Legislature(2005 - 2006)BUTROVICH 205

04/27/2005 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES


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01:33:13 PM Start
01:43:29 PM HB225
02:22:12 PM HB120
02:39:24 PM Confirmation Hearings || University of Alaska Board of Regents
02:42:17 PM Board of Pharmacy
02:46:01 PM Alaska Mental Health Trust
02:47:58 PM Board of Education and Early Childhood Development
02:52:11 PM Board of Pharmacy
02:56:44 PM Board of Dental Examiners
02:59:09 PM Board of Professional Counselors
03:02:13 PM Alaskan Dental Hygienists Association
03:03:25 PM Alaska Board of Psychologists
03:05:29 PM State Physical Therapy and Occupational Therapy Board
03:08:00 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 225 MEDICAL EXAMINERS & AUTOPSIES TELECONFERENCED
Moved SCS HB 225(HES) Out of Committee
+= HB 120 HEALTH CARE EMPLOYEE PROTECTION TELECONFERENCED
Moved HB 120 Out of Committee
+ Confirmation Hearings: TELECONFERENCED
Board of Dental Examiners
Board of Pharmacy
State Physical Therapy and Occupational
Therapy Board
Alaska Mental Health Trust Authority
Board of Trustees
Professional Counselors
University of Alaska Board of Regents
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                               
                         April 27, 2005                                                                                         
                           1:33 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Fred Dyson, Chair                                                                                                       
Senator Gary Wilken, Vice Chair                                                                                                 
Senator Kim Elton                                                                                                               
Senator Donny Olson                                                                                                             
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Lyda Green                                                                                                              
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                              
HOUSE BILL NO. 225                                                                                                              
"An Act relating to medical examiners and medical death                                                                         
examinations."                                                                                                                  
          MOVED SCS HB 225(HES) OUT OF COMMITTEE                                                                                
                                                                                                                                
HOUSE BILL NO. 120                                                                                                              
"An Act relating to safety devices and sharp instruments for the                                                                
prevention of the spread of bloodborne pathogens in health care                                                                 
employees; and providing for an effective date."                                                                                
          MOVED HB 120 OUT OF COMMITTEE                                                                                         
                                                                                                                                
CONFIRMATION HEARINGS:                                                                                                          
                                                                                                                                
University of Alaska Board of Regents - Carl Marrs, Jacob                                                                       
Gondeck                                                                                                                         
                                                                                                                                
Board of Pharmacy - Mary Mundell, Leona Oberts                                                                                  
                                                                                                                                
Alaska Mental Health Trust Authority Board of Trustees -                                                                        
Margaret Lowe                                                                                                                   
                                                                                                                                
Board of Education and Early Child Development - Bonny Gaborik                                                                  
                                                                                                                                
Board of Pharmacy - Leona Oberts                                                                                                
                                                                                                                                
Board of Dental Examiners - Dr. Rebecca Neslund                                                                                 
                                                                                                                                
Board of Professional Counselors - Randy Morton, Tashawna Olson                                                                 
                                                                                                                                
Alaskan Dental Hygienists Association - Victoria Hauff                                                                          
                                                                                                                                
Alaska Board of Psychologists - Dr. Kerry Turnbow                                                                               
                                                                                                                                
State Physical Therapy and Occupational Therapy Board - Jay                                                                     
McDiarmid, Alec Kay, Gary Burlson                                                                                               
                                                                                                                                
     HEARD AND HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 225                                                                                                                  
SHORT TITLE: MEDICAL EXAMINERS & AUTOPSIES                                                                                      
SPONSOR(s): REPRESENTATIVE(s) MCGUIRE                                                                                           
                                                                                                                                
03/18/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/18/05       (H)       HES, FIN                                                                                               
03/31/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
03/31/05       (H)       Moved Out of Committee                                                                                 
03/31/05       (H)       MINUTE(HES)                                                                                            
04/01/05       (H)       HES RPT 5DP                                                                                            
04/01/05       (H)       DP: ANDERSON, KOHRING, MCGUIRE, SEATON,                                                                
                         WILSON                                                                                                 
04/12/05       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
04/12/05       (H)       Moved Out of Committee                                                                                 
04/12/05       (H)       MINUTE(FIN)                                                                                            
04/13/05       (H)       FIN RPT 3DP 4NR                                                                                        
04/13/05       (H)       DP: HAWKER, FOSTER, MEYER                                                                              
04/13/05       (H)       NR: HOLM, STOLTZE, KELLY, CHENAULT                                                                     
04/13/05       (H)       TRANSMITTED TO (S)                                                                                     
04/13/05       (H)       VERSION: HB 225                                                                                        
04/14/05       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/14/05       (S)       HES, FIN                                                                                               
04/27/05       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                              
BILL: HB 120                                                                                                                  
SHORT TITLE: SAFETY FOR HEALTHCARE EMPLOYEES                                                                                    
SPONSOR(s): REPRESENTATIVE(s) WILSON                                                                                            
                                                                                                                                
02/02/05       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/02/05       (H)       HES, L&C                                                                                               
02/24/05       (H)       HES AT 3:00 PM CAPITOL 106                                                                             
02/24/05       (H)       Moved Out of Committee                                                                                 
02/24/05       (H)       MINUTE(HES)                                                                                            
02/25/05       (H)       HES RPT 4DP 1NR                                                                                        
02/25/05       (H)       DP: CISSNA, GARDNER, SEATON, WILSON;                                                                   
02/25/05       (H)       NR: KOHRING                                                                                            
03/22/05       (H)       L&C AT 1:00 PM CAPITOL 17                                                                              
03/22/05       (H)       Moved Out of Committee                                                                                 
03/22/05       (H)       MINUTE(L&C)                                                                                            
03/23/05       (H)       L&C RPT 4DP 2NR                                                                                        
03/23/05       (H)       DP:    CRAWFORD,    LYNN,    GUTTENBERG,                                                               
                         ANDERSON;                                                                                              
03/23/05       (H)       NR: LEDOUX, ROKEBERG                                                                                   
04/12/05       (H)       TRANSMITTED TO (S)                                                                                     
04/12/05       (H)       VERSION: HB 120                                                                                        
04/13/05       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/13/05       (S)       HES, L&C                                                                                               
04/25/05       (S)       HES AT 2:00 PM BUTROVICH 205                                                                           
04/25/05       (S)       Scheduled But Not Heard                                                                                
04/27/05       (S)       HES AT 1:30 PM BUTROVICH 205                                                                         
                                                                                                                              
