the spread of disease.                                                                                        
                                                                                                                                
     DR. BETH FUNK, Chief of  Epidemiology, DHSS, responded that while                                                          
     the answer to his question is  not known exactly, it is suspected                                                          
     the  reason  lies in  the  particularly  crowded conditions  that                                                          
     exist in  college dorms and classrooms.  Similar conditions exist                                                          
     in military institutions.                                                                                                  
                                                                                                                                
     CHAIR DYSON asked  Dr. Funk whether her  organization approves of                                                          
     the bill.                                                                                                                  
                                                                                                                                
     DR.  FUNK   responded  that  while  her   organization  certainly                                                          
     supports  vaccinations, it  is neutral  toward  the bill  because                                                          
     there is  currently no vaccine  available to treat the  strain of                                                          
     meningococcal bacteria  found in Alaska. Although  the department                                                          
     does not have strong feelings  against the legislation, it is not                                                          
     certain that it will have a big impact on public health.                                                                   
                                                                                                                                
     1:45:16 PM                                                                                                               
                                                                                                                                
     SENATOR  GREEN asked  whether there  were other  diseases in  the                                                          
     State  of Alaska  comparable to  the meningococcal  diseases with                                                          
     regards  to their  communicability  and lethality  and for  which                                                          
     there is no vaccine or mandated instruction.                                                                               
                                                                                                                                
     DR. FUNK could not think of any.                                                                                           
                                                                                                                                
     SENATOR ELTON  moved CSHB 185(FIN)  from committee  with attached                                                          
     recommendations and  a zero fiscal  note. Hearing  no objections,                                                          
     the motion carried.                                                                                                        
                                                                                                                                
                                                                                                                                
               SB 162-REPORT STUDENT HEALTH/DISCIPLINE/SAFETY                                                               
                                                                                                                                
  CHAIR DYSON announced SB 162 to be up for consideration. He                                                                   
     advised that he worked on a bill called School Safety and                                                                
     Behavioral Standards, which required that every school establish                                                         
     its behavioral and safety standards with parents and community                                                             
 leaders. Under the bill, schools were required to publish the                                                                  
     standards so that there would not be any controversy when they                                                             
     enforced them. Five years later, the records of the Department                                                             
     of Education show that few schools are complying with the bill.                                                            
 A few additional requirements have been incorporated into the                                                                  
current bill that he hopes will bring greater compliance on the                                                                 
part of the schools.                                                                                                            
                                                                                                                                
1:51:33 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER, Director, Division of  Pubic Health, said he would                                                               
like  to impart  some of  the  data on  obesity in  the State  of                                                               
Alaska. The  department believes  obesity contributes  greatly to                                                               
both Medicaid expenses and to the general expenses of the state.                                                                
                                                                                                                                
The problem of obesity is growing  at an incredibly rapid rate in                                                               
the State  of Alaska and in  the nation. Currently 32  percent of                                                               
children  in the  Anchorage School  District are  overweight when                                                               
they enter elementary  school and over 40 percent  of Alaska high                                                               
school students are overweight or  at risk of becoming overweight                                                               
by the  time that they  graduate. In  the last five  years alone,                                                               
the proportion of children in  the Anchorage School district that                                                               
are of normal  weight decreased from 65 percent to  60 percent of                                                               
the district's student population.                                                                                              
                                                                                                                                
Obesity  is a  growing  problem  for adults  in  Alaska as  well.                                                               
Between  the years  of 1991  and  2003 the  proportion of  Alaska                                                               
adults considered  obese or  overweight grew  from 49  percent of                                                               
the  total  population  in  1991  to  62  percent  of  the  total                                                               
population in  2003. Today, 43  percent of Alaskan adults  do not                                                               
meet the  Center for Disease Control's  (CDC) recommendations for                                                               
physical activity.                                                                                                              
                                                                                                                                
Today  only 18  percent  of high-school  students participate  in                                                               
daily  physical  education, 27  percent  do  not meet  the  CDC's                                                               
minimum recommendations  for physical activity, 28  percent watch                                                               
three or  more hours of television  on an average school  day and                                                               
only 16 percent  consume at least 5 daily servings  of fruits and                                                               
vegetables.                                                                                                                     
                                                                                                                                
