Legislature(1997 - 1998)
01/31/1997 09:00 AM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
January 31, 1997
9:00 a.m.
MEMBERS PRESENT
Senator Gary Wilken, Chairman
Senator Lyda Green
Senator Jerry Ward
Senator Johnny Ellis
MEMBERS ABSENT
Senator Loren Leman, Vice-Chairman
COMMITTEE CALENDAR
SENATE BILL NO. 24
"An Act relating to a requirement that a parent, guardian, or
custodian consent before certain minors receive an abortion;
establishing a judicial bypass procedure by which a minor may
petition a court for authorization to consent to an abortion
without consent of a parent, guardian, or custodian; amending the
definition of 'abortion'; and amending Rules 40 and 79, Alaska
Rules of Civil Procedure; Rules 204, 210, 212, 213, 508, and 512.5,
Alaska Rules of Appellate Procedure; and Rule 9, Alaska
Administrative Rules."
- HEARD AND HELD
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 38
"An Act relating to anatomical gifts, living wills, and do not
resuscitate orders."
- HEARD AND HELD
SENATE BILL NO. 51
"An Act giving notice of and approving the entry into, and the
issuance of certificates of participation in, a lease-purchase
agreement for a centralized public health laboratory facility."
- HEARD AND HELD
PREVIOUS SENATE COMMITTEE ACTION
SB 24 - See Senate Health, Education & Social Services Committee
minutes dated 1/29/96.
SB 38 - No previous Senate committee action.
SB 51 - No previous Senate committee action.
WITNESS REGISTER
Peter Nakamura, MD, MPH
Director
Division of Public Health
Department of Health and Social Services
P.O. Box 110610
Juneau, AK 99811-0610
POSITION STATEMENT: Answered questions.
Sid Heidersdorf
Box 658
Juneau, Alaska 99801
POSITION STATEMENT: Supported SB 24.
Betty Hall
PO Box 22933
Juneau, Alaska 99802
POSITION STATEMENT: Supported SB 24.
John Monagle
PO Box 210527
Auke Bay, Alaska 99821
POSITION STATEMENT: Supported SB 24.
Joelle Hall
11427 Aurora St.
Eagle River, AK 99577
POSITION STATEMENT: Opposed SB 24.
Sharylee Zachary
P.O. Box 1531
Petersburg, AK 99833
POSITION STATEMENT: Supported SB 24.
Marilyn George
P.O. Box 1031
Petersburg, AK 99833
POSITION STATEMENT: Opposed SB 24.
Johanna Munson
Mat-Su, Alaska
POSITION STATEMENT: Opposed SB 24.
Alice Johnstone
Sitkans for Choice
213 Shotgun Alley
Sitka, AK 99835
POSITION STATEMENT: Opposed SB 24.
Pat Yamaguchi
Mat-Su, Alaska
POSITION STATEMENT: Opposed SB 24.
Senator Kelly
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Prime Sponsor of SB 51.
Greg Hayes, Dr.PH
Chief
Laboratories
Division of Public Health, DHSS
PO Box 110613
Juneau, Alaska 99811-0613
POSITION STATEMENT: Presented a slide presentation regarding
SB 51.
Senator Taylor
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Prime Sponsor of SSSB 38.
Matt Anderson, Training Coordinator
Emergency Medical Services Section, DHSS
PO Box 110616
Juneau, Alaska 99811-0616
POSITION STATEMENT: Supported the intent of SSSB 38.
ACTION NARRATIVE
TAPE 97-3, SIDE A
Number 001
SB 24 PARENTAL CONSENT BEFORE MINOR'S ABORTION
CHAIRMAN WILKEN called the Senate Health, Education and Social
Services (HESS) Committee to order at 9:00 a.m. and announced that
testimony and deliberations on SB 24 would continue.