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE LESIL MCGUIRE                                                                                                    
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT: Sponsor of HB 225.                                                                                        
                                                                                                                                
DR. RICHARD MANDSAGER, Director                                                                                                 
Department of Health & Social Services                                                                                          
Division of Public Health                                                                                                       
PO Box 110601                                                                                                                   
Juneau, AK  99801-0601                                                                                                          
POSITION STATEMENT: Supported HB 225.                                                                                         
                                                                                                                                
DR. FRANK FALLICO, Chief Medical Examiner                                                                                       
Office of the State Medical Examiner                                                                                            
4500 S. Boniface Parkway                                                                                                        
Anchorage, AK  99507                                                                                                            
POSITION STATEMENT: Supported HB 225.                                                                                         
                                                                                                                                
DR. DON ROGERS                                                                                                                  
Former State Medical Examiner                                                                                                   
No Address Provided                                                                                                             
POSITION STATEMENT: Supports SB 225.                                                                                          
                                                                                                                                
REPRESENTATIVE PEGGY WILSON                                                                                                     
Alaska State Capitol                                                                                                            
Juneau, AK  99801-1182                                                                                                          
POSITION STATEMENT: Sponsor of HB 120.                                                                                        
                                                                                                                                
DR. BETH FUNK, Acting Chief Section of Epidemiology                                                                             
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Box 240249                                                                                                                      
Anchorage, AK  99524-0249                                                                                                       
POSITION STATEMENT: Available to answer questions on HB 120.                                                                  
                                                                                                                                
GREY MITCHELL, Director,                                                                                                        
Labor Standards and Safety Division                                                                                             
Department of Labor and Workforce Development (DOLWD)                                                                           
POSITION STATEMENT: Supported HB 120.                                                                                         
                                                                                                                                
JOHN BITNEY                                                                                                                     
Alaska Nurses Association                                                                                                       
Palmer AK                                                                                                                       
POSITION STATEMENT: Supported HB 120.                                                                                         
                                                                                                                                
Confirmation Candidates:                                                                                                        
                                                                                                                                
CARL MARRS, Nominee                                                                                                             
University of Alaska Board of Regents                                                                                           
                                                                                                                                
MARY MUNDELL, Nominee                                                                                                           
Board of Pharmacy                                                                                                               
                                                                                                                                
MARGARET LOWE, Nominee                                                                                                          
Alaska Mental Health Trust                                                                                                      
                                                                                                                                
BONNIE GABORIK, Nominee                                                                                                         
Board of Education and Early Childhood Development                                                                              
                                                                                                                                
LEONA OBERTS, Nominee                                                                                                           
Board of Pharmacy                                                                                                               
                                                                                                                                
DR. REBECCA NESLUND, Nominee                                                                                                    
Board of Dental Examiners                                                                                                       
                                                                                                                                
RANDY MORTON, Nominee                                                                                                           
Board of Professional Counselors                                                                                                
                                                                                                                                
TASHAWNA OLSON, Nominee                                                                                                         
Board of Professional Counselors                                                                                                
                                                                                                                                
VICTORIA HAUFF, Nominee                                                                                                         
Alaskan Dental Hygienists Association                                                                                           
                                                                                                                                
DR. KERRY TURNBOW, Nominee                                                                                                      
Alaska Board of Psychologists                                                                                                   
                                                                                                                                
JAY MCDIARMID, Nominee                                                                                                          
State Physical Therapy and Occupational Therapy Board                                                                           
                                                                                                                                
ALEC KAY, Nominee                                                                                                               
State Physical Therapy and Occupational Therapy Board                                                                           
                                                                                                                                
GRAY BURLESON, Nominee                                                                                                          
State Physical Therapy and Occupational Therapy Board                                                                           
                                                                                                                                
JACOB GONDEK, Nominee                                                                                                           
University of Alaska Board of Regents-Student Seat                                                                              
                                                                                                                              
ACTION NARRATIVE                                                                                                              
                                                                                                                                
CHAIR FRED DYSON  called the Senate Health,  Education and Social                                                             
Services  Standing  Committee meeting  to  order  at 1:33:13  PM.                                                             
Present  were Senators  Elton, Wilken  and  Chair Dyson.  Senator                                                               
Olson arrived at 1:40.                                                                                                          
                                                                                                                                
              HB 225-MEDICAL EXAMINERS & AUTOPSIES                                                                            
                                                                                                                                
CHAIR DYSON announced HB 225 to be up for consideration.                                                                        
                                                                                                                                
REPRESENTATIVE  LESIL   MCGUIRE,  sponsor,  explained   that  the                                                               
understaffed condition  of the  Alaskan Medical  Examiners office                                                               
causes  some  unexplained  deaths   to  go  unexamined;  it  also                                                               
diminishes the  state's ability to  acknowledge and react  to the                                                               
outbreak  of communicable  diseases. Last  year over  1,100 cases                                                               
were filed  and the office  has only one state  medical examiner.                                                               
His  duties  are  multifaceted.  One of  the  most  important  is                                                               
performing  autopsies, but  he also  has to  testify in  court in                                                               
cases of  a suspicious  death. This  becomes an  important public                                                               
issue  because  a lot  of  autopsies  are suspicious  and  crimes                                                               
cannot  come  to  light  and  because deaths  can  be  caused  by                                                               
contagious  diseases.  HB  225 requires  the  Medical  Examiner's                                                               
Office to be  staffed with at least one medical  examiner and one                                                               
deputy medical examiner.                                                                                                        
                                                                                                                                