There  have   been  recent  significant   changes  in   the  food                                                               
environment  of American  children that  have contributed  to the                                                               
growing obesity  problem. More children are  consuming more meals                                                               
outside of the home and the  portions of those meals are becoming                                                               
larger. Today 43 percent of  American's elementary schools and 98                                                               
percent of its high schools  sell low-nutrient, high calorie a la                                                               
carte and vending machine foods and beverages.                                                                                  
                                                                                                                                
National  trends are  reflected in  the nutrition  environment of                                                               
Alaska schools. Today only 28  percent prohibit soda during lunch                                                               
and  only 17  percent of  Alaskan schools  with vending  machines                                                               
have policies regulating the content of these machines.                                                                         
                                                                                                                                
     The Federal Woman,  Infants and Children Act passed  in 2004 will                                                          
     implement requirements  for schools receiving WIC  funding during                                                          
     the 2006-2007  school year. Its  mandate will require  schools to                                                          
     establish goals for nutritional  education and physical activity,                                                          
     nutrition  guidelines for  foods available  at school  during the                                                          
     day  and   the  establishment  of   a  plan  for   measuring  the                                                          
     implementation  of  a  school's  wellness  policy.  Currently  89                                                          
     percent  of Alaska  school  districts and  87  percent of  Alaska                                                          
     schools  participate   in  the  National  School   Lunch  Program                                                          
     provided through WIC funding.                                                                                              
                                                                                                                                
     SENATOR ELTON  asked Dr. Mandsager  whether the  WIC requirements                                                          
     would be applied to schools individually or to school districts.                                                           
                                                                                                                                
     DR. MANDSAGER did not remember.                                                                                            
                                                                                                                                
     SENATOR GREEN said she believes the  bill would be applied to the                                                          
     school districts.                                                                                                          
                                                                                                                                
     2:03:33 PM                                                                                                               
                                                                                                                                
     DR.  MANDSAGER said  overweight children  are at  a significantly                                                          
     greater   risk   of   developing  high   blood   pressure,   high                                                          
     cholesterol,   orthopedic   disorders,   type  2   diabetes   and                                                          
     psychological  disorders.  Overweight  adults face  an  increased                                                          
     risk  of  premature  mortality, cardiovascular  disease,  Type  2                                                          
     diabetes,  musculoskeletal disorders,  sleep apnea,  gall bladder                                                          
     disease, arthritis and certain types of cancer.                                                                            
                                                                                                                                
     There is a tremendous controversy  among scientists over the cost                                                          
     of obesity. A year ago it was  thought to be the number two cause                                                          
     of  death in  American after  tobacco. Last  fall the  Center for                                                          
     Disease Control released information,  in the presence of intense                                                          
     internal scientific  argument, reducing  the estimate  of obesity                                                          
     related  deaths  from  400,000 to  375,000  deaths  annually.  It                                                          
     recently lowered  its estimate to 100,000  obesity related deaths                                                          
     per  year. These  figures  seem to  indicate  that nobody  really                                                          
     knows the death consequence of obesity.                                                                                    
                                                                                                                                
     Despite  the controversy  over the  issue of  death, the  rate of                                                          
     incidence  of  obesity  related  diseases,  particularly  Type  2                                                          
     diabetes,  and the  financial cost  of these  diseases is  better                                                          
     known.  Obesity  costs Alaska  $195  million  annually in  direct                                                          
     medical expenses,  $17 million of  which is financed  by Medicare                                                          
     and $29 million that is  financed by Medicaid. Diabetes in Alaska                                                          
     has doubled in the past 10  years. Today five percent of Alaska's                                                          
adult  population  has been  told  by  a  doctor that  they  have                                                               
diabetes and diabetes  is one of the top five  causes of death in                                                               
the state.  It is estimated  that one  in three children  born in                                                               
the year 2000 will develop diabetes as a consequence of obesity.                                                                
                                                                                                                                
2:11:47 PM                                                                                                                    
                                                                                                                                
CHAIR  DYSON asked  whether the  recent increase  in the  rate of                                                               
diabetes  is  due  to  recent   improvements  in  data  recording                                                               
methods.                                                                                                                        
                                                                                                                                
DR.  MANDSAGER  responded  it is  unrelated  to  data  collection                                                               
techniques.                                                                                                                     
                                                                                                                                