DR. PETER NAKAMURA , Director of the Division of Public Health,
Department of Health and Social Services (DHSS), presented
information on questions asked by committee members at the previous
hearing. With regard to the number of Native American physicians
in Alaska, it is difficult to ascertain because statistics on
physicians do not include ethnic identification. Dr. Nakamura was
personally aware of five Native American physicians who work for
Native corporations and the Public Health Service. Two are female
physicians, and of the five, two are Alaska Natives. Other Native
American physicians have practiced, and may be practicing in
Alaska, however an actual count is not available. To obtain the
number of female physicians in Alaska, he counted the number of
female physicians licensed in association registers. There are
126.
Number 097
DR. NAKAMURA provided a packet of information to committee members
regarding the nature of counseling and counselor training. The
packet included DHSS information made available to all public
health nurses and nurse practitioners, as well as statements and
directives of the American College of OBGYN and the residency
program. Regarding the psychological impact of abortion on young
women, 225 cases were identified in a literature search. The
summary of the study performed using those 225 cases is included in
the packet. The study dates back to the period when abortions were
illegal to the present, and reports trends in terms of the
psychological impact on minors who delivered children compared to
minors who had abortions. There has been a significant change in
those trends. When abortion was illegal, the psychological impact
was definitely stronger on those minors who had abortions. With
time, education, practice, and better knowledge, a total shift has
occurred so that now the stronger psychological impact is on those
minors who carry a pregnancy to term.
Number 126
SENATOR GREEN questioned the basis upon which Dr. Nakamura's last
statement was made. DR. NAKAMURA replied that the information is
based on the evaluation of the studies that have been done through
this extended period of time.
SENATOR WARD asked what dates the 225 cases covered. DR. NAKAMURA
said the cases date from the pre-war years to the present.
SENATOR WARD asked for the specific years. DR. NAKAMURA was una
to cite specific years at that moment, therefore SENATOR WARD note
he would get the information at a later time.
DR. NAKAMURA responded to the remaining questions from the previous
committee hearing. Regarding the risk of breast cancer following
an abortion, a study was published in January, 1997 in the New
England Journal of Medicine. The study was conducted in Denmark,
where registers on abortion are kept, and included 1,500,000
females. The study demonstrated there is absolutely no correlation
between the practice of abortion and breast cancer. The study
disputed the Harborview study and identified how it was defective.
In the Harborview study, a retrospective review was conducted on
women with cancer to find out if they had abortions. It was
determined women who already had cancer were more readily willing
and able to disclose they had abortions, than those who did not
have cancer. The use of that group skewed the information
measurably. In the Denmark study, names were taken from the
registry, which began in 1973, and from records kept prior to that
time. The women were contacted to find out whether they did, or
did not, have cancer. The results refuted the previous studies.
Number 176
SENATOR WARD asked whether the American Medical Association
conducted the study in Denmark. DR. NAKAMURA answered no, it was
conducted by the Danish medical association. SENATOR WARD asked
whether the study was overseen by American doctors. DR. NAKAMURA
responded it was not and explained the study was done independently
and was reviewed by the scientific community and approved for
journal publication. That process takes about one year, sometimes
longer.
SENATOR WARD questioned whether any American medical doctors
participated in the other one. DR. NAKAMURA stated he could not
identify them as authors but he could not say they did not
participate in any way. He offered to find out the nationalities
of the authors.
Number 188
Regarding the question on the risk of abortions compared to the
risk of term deliveries, DR. NAKAMURA informed committee members
that there is no study that he is aware of that demonstrates that
the risk of abortion is greater than the risk of a delivery.
SENATOR WARD remarked the National Association of Social Workers
(NASW) has made the statement that in all cases it is safer to have
an abortion than to deliver. He asked Dr. Nakamura if he agreed
with that statement. DR. NAKAMURA did not agree that to be true in
all cases. SENATOR WARD asked Dr. Nakamura if the NASW's statement
was wrong. DR. NAKAMURA replied that would depend on how that
comment was stated and what NASW's intent was, and the context in
which the statement was made.