CHAIR  DYSON asked  if staff  to this  office could  be increased                                                               
without this legislation.                                                                                                       
                                                                                                                                
REPRESENTATIVE MCGUIRE replied that it could.                                                                                   
                                                                                                                                
CHAIR DYSON  asked if  the additional  position mandated  in this                                                               
bill is reflected in the Governor's budget.                                                                                     
                                                                                                                                
REPRESENTATIVE MCGUIRE replied:                                                                                                 
                                                                                                                                
     It is reflected  in the House version and  I believe it                                                                    
     will be  reflected in the  ultimate version  that comes                                                                    
     out of the  conference committee. That is  why there is                                                                    
     a zero fiscal note.   An additional $100,000 was put in                                                                    
     for  this position....  I  think from  conversations...                                                                    
     with members of the your body  it may well have been an                                                                    
     oversight.                                                                                                                 
                                                                                                                                
She did  not want to create  more government, there are  few very                                                               
important areas that should be left  to the state and this is one                                                               
of  those  areas.    She  did  not  want  to  see  this  position                                                               
contracted out or left unfilled.                                                                                                
                                                                                                                                
CHAIR DYSON asked  Dr. Mandsager if the  administration has taken                                                               
a position on this bill.                                                                                                        
                                                                                                                                
DR.  RICHARD  MANDSAGER,  Director, Division  of  Public  Health,                                                               
Department of  Health and Social  Services (DHSS)  testified that                                                               
he supported the  bill; however he clarified  that the division's                                                               
budget currently  does have just  enough money in it  for minimal                                                               
operation by  two medical  examiners and  he has  been recruiting                                                               
for the  other position  for about six  months now.  He explained                                                               
the reason  for the $100,000  increment in the  Governor's budget                                                               
was  to begin  building the  capacity of  the Medical  Examiner's                                                               
Office to  more fully meet  its missions including  attempting to                                                               
answer  questions from  the bereaved  as to  why their  loved one                                                               
died.                                                                                                                           
                                                                                                                                
CHAIR DYSON said he understands  that the administration supports                                                               
the bill and  the administration has established  funding for the                                                               
addition  to the  examiners  office and  the  Division of  Public                                                               
Health is currently recruiting the additional staff.                                                                            
                                                                                                                                
DR. MANDSAGER replied that that is correct.                                                                                     
                                                                                                                                
SENATOR ELTON said this bill not  only provides for a deputy, but                                                               
it  also establishes  his  general  duties and  he  asked if  the                                                               
department would establish his duties if  it had one at this time                                                               
rather than having those duties  established in law as they would                                                               
be doing under this bill.                                                                                                       
                                                                                                                                
DR.  MANDSAGER  replied  that he  thought  the  department  would                                                               
establish those duties without this bill  in that case.  The only                                                               
other  difference this  bill  would make  is  that under  current                                                               
statute  the department  could recruit  for a  second person  who                                                               
might  not  be  totally  qualified  to be  a  deputy.  This  bill                                                               
requires  recruiting  someone who  is  qualified  to serve  as  a                                                               
deputy medical examiner.                                                                                                        
                                                                                                                                
1:43:29 PM                                                                                                                    
SENATOR  ELTON asked  whether the  department has  looked at  the                                                               
possibility of having contract positions  throughout the state to                                                               
carry out some of the duties of the medical examiner.                                                                           
                                                                                                                                
1:44:43 PM                                                                                                                    
DR. FRANK  FALLICO, Chief Medical Examiner,  Department of Health                                                               
and  Social  Services (DHSS),  replied  that  the department  has                                                               
considered that  option and determined  that it is  too difficult                                                               
to  find  enough staff  who  are  qualified to  perform  forensic                                                               
autopsies.                                                                                                                      
                                                                                                                                
CHAIR DYSON said he has  heard that the Medical Examiner's Office                                                               
misses the  cause of some  accidental deaths,  particularly those                                                               
involving carbon  monoxide, because  it does not  have sufficient                                                               
manpower to perform autopsies.                                                                                                  
                                                                                                                                
DR. FALLICO, replied:                                                                                                           
                                                                                                                                
     As a matter of fact,  we have investigated those deaths                                                                    
     very thoroughly and  when an autopsy is  required we do                                                                    
     it.  I do not believe  that we have missed any of those                                                                    
     deaths.  However,  I  will  say   that  they  are  very                                                                    
     difficult death  determinations sometimes and  they can                                                                    
     be missed even under the best of circumstances.                                                                            
                                                                                                                                
     We  have a  problem with  the transportation  of bodies                                                                    
     and  doing  this  sort  of   work  within  our  budget.                                                                    
     However,   we  have   special  sensitivity   to  carbon                                                                    
     monoxide deaths.  As you  know, there have been quite a                                                                    
     few of  them here under  tragic circumstances and  I do                                                                    
     not believe that  we have missed any  of them. However,                                                                    
     one sometimes  does not  know what  one misses,  if you                                                                    
     will, and we certainly  would have a better opportunity                                                                    
     to pick  up those accidental  deaths to which I  am now                                                                    
     deferring if  indeed we had  one more  medical examiner                                                                    
     here.                                                                                                                      
                                                                                                                                
     You  know  this  office  really   can't  run  with  one                                                                    
     examiner because  I am stretched  to the point  where I                                                                    
     have to triage or turn  away cases that would, perhaps,                                                                    
     be done in other good  jurisdictions.  Once again, I do                                                                    
     not  believe that  we have  missed any  carbon monoxide                                                                    
     deaths  that are  of  a level  of  suspicion such  that                                                                    
     others would disapprove of us having turned them down.                                                                     
                                                                                                                                
CHAIR  DYSON said  that he  has heard  that the  department often                                                               
gets requests to examine cases  on behalf of family members whose                                                               
recently deceased relatives had  made suspicious changes to their                                                               
will immediately before their deaths.                                                                                           
                                                                                                                                