CHAIR DYSON  asked whether data  on diabetes is just  as accurate                                                               
today as  it was  ten years  ago when the  big jumps  in diabetes                                                               
began.                                                                                                                          
                                                                                                                                
DR. MANSAGER replied:                                                                                                           
                                                                                                                                
     It is with one caveat.  If you assume that the accuracy                                                                    
     of diagnosis  and the codes  are the same as  they were                                                                    
     ten year ago, then your statement is valid.                                                                                
                                                                                                                                
2:16:41 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER continued SB 162  would help to address the problem                                                               
by requiring  schools to  determine the  average body  mass index                                                               
(BMI)  of their  students.  This would  give schools  information                                                               
from which to develop their own welfare and wellness policies.                                                                  
                                                                                                                                
He added:                                                                                                                       
                                                                                                                                
     There  is   an  amendment  that  I   would  suggest  be                                                                    
     considered if  this bill is to  move. On page 3  of the                                                                    
     bill,  on  line  29,  current  statute  says  that  the                                                                    
     Department of  Health and  Social Services  shall train                                                                    
     and certify  public health nurses and  school districts                                                                    
     to  conduct hearing  and screening  tests. In  fact, we                                                                    
     are not  meeting that statute  today. We  are assisting                                                                    
     school districts  when we are  requested to  train, but                                                                    
     we  aren't  certifying  anybody and  we  clearly  don't                                                                    
     train everybody.                                                                                                           
                                                                                                                                
     We  have   submitted  a  zero  fiscal   note  with  the                                                                    
     assumption that  we can come  to an  understanding that                                                                    
     the wording  for that  can be  changed to  say, "assist                                                                    
          the department  of education  and early  development in                                                               
          training school district employees."  If this bill were                                                               
          to be moved, that would be my suggestion for a change.                                                                
                                                                                                                                
     CHAIR  DYSON understood  Dr. Mandsager  to  have implied  schools                                                          
     that  are  proactive  in  addressing the  problem  would  have  a                                                          
     greater  chance  of  receiving funds  to  help  facilitate  their                                                          
     efforts.                                                                                                                   
                                                                                                                                
     DR. MANDSAGER  said the  department has  a proposal  with Senator                                                          
     Stevens to  increase the funding  for its obesity program  and he                                                          
     envisions using that  money in partnership with  schools. He said                                                          
     the compilation of BMI data  in the Anchorage school district has                                                          
     encouraged the  community, the mayor's  office and the  school to                                                          
     discuss the problem.                                                                                                       
                                                                                                                                
     CHAIR DYSON said:                                                                                                          
                                                                                                                                
          So getting the information on  the BMI gives the school                                                               
          districts a baseline  to decide if and  where they have                                                               
          a problem and a  baseline to evaluate the effectiveness                                                               
          of whatever they  do. Having that baseline  is going to                                                               
          help them  to convince  the funding sources  that there                                                               
          is a problem that needs to be addressed.                                                                              
                                                                                                                                
     DR. MANDSAGER said:                                                                                                        
                                                                                                                                
          I  would  also  argue  that  it  gives  information  to                                                               
          communities to  decide what they, as  communities, want                                                               
          to do to address the problem.                                                                                         
                                                                                                                                
                                                                                                                                
     2:21:42 PM                                                                                                               
                                                                                                                                
     BEVERLY  SMITH,  Christian   Science  Committee  on  Publication,                                                          
     Alaska, said:                                                                                                              
                                                                                                                                
          The  Committee on  Publication for  Alaska respectfully                                                               
          requests an  amendment on  page 3 to  add part  C which                                                               
          would  say,  'Notwithstanding  A  of  this  section,  a                                                               
          person required to  conduct a test or cause  a child to                                                               
          receive a vision, weight,  height and hearing screening                                                               
          under this  section is exempt from  this requirement if                                                               
          the  parent or  guardian of  the child  objects to  the                                                               
          testing  procedure on  the grounds  that the  procedure                                                               
          conflicts with  the religious  tenants or  practices of                                                               
          the  parent  of  guardian.'  The parent  shall  sign  a                                                               
     statement  that   the  parent  knowingly   refuses  the                                                                    
     examination  and  the  person conducting  the  test  or                                                                    
     causing the child to receive  an examination shall have                                                                    
     a copy of this signed  statement retained in the school                                                                    
     record.                                                                                                                    
                                                                                                                                