Number 214
SENATOR WARD said that since he requested the packet of information
provided by Dr. Nakamura, he wanted to make sure it was in the
packet. He appreciated Dr. Nakamura's testimony that there are two
Native female doctors who perform abortions. DR. NAKAMURA
clarified the question was not whether those doctors perform
abortions, but what the ratio of male and female physicians is in
Alaska, and how many physicians are Native Americans. No question
was asked regarding the number of physicians who perform abortions.
DHSS does not have that information, it does not know which doctors
participate in the practice.
SENATOR WARD apologized for not making himself clear. He was aware
of several instances in the Bush where young Native girls were
quite intimidated by the whole process which resulted in an
abortion. DR. NAKAMURA noted abortions are not performed anywhere
in the rural areas. SENATOR WARD indicated he understood that,
which is why he questioned how many peer pressures - how many women
or how many Natives actually perform abortions.
SENATOR WARD said he now understands that the answer is zero. He
asked whether all doctors performing abortions in Alaska have
specific training in pre and post abortion counseling, and whether
that information is verified in the packet of materials provided by
Dr. Nakamura. DR. NAKAMURA maintained the packet does not include
signed testimony by every individual physician, because he does not
know who they are, however any standards set by any organization
that deals with this practice requires practitioners to be well
versed in pre and post abortion counseling. The packet contains an
outline of those requirements laid out by the American College of
OBGYN and the college for OB residency training.
SENATOR WARD asked whether a specific training course is required
prior to practice. DR. NAKAMURA indicated the training actually
begins well before physicians specialize. All physicians are
trained in counseling; maybe not specifically in depth in an issue
like abortion counseling, but counseling itself is a rather
technical procedure that starts with an assessment process that
occurs.
Number 245
SENATOR WARD asserted he was talking specifically about abortion
counseling because he knows of young women who did not receive it
in Alaska. He is trying to determine, if in fact, the people who
are performing abortions are legally required to have specific
training for abortion counseling. DR. NAKAMURA answered they are
not required by law.
Number 256
SENATOR GREEN acknowledged she was very troubled by Dr. Nakamura's
previous testimony and even more troubled after she read the script
of his testimony. She asked whether he is the Director of the
Division of Public Health. DR. NAKAMURA responded affirmatively.
She asked whether he really believed the testimony he provided to
the committee, and then read the following paragraph from his
testimony:
Basic principles of law in society hold that parents should be
involved in, and responsible for, assuring appropriate medical
care for their children. Parents ordinarily act in the best
interests of their children, and minors benefit from the
advice and emotional support of their parents.
DR. NAKAMURA clarified he said, "minors generally benefit" because
it is not 100 percent.
SENATOR GREEN asserted he must have some very compelling reasons to
justify ignoring the basic laws and principles mentioned. DR.
NAKAMURA said "yes." SENATOR GREEN asked if she could infer from
his testimony that he believes it is okay for a 16, 15, 14, 13, 12,
or 11-year-old girl to have an abortion performed on her body
without the knowledge or consent of her parents. DR. NAKAMURA
responded that each case is an individual case. To answer Senator
Leman's question - in what kind of a situation would he recommend
this procedure if a minor refuses to involve her parents - he
contacted physicians to request real life scenarios. Dr. Nakamura
was told of a young lady who is now hospitalized in an intensive
care unit and will be there for about one year, who has feeding and
draining tubes, and is on a respirator, because she was unable to
obtain an abortion through the legal procedures, and as a result
had an illegal septic abortion. In other situations, minors have
carried fetuses without a brain or spinal chord and were therefore
not viable. In counseling these individuals indicated, in no
uncertain terms, they would seek illegal abortions or find some
other way to induce the loss of the fetus, significantly increasing
complications. There are situations where a parent or custodian
has already demonstrated he/she is abusive. One-third of all
minors who do not seek parental consent are already in abusive or
coercive situations. Over 4,000,000 undergo domestic violence
every year and 50 to 55 percent of the children in these families
have also been abused. There are situations where it is unsafe for
a physician to allow a minor to leave the office.