DR. FALLICO responded:                                                                                                          
                                                                                                                                
     In forensic  cases an autopsy  is done if it  will help                                                                    
     solve the  case; it is  not done solely at  the request                                                                    
     of family members  or even at the request  of police or                                                                    
     troopers unless we both agree to  do it.  I always work                                                                    
     through the  proper police or  trooper agencies  to see                                                                    
     if  the investigation  really warrants  an autopsy.  In                                                                    
     cases where  autopsies are not  warranted, I do  not do                                                                    
     them at  the request  of families  because that  is not                                                                    
     the purpose of  this office and it is  certainly out of                                                                    
     the question given our current staff level.                                                                                
                                                                                                                                
CHAIR DYSON  asked if he is  correct in believing that  the death                                                               
of an elderly person does  not trigger a police investigation and                                                               
all that is  required to close a case is  a physician's signature                                                               
on the death certificate.                                                                                                       
                                                                                                                                
DR. FALLICO  replied that if  the death  is a natural  death that                                                               
occurs in a  hospital, it does not trigger  an investigation from                                                               
his office.  If that same  death occurs outside of  the hospital,                                                               
there are  two ways  in which it  can be handled.   The  first is                                                               
that the police will go to  the home and investigate to determine                                                               
whether  or not  it was  a natural  death. If  so, that  death is                                                               
reported to  him and  he makes  a determination  of the  cause of                                                               
death  and signs  the death  certificate.   He said  that in  the                                                               
great majority of cases, that does  not require an autopsy and if                                                               
the family asks  him for one, he  tells them that he  is not able                                                               
to do it. He refers them to  a private pathologist who is able to                                                               
perform the autopsy.                                                                                                            
                                                                                                                                
1:52:05 PM                                                                                                                    
He said the  second way involves what is called  an expected home                                                               
death  where paper  work is  set up  in advance.  In these  cases                                                               
there  is no  real  investigation  by police  and  no autopsy  is                                                               
performed.   Sometimes with these expected  home deaths, however,                                                               
the  troopers disagree  and they  actually investigate  the case,                                                               
but nothing  happens with his  office except that the  paper work                                                               
is filled out.                                                                                                                  
                                                                                                                                
CHAIR DYSON asked if the police  must respond to a death that has                                                               
occurred  in an  assisted living  home  or a  private home  where                                                               
hospice care was provided.                                                                                                      
                                                                                                                                
DR.  FALLICO responded  that it  depends  on whether  or not  the                                                               
death is  reported and on the  individual circumstances. Assisted                                                               
living  home  deaths push  a  very  sensitive button  because  of                                                               
certain  recent deaths  and  issues of  elder  abuse. The  police                                                               
certainly show up in some of those cases.                                                                                       
                                                                                                                                
He said  that in every case  he reviews the paper  work and makes                                                               
an independent determination about the  cause and manner of death                                                               
and  he will  require an  autopsy in  some of  those cases  - for                                                               
example, if  they die in certain  nursing homes - because  of the                                                               
possible political  and legal  pressure that  may arise  from the                                                               
deaths.                                                                                                                         
                                                                                                                                
CHAIR DYSON supposed:                                                                                                           
                                                                                                                                
     Here is  a scenario  that I have  heard of,  an 87-year                                                                    
     old man who  has been non ambulatory for  six years and                                                                    
     who is  incompetent, miraculously decides to  marry his                                                                    
     29 year-old personal care  attendant whose boyfriend is                                                                    
     the  supervising  physician  and two  weeks  after  the                                                                    
     magic marriage,  he ups  and dies.  But in  the interim                                                                    
     his will has been changed;  but arguably he has died of                                                                    
     natural causes and the  supervising physician signs the                                                                    
     death certificate.   Is there  anything in  our process                                                                    
     that  looks at  recent  changes in  status  such as  in                                                                    
     marriages  or  in  wills  that may  make  you  and  the                                                                    
     troopers   decide    that   a   case    needs   greater                                                                    
     consideration?                                                                                                             
                                                                                                                                
DR.  FALLICO  responded   that  his  office  is   not  a  primary                                                               
investigation agency and  would refer such a case  to the primary                                                               
investigative agents and offer its assistance.                                                                                  
                                                                                                                                
1:56:13 PM                                                                                                                    
CHAIR  DYSON asked  if recent  changes in  a will  or in  marital                                                               
status automatically trigger an investigation.                                                                                  
                                                                                                                                
DR.  FALLICO replied  he  believes that  the  police or  troopers                                                               
would investigate such  cases because that is part  of their job.                                                               
He believes that they would inform  him of such changes before he                                                               
made any  decision regarding  the case.   He  added that  he must                                                               
ultimately rely  on the judgment  of the police and  troopers and                                                               
if  they are  not willing  to  go forward  on a  case, he  cannot                                                               
perform an independent investigation.                                                                                           
                                                                                                                                
SENATOR  WILKEN  said he  was  puzzled  about  why this  bill  is                                                               
necessary if the issue was already being taken care of.                                                                         
                                                                                                                                
DR.  MANDSAGER  replied  he  thought  the  reason  Representative                                                               
McGuire  introduced  this  bill  was  because  she  believes  the                                                               
department hasn't  paid enough  attention to  making sure  to has                                                               
the two  positions filled.   Even, if  the bill doesn't  pass, he                                                               
would  continue to  try and  staff  the office  with two  medical                                                               
examiners with  the current budgetary amount  and it is a  bit of                                                               
an  improvement over  current  practice in  that  it states  very                                                               
clearly that  the state needs  two medical examiners.  He stated,                                                               
"My personal opinion is that  that's a correct statement and this                                                               
bill  would put  it into  statute rather  than leaving  it as  an                                                               
opinion."                                                                                                                       
                                                                                                                                