     Parents  that use  prayer and  spiritual means  for the                                                                    
     care  and  healing  of their  children  can  choose  to                                                                    
     object  to   a  vision,  weight,  height   and  hearing                                                                    
     examination. Christian Science is  one of the religious                                                                    
     non-medical   forms  of   treatment   that  relies   on                                                                    
     spiritual  means   through  prayer  to   heal  illness,                                                                    
     injuries and other conditions.                                                                                             
                                                                                                                                
     2:25:01 PM                                                                                                               
                                                                                                                                
SENATOR GREEN said:                                                                                                             
                                                                                                                                
     Over  time the  school has  become the  doctor's office                                                                    
     for many people and for people  who prefer not to go to                                                                    
     a medical  doctor, it becomes  an end-run  around their                                                                    
     choice.  That is  my concern  with this  bill. I  think                                                                    
     that  it  goes  too  far  and I  think  it  creates  an                                                                    
     incredible  reporting  burden   for  many  schools  and                                                                    
     people.                                                                                                                    
                                                                                                                                
     I  think that  Dr. Mandsager's  stated lack  of success                                                                    
     tying  to  change the  diets  of  some of  his  obesity                                                                    
     patients demonstrates that we  don't impact people very                                                                    
     well  this   way  and  I   certainly  don't   want  the                                                                    
     Legislature involved  in it.  This is a  laudable goal,                                                                    
     but a strange way of going about it.                                                                                       
                                                                                                                                
BARBARA TOMPSON, director, Division of Teaching and Learning                                                                    
Support, DHSS, said:                                                                                                            
                                                                                                                                
     I  am  here  to  speak  to  the  fiscal  note  that  we                                                                    
     prepared. It  indicates that the  costs related  to the                                                                    
     bill are  indeterminate at this  time. We know  that we                                                                    
     would  have   to  draft  and  implement   a  number  of                                                                    
     regulations related to the  collecting and recording of                                                                    
     data that the school  districts are required to provide                                                                    
     under  this bill.  We just  don't know  what they  will                                                                    
     translate into cost-wise.                                                                                                  
                                                                                                                                
     To speak  to the  amendment that  was proposed,  if the                                                                    
     language is  changed to have  the Department  of Health                                                                    
          and Social Services assist  the Department of Education                                                               
          in Training,  the fiscal note  will have to  be revised                                                               
          because we  did not  account for the  way that  it will                                                               
          affect the fiscal note.                                                                                               
                                                                                                                                
     2:32:51 PM                                                                                                               
                                                                                                                                
     CHAIR DYSON asked whether the  department has taken a position on                                                          
     this bill.                                                                                                                 
                                                                                                                                
     MS.  THOMPSON  said the  department  has  not taken  an  official                                                          
     position on the bill.                                                                                                      
                                                                                                                                
     CHAIR DYSON said he does not  see how writing down the height and                                                          
     weight of  a kid on a  chart is going to  be especially difficult                                                          
     for  a school.  Overweight  children coming  out  of the  schools                                                          
     represent a  great unfunded  mandate upon the  state and  some of                                                          
     that  costs  associated with  it  should  be transferred  to  the                                                          
     schools that are in part responsible for them.                                                                             
                                                                                                                                
     2:36:56 PM                                                                                                               
                                                                                                                                
     SENATOR  GREEN said  she  was not  referring  to measurements  of                                                          
     height  and weight,  which she  believes are  already taken,  but                                                          
     rather to the  costs that are associated with  the collection and                                                          
     analysis of  the data.  She asked  if a  "Body Mass  Index" (BMI)                                                          
     refers to a diagnosis.                                                                                                     
                                                                                                                                
     2:38:21 PM                                                                                                               
                                                                                                                                
     DR. MANDSAGER said the BMI is  only a screen and not a diagnosis.                                                          
     It is the  best test for obesity that the  schools can reasonably                                                          
     be expected to administer.                                                                                                 
                                                                                                                                
     2:43:14 PM                                                                                                               
                                                                                                                                
     DR. OLSON remarked he would like  to hear the position of private                                                          
     schools on the bill.                                                                                                       
                                                                                                                                
     CHAIR  DYSON held  SB 162  in committee.  There being  no further                                                          
     business to come  before the committee, he  adjourned the meeting                                                          
     at 2:45 PM.                                                                                                                
                                                                                                                                

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