Number 312
SENATOR GREEN did not think this bill would encourage that type of
situation. She referred to the following statistics provided by
DHSS: 61 percent of unmarried minors inform one or both parents;
20 percent do not inform their parents but involve at least one
responsible adult such as clergy, another relative, teacher,
counselor or professional other than the principle physician. One-
third of minors who do not inform their parents have already
experienced family violence and fear it will recur. She asked
whether the one-third of minors who do not inform their parents
because of the fear of violence would comprise about 14 percent of
the total 40 percent who do not inform their parents. That would
mean about 86 percent do not experience violence in the home. Dr.
Nakamura explained he would like to go back to the articles those
numbers were taken from to verify the numbers.
SENATOR GREEN stated the inference in the testimony was that one-
third of minors are exposed to violence, yet the numbers breakdown
to 14 percent. Although 14 percent is unfortunate, actions taken
for the general population should not be based on the needs of that
limited percent of the population. DR. NAKAMURA noted the 86
percent do not need legislation, it is the 14 percent that do not
have a functional relationship with their parents and will now have
additional court requirements and abusiveness. That is the group
DHSS is concerned about.
SENATOR GREEN felt SB 24 would address the next step, a judicial
bypass, for the 14 percent. DR. NAKAMURA commented it would force
a relationship which could then become even more abusive or
detrimental. Dr. Nakamura remarked that the court system is an
intimidating process for youngsters, and is a process they are not
aware of. SENATOR GREEN doubted it would be more intimidating than
subjecting oneself to an abortion without a parent or guardian for
guidance.
Number 350
SENATOR GREEN indicated she would be submitting more questions to
Dr. Nakamura in writing and noted although she has a natural
respect for physicians, she was incredibly disappointed in the
testimony presented by Dr. Nakamura in opposition to SB 24 and in
his representation for DHSS.
SENATOR WARD asked Dr. Nakamura to supply to the committee the
number of doctors he surveyed to obtain first hand situations in
which parental consent would not be justified. DR. NAKAMURA said
he spoke to three doctors. SENATOR WARD asked how he decided which
doctors to call. DR. NAKAMURA replied he learned through
colleagues, and others, these particular doctors had a familiarity
with these kinds of problems.
Number 373
SID HEIDERSDORF supported SB 24. As the father of three girls, he
was disturbed to hear people object to a requirement ensuring that
abortion facilities and school counselors would respect his rights
and responsibilities as a parent. SB 24 makes good policy because
it supports the concept of the family and recognizes that parents
are responsible for their children. Minor children are not mature
enough to make a decision regarding serious medical matters without
parental advice, especially when the decision to have an abortion
involves a life or death decision that carries ramifications in
later years. Who, better than the parents, has the best interests
of their children at heart. In those extreme cases where that is
not true, a judicial bypass takes care of that problem.
Legislation based on extreme cases is not good law. He asked the
committee to support a principle in state law that finds parents to
be the best people to provide love and care for their children,
regardless of what kinds of statistics are presented. That policy
protects the child. The fact remains that a minor child who finds
herself pregnant may face incredible pressures from a boyfriend and
from abortion counselors at schools. They need other individuals,
hopefully the parents, to be involved in the decision. There are
plenty of individuals who have come forward and believe they were
pressured to have an abortion when they did not want one. He
disagreed with prior testimony which categorized pregnant teens
into two groups: those who go to their parents no matter what, and
those who do not. He believes there is a third group in the
middle. SB 24 is for the middle group. Regarding the dire
predictions made if SB 24 passes, similar legislation is in effect
in many other states with no detrimental effects. He added there
is a lot more to the story about the woman who will be hospitalized
for a year, referred to by Dr. Nakamura, that was revealed. The
negative psychological impacts of abortion are well known by post
abortion counselors.
Number 446
JOHN MONAGLE , President of Alaskans for Life, testified in favor of
SB 24. He was disappointed that the Administration sends
representatives to speak of gloom and doom while purporting to be
supporters of family, fairness, and justice. Twenty seven states
have successfully passed similar legislation.