2:00:50 PM                                                                                                                    
REPRESENTATIVE MCGUIRE  commented that it's not  uncommon for the                                                               
legislature to set out in statute  a series of standards in areas                                                               
if  wants to  -  even  within the  departments  of the  Executive                                                               
Branch there is precedent for it. She said further:                                                                             
                                                                                                                                
     And then secondly,  I would just say that  I do respect                                                                    
     what  you have  to say  and as  I have  said earlier  I                                                                    
     tread  lightly in  this area,  but  I do  think it's  a                                                                    
     matter  of  such  importance  that   it  should  be  in                                                                    
     statute.                                                                                                                   
                                                                                                                                
     The concern  that I have,  Senator Wilken is  that when                                                                    
     you look back at the  history, it's been an interesting                                                                    
     one.  There  was a  point  in  time where  the  Medical                                                                    
     Examiner  Office   had  as  many  as   five  physicians                                                                    
     throughout  the state  that  were  doing autopsies.  We                                                                    
     were rated in the top  tier of medical examiner offices                                                                    
     in  the  United States.  And  over  the years  we  have                                                                    
     simply  have eliminated  those positions  or they  have                                                                    
     fallen off and we have not filled them....                                                                                 
                                                                                                                                
2:03:22 PM                                                                                                                    
SENATOR ELTON  asked if  the word "or"  should be  placed between                                                               
"Medical Examiner" and "Deputy Medical  Examiner" on page 3, line                                                               
19,  to  form the  phrase  "Medical  Examiner or  Deputy  Medical                                                               
Examiner."                                                                                                                      
                                                                                                                                
REPRESENTATIVE  MCGUIRE thanked  Senator Elton  for pointing  out                                                               
the drafting error and said  that the suggested corrections would                                                               
be made.                                                                                                                        
                                                                                                                                
SENATOR ELTON  moved on  page 3,  line 19,  to insert  "or" after                                                               
"Examiner".  There  were  no  objections   and  Amendment  1  was                                                               
adopted.                                                                                                                        
                                                                                                                                
2:04:46 PM                                                                                                                    
DR. DON ROGERS,  former State Medical Examiner,  supported HB 225                                                               
saying that  autopsies should be  performed on all  the coroner's                                                               
cases  because if  one solely  relies on  police departments  and                                                               
witnesses, one will often be  mislead.  Accurate determination of                                                               
the cause of death is a  requirement on the death certificate and                                                               
if  one does  not do  the examination  and signs  the certificate                                                               
without  looking at  the body,  one  is going  to be  wrong in  a                                                               
substantial number of cases.   Medical examiners also have a duty                                                               
to alleviate the concerns of the families of the deceased.                                                                      
                                                                                                                                
2:07:11 PM                                                                                                                    
DR. ROGERS stated that the  Medical Examiner's Office lab needs a                                                               
toxicology component because it currently  is not able to perform                                                               
carbon monoxide tests.                                                                                                          
                                                                                                                                
SENATOR  ELTON  asked  if  the Office  of  the  Medical  Examiner                                                               
generally provides autopsies  on the bodies of people  who die in                                                               
hospital.                                                                                                                       
                                                                                                                                
DR. ROGERS  replied that  the Medical  Examiner does  not perform                                                               
autopsies  for natural  deaths that  occur in  the hospital.   He                                                               
explained that the law requires  an autopsy for deaths that occur                                                               
under  anesthesia or  that  occur shortly  after  admission to  a                                                               
hospital.                                                                                                                       
                                                                                                                                
SENATOR OLSON asked whether the  investigation of those deaths is                                                               
a  matter  of  the  Medical   Examiners  discretion  or  if  they                                                               
automatically fall under  the purview of the  Medical Examiner by                                                               
law.                                                                                                                            
                                                                                                                                
2:09:42 PM                                                                                                                    
DR. ROGERS replied that when  he worked for the Medical Examiners                                                               
Office,  it   performed  autopsies   for  all   deaths  involving                                                               
anesthesia or a  possible medical error because most  of the time                                                               
the  physicians  and  the families  wanted  someone  besides  the                                                               
hospital personnel  performing the  investigation.  He  said that                                                               
in a state as small as ours with  as few deaths as we have, it is                                                               
possible to perform most, if not all, autopsies.                                                                                
                                                                                                                                
2:11:35 PM                                                                                                                    
SENATOR OLSON asked what level of education and experience is                                                                   
required to perform the duties of the Medical Examiner and the                                                                  
Deputy Medical Examiner.                                                                                                        
                                                                                                                                
DR. FALLICO replied:                                                                                                            
                                                                                                                                
     The  answer is  to  be fully  qualified  as a  forensic                                                                    
     pathologist certified in  the sub-specialty of forensic                                                                    
     pathology, one must go to  medical school, obtain an MD                                                                    
     or a DO  degree, followed by at  least certification in                                                                    
     anatomic pathology, which is  a branch of pathology and                                                                    
     that  takes  two  to  three  years,  followed  then  by                                                                    
     certification  in  forensic  pathology  and  that's  an                                                                    
     additional year of training.                                                                                               
                                                                                                                                
     Now, another way to do  it would be to become certified                                                                    
     in anatomic  pathology and  clinical pathology,  like I                                                                    
     am,  followed by  another year  of forensic  pathology.                                                                    
     So you know  there's a long arduous  course for getting                                                                    
     there - many  years. And for a variety  of reasons that                                                                    
     I won't  get into,  very very few  people go  into this                                                                    
     field.   There are  about 300 fully  qualified forensic                                                                    
     pathologists  practicing  in  the  country  full  time.                                                                    
     Those are  the numbers. So, with  these great shortages                                                                    
     and  so  forth,  we  are not  talking  about  top-rated                                                                    
     people.    It  is  possible  that  people  with  lesser                                                                    
     training could do  this work, but we've  all read about                                                                    
     the disasters across the  country in medical examiner's                                                                    
     offices  where less-than-well-qualified  people perform                                                                    
     the  work.   What  we  have  done  is set  the  highest                                                                    
     standards here  no matter what,  because we  don't want                                                                    
     to go back to the  old ways of doing partial autopsies,                                                                    
     of not  weighing certain organs  and having  my reports                                                                    
     reflect that certain  things in the past  that may have                                                                    
     been acceptable,  but today I would  be criticized for.                                                                    
     When I get  up on the stand - you  probably all know me                                                                    
     - you  read about what I  do. I was just  down there in                                                                    
     Juneau  earlier  this week  and  I'm  under very,  very                                                                    
     detailed cross examination with  experts that are flown                                                                    
     up here  by the defense  and others to certify  my work                                                                    
     and try  and attack  defense. So, I  feel what  we need                                                                    
     are fully  qualified people as I've  described in those                                                                    
     qualifications.                                                                                                            
                                                                                                                                