BETTY HALL , representing Black Americans for Life, testified in
support of SB 24. As a retired nurse, she finds the lack of the
use of a pre-operative checklist by abortionists, to ascertain pre-
existing medical conditions, to be most disturbing. She described
a case in which a 14-year-old girl had an abortion during which
complications occurred, at which point the girl's mother was called
to sign a consent form for follow-up treatment. The medical costs
amounted to over $30,000. She questioned a policy in which consent
is required for follow-up treatment, but not for the abortion.
SENATOR WARD shared Ms. Hall's concerns about the lack of any form
of counseling guidelines for physicians who perform abortions. He
was unsure whether the cases he referred to earlier were unusual,
but those women were not fully aware of what happened to them.
From their stories, it did not appear they were given any options
or counseling.
MS. HALL could not speak to counseling since she never attended any
abortions, however she believed most girls are told the procedure
involves removing a blob of tissue, not a baby, and some of the
girls are so young they do not know what they are getting involved
in.
Number 498
JOELLE HALL testified in opposition to SB 24. She disagreed with
Senator Green's conclusion that 14 percent of cases in which the
girl does not go to her parents or clergy is too small of a
percentage to direct legislation, because that group is the most
likely to pursue illegal abortions rather than go a through
judicial bypass. It is unacceptable to deny girls their
constitutional right and possibly die as a result. Fourteen
percent is enough to warrant the protection of the law. SB 24
confuses parental desires with parental rights.
SHARYLEE ZACHARY indicated that she was leaning toward supporting
SB 24 because it is important to teach children that for every
action there is a consequence. Family members stand together to
work through the happenings and consequences, learn from them, and
encourage each other to make wiser decisions the next time and to
be responsible. It is important to teach children the great value
and sanctity of life and the value of abstinence until marriage.
One reason for the introduction of SB 24 is that many people do not
live their lives in such a manner and do not teach these truths to
their children. There are many single parent families where there
was never a marriage or commitment. There are a multitude of
fatherless families living in poverty, and children are joining
gangs to find security and a family feeling. Few people are
accepting the consequences of their actions. This bill drives a
wedge into the parent-child relationship. Parents would not be
given a chance to help their child. She questioned whether SB 24
allows people outside of the family to fill their children with the
types of lies that will cause them not to live up to their
responsibilities. She supported any legislation that does not
contribute to the breakdown of families.
Number 581
MARILYN GEORGE testified in opposition to SB 24. When working on
a crisis line in Idaho, she became aware of how scared teenagers
are of telling their parents about a pregnancy.
TAPE 97-3, SIDE B
Number 587
JOHANNA MUNSON testified in opposition to SB 24. Restrictive
bills, such as SB 24, endanger teens' health by inhibiting them
from seeking safe medical care early in pregnancy. The Legislature
is not in the position to make personal choices for individual
teenage women. If the Legislature looked at the facts and was
aware of what is really going on with teenage women who get
pregnant, it would kill the bill. Statistics reveal that 50
percent of teenagers in the Mat-Su Valley who get pregnant live in
homes where they are psychologically or sexually abused. These
young teenagers cannot be forced into a position that requires them
to consult with their parents. If 60 percent of teenagers do
consult with their parents, as statistics indicate, SB 24 will not
change that circumstance at all, and the Legislature should be
concerned about the other 40 percent. SB 24 might be the worst
thing that could be done for the 40 percent.
SENATOR WARD commented that he had looked into the teenage
pregnancy situation in his communities and his observations differ
from Ms. Munson's. He asked her to forward her statistics to the
committee.
ALICE JOHNSTONE spoke on behalf of herself and for Sitkans for
Choice, which represents the majority of women in Sitka who are
pro-choice. The real purpose of SB 24 is to prevent abortions. SB
24 will not prevent teen pregnancy or reduce the number of children
raising children. In Minnesota, the birth rate among mothers, age
15-17 increased 38.4 percent after enforcement of a parental
notification law. Statistics compiled by the federal Center for
Disease Control and other sources indicate the risk of death from
pregnancy, is, on average, 24 times higher than from the risk of
death from abortion at up to 12 weeks of pregnancy. Teenagers are
much more likely to suffer medical complications attributable to
childbirth, than adults. This bill will create more teenage
mothers. There is no bill that will force unwed fathers to not
only support, but also participate in rearing their children. The
young mother gives up nine months of her life to incubate an unborn
infant, then faces the wrenching decision to give it up for
adoption or, if she chooses to keep the child, a life of poverty,
while the young man responsible gets off scott free. She
questioned why SB 24 does not have a fiscal note appropriating
funds to support these young mothers and their infants. If
Minnesota is an example, Alaska will have a third more unwed
mothers who will be applying for welfare. Even better would be an
amendment to SB 24 authorizing confidential reproductive health and
counseling services which could dispense candid information about
sexuality, reproduction, contraception, and the importance of
family support and communication. Such programs would help to
reduce teen pregnancy and also strengthen family bonds. She urged
committee members to pass SB 24 out of committee with "do not pass"
recommendations or take action to supply the kind of counseling
services mentioned in order to prevent unwanted teenage
pregnancies.
Number 518
PAT YAMAGUCHI testified in opposition to SB 24 because not all
parents communicate with their children, and some teens get
pregnant because they lack a social system that supports the
parent-child bond. As a pharmacist she has worked in many
situations where she has counseled, by the request of the physician
and teenager, about choices. Many teenagers do seek counseling
from various medical professionals, as well as their church groups,
friends, and parents. SB 24 should not be passed until other
support systems have been strengthened.
CHAIR WILKEN thanked everyone for participating, and announced
testimony on SB 24 was closed. He intends to vote on SB 24 as the
first order of business on Monday morning. He asked committee
members if they preferred to discuss the bill at that time.
SENATOR WARD relayed that Ms. Betty Hall asked him to inform
committee members that there was an abused young lady who had an
abortion and was then sent back to the abusive situation.
CHAIR WILKEN announced SB 24 would be taken up as the first order
of business on Monday.
SB 51 APPROVE CENTRALIZED PUBLIC HEALTH LAB
CHAIRMAN WILKEN announced that SB 51 would be the next order of
business. The committee recessed at 9:58 a.m., awaiting the
arrival of Senator Kelly. The committee was called to order at
9:59 a.m.
Number 482
SENATOR KELLY , Prime Sponsor of SB 51, informed the committee that
last year this bill passed the House, came to the Senate. There
was a great deal of support in the Senate, but the bill was unable
to get to third reading on the final day of session and therefore,
the bill died. Senator Kelly believed that in the zeal to close
the fiscal gap, capital facilities throughout Alaska are being
overlooked. In spite of the fiscal gap, Alaska will have to work
something out within the long-range strategy in order to invest
more money in capital projects. Senator Kelly said that SB 51 is
a good first step and indicated that he is working on another plan.
CHAIRMAN WILKEN noted that Forrest Browne from the Department of
Revenue was present in order to answer questions as well as Tom
Lane from the Division of Administration in DHSS.
Number 453
DR. GREG HAYES , Chief of the Section of Public Health Laboratories
in DHSS, informed the committee that he had been in Alaska for
three years. Prior to that, Dr. Hayes was the Director of the
Public Health Laboratories for Indiana. Dr. Hayes discussed his
education in this field. The new consolidated Public Health
Laboratory facility addressed in SB 51 would be located in
Anchorage. The new facility would include the functions of the
Anchorage and Juneau Public Health Laboratories and the Medical
Examiner's Laboratory. Design and construction costs would be paid
through debt financing through the sale of certificates of
participation for a lease purchase of the facility.
The services of the State Public Health Laboratory are directed
towards prevention and control of disease in the community which
differs from clinical laboratories focusing on individual care.