SENATOR  OLSON  asked  how  this  bill  would  apply  to  foreign                                                               
graduates and that, "Obviously, there are pathologists there."                                                                  
                                                                                                                                
DR. FALLICO answered  that he is a foreign  medical graduate from                                                               
the University  of Bologna.  As long as  the graduate  passes the                                                               
qualification  to practice  medicine  in the  United States,  and                                                               
specifically holds  a valid bona  fide state license, he  is just                                                               
as qualified as anyone else.                                                                                                    
                                                                                                                                
SENATOR WILKEN moved  to report SCS HB 225(HES)  out of committee                                                               
with individual recommendations. There were  no objections and it                                                               
was so ordered.                                                                                                                 
                                                                                                                                
             HB 120-HEALTH CARE EMPLOYEE PROTECTION                                                                           
                                                                                                                                
CHAIR DYSON announced HB 120 to be up for consideration.                                                                        
                                                                                                                                
REPRESENTATIVE PEGGY  WILSON, sponsor  of HB 120,  explained that                                                               
this  bill  repeals  two exemptions  from  Alaska's  Blood  Borne                                                               
Pathogen  Protection Standards  to  bring  Alaska standards  into                                                               
compliance  with federal  standards.   Alaska  adopted its  blood                                                               
borne  regulations in  2000 and  in 2001  the federal  government                                                               
adopted theirs.  Overall, Alaska's  regulations are  stronger and                                                               
tighter than the  federal regulations except in  two areas. Those                                                               
are dental  and health care offices  with less than 25  full time                                                               
employees. This bill  is really a housekeeping  bill that ensures                                                               
that state  statutes are equal  to the federal guidelines  and it                                                               
is  mainly for  the  purpose of  qualifying  for certain  federal                                                               
grants.                                                                                                                         
                                                                                                                                
CHAIR  DYSON asked  if the  medical community  has weighed  in on                                                               
this bill.                                                                                                                      
                                                                                                                                
REPRESENTATIVE WILSON  replied that  the Department of  Labor and                                                               
Workforce Development, the Nurses  Association, the Alaska Dental                                                               
Society and the  Alaska Hygienists Society all  support this bill                                                               
and no one is against it.                                                                                                       
                                                                                                                                
CHAIR DYSON asked  if the Alaska Medical Association  has taken a                                                               
position on it.                                                                                                                 
                                                                                                                                
REPRESENTATIVE  WILSON replied  that they  have not  commented on                                                               
the bill.                                                                                                                       
                                                                                                                                
CHAIR  DYSON asked  Dr.  Funk, Department  of  Health and  Social                                                               
Services (DHSS),  if she is  aware of anyone who  takes exception                                                               
to this bill.                                                                                                                   
                                                                                                                                
DR. BETH  FUNK, Acting Chief,  Epidemiology Section,  Division of                                                               
Public Health,  Department of Health and  Social Services (DHSS),                                                               
replied that she is not aware of anyone.                                                                                        
                                                                                                                                
GREY  MITCHELL, Director,  Labor Standards  and Safety  Division,                                                               
Department of Labor and Workforce Development (DOLWD), said:                                                                    
                                                                                                                                
     Currently  we  are  having  some  difficulty  with  our                                                                    
     federal counterparts  who provide  us with  grant funds                                                                    
     to carry  out our  program -  and that  is specifically                                                                    
     because   under   the   agreement   that   the   Alaska                                                                    
     Occupational  Safety  and  Health Program  was  created                                                                    
     under  in  1970,  we  agreed  that  we  would  maintain                                                                    
     standards  that  were  at least  effective  as  federal                                                                    
     standards.   And  this  is  an area  where  we are  not                                                                    
     meeting the  minimum federal  standards because  we are                                                                    
     exempting  dental offices  and  small medical  offices.                                                                    
     So, to kind  of straighten that out,  we've taken those                                                                    
     two  exemptions  off of  the  list  and essentially  we                                                                    
     haven't  heard   any  negative  comments.   The  dental                                                                    
     community has  come out in  support of the  bill. Small                                                                    
     medical offices  haven't voiced  any opposition  to it.                                                                    
     Our  in-the-field personnel  in the  industrial hygiene                                                                    
     area  have essentially  been  guiding these  businesses                                                                    
     toward  compliance with  federal requirements  already.                                                                    
     And  the  overwhelming  consensus   is  that  they  are                                                                    
     already in compliance with federal standards.                                                                              
                                                                                                                                
2:22:12 PM                                                                                                                    
SENATOR ELTON  asked if he  is correct  in believing that  all of                                                               
the entities that  fall under the scope of this  bill are already                                                               
required to  be in compliance  with federal regulations  and thus                                                               
this bill is not going to  aggrieve anyone any more than they are                                                               
already aggrieved.                                                                                                              
                                                                                                                                
MR. MITCHELL replied that he is correct.                                                                                        
                                                                                                                                
JOHN BITNEY, Alaska Nurses Association, supported HB 120.                                                                       
                                                                                                                                
SENATOR OLSON asked if a  particular problem caused this issue to                                                               
come to light.                                                                                                                  
                                                                                                                                
REPRESENTATIVE WILSON replied  there was none that  she was aware                                                               
of and that, "This is just  something that needs to be taken care                                                               
of."  The  impact of  this  legislation  is  not expected  to  be                                                               
significant  for   two  reasons.  One  is   that  the  businesses                                                               
currently exempt under the Alaska  law are already complying with                                                               
federal requirements and also the  participation required for the                                                               
front-line  health  care workers  in  the  evaluation process  is                                                               
automatic.                                                                                                                      
                                                                                                                                
SENATOR OLSON  asked how this  bill would affect health  aides in                                                               
rural  Alaska  who are  minimally  trained  and under-funded  and                                                               
often  do   not  have   adequate,  much   less  state-of-the-art,                                                               
equipment. He said  one village he visited last  year didn't even                                                               
have sterile suture equipment.                                                                                                  
                                                                                                                                
REPRESENTATIVE WILSON replied that she  was not sure. She assumed                                                               
they are  required to be trained  and that would fall  back under                                                               
the umbrella  of who is in  charge of them and  who oversees what                                                               
they do.                                                                                                                        
                                                                                                                                
SENATOR  WILKEN   asked  Representative   Wilson  to   state  her                                                               
professional background for the record.                                                                                         
                                                                                                                                
REPRESENTATIVE WILSON replied that she  is a registered nurse and                                                               
a former Emergency Medical Technician  III who practiced in rural                                                               
Southeast Alaska.  She personally  understands the  importance of                                                               
protection for yourself and your patients.                                                                                      
                                                                                                                                
SENATOR  WILKEN moved  to report  HB  120 out  of committee  with                                                               
individual recommendations  and attached fiscal note.  There were                                                               
no objections and it was so ordered.                                                                                            
2:31:28 PM                                                                                                                    
^ Confirmation Hearings                                                                                                     
^ University of Alaska Board of Regents                                                                                       
                                                                                                                                
CHAIR DYSON  asked Mr. Marrs why  he wants to serve  on the Board                                                               
of Regents for the University of Alaska.                                                                                        
                                                                                                                                
CARL MARRS responded that the  has spent an significant amount of                                                               
time developing a  scholarship fund for the  University of Alaska                                                               
(UAA) and  he would like to  see that fund  put to good use.   He                                                               
said that  the UAA system  has the  potential of becoming  one of                                                               
the leading  fisheries schools in  the country and he  would like                                                               
to see it achieve its potential.                                                                                                
                                                                                                                                
2:39:24 PM                                                                                                                    
^BOARD OF PHARMACY                                                                                                            
                                                                                                                                
CHAIR  DYSON asked  Ms. Mundell  why she  wants to  serve on  the                                                               
Board of Pharmacy.                                                                                                              
                                                                                                                                
MARY MUNDELL  replied that as  a pharmacist and a  business owner                                                               
she would bring a unique perspective to the board.                                                                              
                                                                                                                                
CHAIR DYSON asked her how  she feels about allowing physicians to                                                               
delegate prescription authority to pharmacists.                                                                                 
                                                                                                                                
MS. MUNDELL responded that her  attitude depends on the degree of                                                               
delegation.  She  added that it is an issue  of great concern for                                                               
all  parties  and  it  deserves  thorough  consideration  by  the                                                               
members of the board.                                                                                                           
                                                                                                                                
2:42:17 PM                                                                                                                    
CHAIR DYSON  asked her  if she  believes that  there should  be a                                                               
direct relationship between the patient  and the physician who is                                                               
giving the pharmacy prescriptive authority.                                                                                     
                                                                                                                                
MS.  MUNDELL   responded  that  there   must  be  some   sort  of                                                               
interaction  between  physicians and  patients.    She said  that                                                               
there  must,  however, be  some  consideration  of conditions  in                                                               
rural Alaska.                                                                                                                   
                                                                                                                                
CHAIR DYSON thanked her for her statements.                                                                                     
                                                                                                                                
2:44:47 PM                                                                                                                    
^Alaska Mental Health Trust                                                                                                   
                                                                                                                                
CHAIR DYSON  the asked  Ms. Lowe  why she wants  to serve  on the                                                               
Alaska Mental Health Trust Board.                                                                                               
                                                                                                                                
MARGARET  LOWE said  that she  has actively  participated in  the                                                               
development  of the  Alaska  Mental Health  Trust  over the  past                                                               
several years and  she feels that the proper management  of it is                                                               
important to  the state's ability  to assist people  with special                                                               
needs.                                                                                                                          
                                                                                                                                
2:46:01 PM                                                                                                                    
^BOARD OF EDUCATION AND EARLY CHILDHOOD DEVELOPMENT                                                                           
                                                                                                                                
CHAIR DYSON then asked Ms. Gaborik  why she wants to serve in her                                                               
prospective position.                                                                                                           
                                                                                                                                
BONNIE  GABORIK  replied  that  she  has  been  involved  at  the                                                               
elementary  level of  education for  almost 30  years and  she is                                                               
currently a  principal.   She said  that over  the years  she has                                                               
served   at  all   administrative  levels   gaining  considerable                                                               
knowledge  of  school  administration; this  experience  and  her                                                               
enthusiasm would be an asset to the board.                                                                                      
                                                                                                                                
2:47:58 PM                                                                                                                    
^Board of Pharmacy                                                                                                            
                                                                                                                                
CHAIR DYSON  then asked Ms. Oberts  why she wants to  serve on he                                                               
Board of Pharmacy.                                                                                                              
                                                                                                                                
LEONA OBERTS  replied that  she is  concerned with  health issues                                                               
and  has  considerable  administrative  knowledge  to  offer  the                                                               
board.                                                                                                                          
                                                                                                                                
2:52:11 PM                                                                                                                    
^Board of Dental Examiners                                                                                                    
                                                                                                                                
CHAIR  DYSON asked  Dr. Neslund  why she  wants to  serve on  the                                                               
Board of Dental Examiners.                                                                                                      
                                                                                                                                