The Public Health Laboratory focuses on communicable disease
testing and work in partnership with the Centers for Disease
Control and private laboratories in Alaska. The Public Health
Laboratory fulfills an assessment, policy development and assurance
role. Advanced testing for infectious agents not routinely
performed in the private sector are performed by the Public Health
Laboratory. Data is constantly being gathered for targeted disease
control efforts. In the event of an epidemic, the Public Health
Laboratory is able to apply state of the art technology for rapid
testing of large numbers of specimens. Furthermore, the Public
Health Laboratory specializes in disease surveillance and the
recognition of new and reemerging diseases.
Number 425
Dr. Hayes reviewed some examples of how the Public Health
Laboratory has benefited Alaskans. The State Laboratory provides
essential services for disease surveillance, control, and
prevention as well as recognition of new and emerging diseases.
Alaska's Public Health Laboratory is an essential component of the
state and national public health system. Moreover, the State
Public Health Laboratory's mission is to provide scientific and
technical information for disease prevention and is Alaska's first
line of defense for recognizing and controlling the spread of
communicable diseases. Dr. Hayes reviewed the core functions of
the Public Health Laboratory which are very different from the role
of a private clinical laboratory.
Dr. Hayes pointed out that even the most ardent supporters of
governmental privatization are reluctant to argue for privatizing
the public health function. All 50 states and U.S. territories
have public health laboratories of which none are privatized. Dr.
Hayes discussed the criteria commonly used by state governments in
order to determine whether privatization is appropriate or not.
None of the criteria fit the Public Health Laboratory. He noted
that if testing were privatized, multiple contracts would be
necessary since no one private laboratory performs all types of
testing currently performed at the State Public Health Laboratory.
Furthermore, for many tests there are no private laboratories that
perform the test. The few tests that a private laboratory could
perform would merely be added to its current work load being sent
out of state.
Number 347
Dr. Hayes explained why a new facility is necessary. Two of the
facilities are in disrepair with mechanical and structural
inadequacies for conducting laboratory testing. The laboratories
are in leased space with poor facility layouts and space
limitations for future growth. The Juneau and Anchorage facilities
have major health and safety concerns such as inadequate
ventilation systems for working with infectious organisms. The
Juneau and Anchorage facilities also have inadequate wiring. Dr.
Hayes discussed specific examples of these problems. Further, the
State Medical Examiner needs to find a permanent home. Currently,
the Medical Examiner resides in the Department of Public Safety's
Crime Detection Laboratory. The Crime Laboratory needs this space
in order to develop a much needed DNA analysis laboratory.
Dr. Hayes stated that construction of a new facility would save the
state money. An unrecoverable investment would be necessary to
repair the current facilities, and consultants say that the
facilities could not be brought up to code. A new facility would
maintain an essential public health service more cheaply and more
efficiently. The duplication of activities at multiple locations
would not be necessary. Dr. Hayes stated that a new facility would
solve the following problems: the fragmentation of services,
leased and temporary space, current facilities ill design for
current operations, a significant capital investment to fix current
facilities although the facilities would not meet code, and the
state does not need nor can it afford four separate facilities.
Dr. Hayes noted that there have been 14 separate studies since 1985
regarding how to correct problems and position the state
laboratories for the future. The conclusion of these studies
strongly support the construction of a new facility. In the first
year of occupancy, a new facility would save the state $293,000 and
would save DHSS approximately $218,000 in personnel and lease
costs. Further, the Department of Administration would save
$75,000 in lease costs. The cost of the new facility is estimated
to be $18,440,000 with annual payments of $2,420,000 for 10 years
with a total estimated debt of $24,130,000. The costs from last
year's proposal have been adjusted for inflation and the
assumptions of the coroner's responsibilities by the Medical
Examiner's Program.
With regard to the Medical Examiner, it is imperative that the
Medical Examiner Laboratory be near Public Safety's Crime Detection
Laboratory due to their close interaction and cooperation. Dr.