DR.   REBECCA  NESLUND   answered  that   she  initially   became                                                               
interested in the board when  she discovered how difficult it was                                                               
to obtain  a dental license  in Alaska.  She joined the  board so                                                               
that she could  work towards expediting the  process of obtaining                                                               
a  dental license,  which  she has  accomplished.  She wanted  to                                                               
remain  on the  board  to contribute  to  its ongoing  discussion                                                               
about dental assistance personnel and  living in a rural area she                                                               
believes  it  is  important  that   the  board  has  someone  who                                                               
understands rural conditions in Alaska.                                                                                         
                                                                                                                                
CHAIR  DYSON asked  what are  the biggest  challenges facing  the                                                               
dental community of Alaska.                                                                                                     
                                                                                                                                
DR. NESLUND replied that one of  the big issues is the difficulty                                                               
that rural communities have in recruiting dental professionals.                                                                 
                                                                                                                                
CHAIR DYSON thanked her for her comments.                                                                                       
                                                                                                                                
2:56:44 PM                                                                                                                    
^Board of Professional Counselors                                                                                             
                                                                                                                                
CHAIR DYSON asked  Mr. Morton why he wants to  serve on the Board                                                               
of Professional Counselors.                                                                                                     
                                                                                                                                
RANDY MORTON  replied that he  believes in community  service and                                                               
this interest  has led him to  become a member of  the Chamber of                                                               
Commerce and  the Rotary Club  in Nome.  He  has had a  number of                                                               
careers throughout his life and has  been involved in a number of                                                               
organizations; this speaks  to his ability to learn  and adapt to                                                               
new positions.                                                                                                                  
                                                                                                                                
CHAIR DYSON thanked him for his willingness to serve.                                                                           
                                                                                                                                
2:59:09 PM                                                                                                                    
CHAIR DYSON asked  Ms. Olson why she wants to  serve on the Board                                                               
of Professional Counselors.                                                                                                     
                                                                                                                                
TASHAWNA OLSON  responded that  she has been  a counselor  in the                                                               
state of  Alaska for 24  years serving  at the Homer  High School                                                               
and in private practice.  She grew  up in a funeral home with her                                                               
father who  was a remarkable  grief counselor and  counseling has                                                               
been her  passion since childhood.   She said that  counseling is                                                               
important for Alaskan  communities and she wants to  see that the                                                               
best possible services are offered in the state.                                                                                
                                                                                                                                
CHAIR DYSON thanked her for her comments today.                                                                                 
                                                                                                                                
^Alaskan Dental Hygienists Association                                                                                        
                                                                                                                                
CHAIR  DYSON asked  Ms.  Hauff  why she  wants  to  serve on  the                                                               
Alaskan Dental Hygienists Association.                                                                                          
                                                                                                                                
VICTORIA  HAUFF  replied  that  she has  been  president  of  the                                                               
association for  the past three  years and this  experience gives                                                               
her an important perspective on the practice of dental hygiene.                                                                 
                                                                                                                                
3:02:13 PM                                                                                                                    
^Alaska Board of Psychologists                                                                                                
                                                                                                                                
CHAIR DYSON then  asked Dr. Turnbow why he wants  to serve on the                                                               
Alaska Board of Psychologists.                                                                                                  
                                                                                                                                
DR.  KERRY   TURNBOW  replied  that   he  has  been   a  licensed                                                               
psychologist  since  the  inception  of the  program  and  he  is                                                               
passionate about counseling.                                                                                                    
                                                                                                                                
SENATOR  WILKEN  noted  that  he  is a  personal  friend  of  Dr.                                                               
Turnbow's  and wanted  the committee  to know  that it  could not                                                               
find a better guy for the board.                                                                                                
                                                                                                                                
3:03:25 PM                                                                                                                    
^State Physical Therapy and Occupational Therapy Board                                                                        
                                                                                                                                
CHAIR DYSON  asked Mr.  McDiarmid why  he wants  to serve  on the                                                               
State Physical and Occupational Therapy Board.                                                                                  
                                                                                                                                
JAY MCDIARMID  answered that  all of the  board members  are from                                                               
Anchorage  and   members  of   the  Fairbanks   physical  therapy                                                               
community feel that they should have a voice on it as well.                                                                     
                                                                                                                                
3:05:29 PM                                                                                                                    
CHAIR DYSON  thanked him  for his willingness  to serve  and then                                                               
asked  Mr. Kay  why he  wants to  serve on  the Alaskan  Board of                                                               
Physical Therapy.                                                                                                               
                                                                                                                                
ALEC KAY  replied that he  has been  in physical therapy  for the                                                               
past 15  years and wants to  contribute to the betterment  of the                                                               
field at the board level.                                                                                                       
                                                                                                                                
CHAIR DYSON  thanked him for  his willingness to serve  and asked                                                               
Mr. Burleson why he wanted to serve in this capacity.                                                                           
                                                                                                                                
GARY BURLESON  answered that  he really  doesn't have  an agenda,                                                               
but he was  asked to join by  other board members.   He said that                                                               
he retired from  being a physical therapist  after practicing for                                                               
35 years.                                                                                                                       
                                                                                                                                
^University of Alaska Board of Regents-Student Seat                                                                           
                                                                                                                                
CHAIR DYSON  the asked Mr. Gondeck  why he wants to  serve on the                                                               
Board of Regents of the University of Alaska system.                                                                            
                                                                                                                                
3:08:00 PM                                                                                                                    
JACOB GONDEK replied that he has  had the chance to represent UAA                                                               
as a student body president and  he wants to serve the University                                                               
system at the state level.                                                                                                      
                                                                                                                                
CHAIR DYSON thanked  the witness for his  testimony and announced                                                               
that Gregory Gursey,  nominee for the Board  of Dental Examiners,                                                               
was the only one who wasn't  able to join the committee today. He                                                               
then adjourned the meeting.                                                                                                     
                                                                                                                                

Document Name Date/Time Subjects