Hayes presented a map depicting the most desirable sites for this
project. In conclusion, Dr. Hayes requested the committee's
support of this projects.
Number 273
SENATOR ELLIS asked if the new facility would be able to
accommodate the functions of the Fairbanks laboratory at some point
in the future. DR. HAYES said that would be a new project. Funds
were cut from last year's bill for a centralized laboratory, so
Fairbanks was not included in the project.
SENATOR ELLIS asked if Alaska's public health mission made more
sense if the Fairbanks laboratory were consolidated with the
facility in Anchorage. Is that the most ideal situation? DR.
HAYES said that would be a matter of opinion. From his perspective
in last year's bill, a centralized option was in the best interest
of the state. However, that has changed through the political
process.
SENATOR ELLIS inquired as to if this project would include the
possibility of an addition for future needs. DR. HAYES explained
that when the meeting with the architects occurs, there is a
certain footage included for the growth in any new building. If
additional space for the future can be had, it will be planned in
the building. In response to Senator Ellis, Dr. Hayes believed
that there is a yearly lease arrangement for the Fairbanks
laboratory. TOM LANE interjected that the lease is from the
University and there is no concern for the future. DR. HAYES noted
that the Juneau Laboratory is on a monthly lease.
DR. MICHAEL PROPST , the State Medical Examiner, said that he was
present to answer questions.
Number 231
MARILYN GEORGE said that Dr. Hayes did not seem to take into
consideration the weather in Alaska. The ability to send the tests
to Juneau is important. Often, the planes do not get in. The
Juneau Laboratory does the microbiology, and often time is of the
essence with the results. Ms. George believed that the Juneau
Laboratory should not be closed. She also mentioned the job
displacement created by the closure of the Juneau Laboratory.
CHAIRMAN WILKEN asked if anyone else wanted to testify. Hearing
none, he announced that a vote on SB 51 would taken on Monday.
SENATOR GREEN pointed out that SB 51 does not include a location.
She agreed to talk with Senator Kelly regarding this issue.
SENATOR KELLY reiterated the importance to place the facility
adjacent to the Crime Laboratory as explained by Dr. Hayes.
SENATOR GREEN thought this would be a great facility to be located
in the Mat-Su.
Number 164
SB 38 ANATOMICAL GIFTS,LIVING WILLS & DNR ORDER
CHAIRMAN WILKEN introduced SSSB 38 as the final order of business
before the committee.
SENATOR TAYLOR , Prime Sponsor of SSSB 38, said that SSSB 38 would
modify existing statutes regarding living wills and organ donors.
He explained that those provisions are found in different sections
and titles which creates some confusion. Often hospitals and EMTs
do not know if a living will exists or if a person is an organ
donor. Senator Taylor informed the committee that he had been to
a dinner at Providence Hospital in which statistics were revealed
indicating that living wills are being disregarded by care giving
institutions. Much of the reason for that can be attributed to the
ineffective manner in which this information is communicated.
Therefore, SSSB 38 would at least address those with driver's
licenses. The drivers' license would have a notice communicating
whether the person has a living will or is an organ donor or not.
Senator Taylor discussed statistics regarding the number of organ
donor recipients and those still waiting. Anything facilitating
this process is necessary.
Senator Taylor indicated that by adding this information to the
drivers' license, there could be a central depository at some
point. That notion is being reviewed as a possible amendment to
the legislation. He discussed how a policeman can, in minutes,
access much information about a person from their license plate
number. Senator Taylor expressed excitement with the possibility
that this same sort of system could be utilized by an EMT or
hospital simply by using the driver's license in order to obtain
information regarding a living will or organ donation.
TAPE 97-4, SIDE A
Number 007
SENATOR TAYLOR concluded by pointing out that if the statistics
from Providence Hospital are to be believed, there are many people
administering medical care in good faith to those who have
specifications stating otherwise.
SENATOR GREEN pointed out that SSSB 38 is before the committee, not
SB 38.
SENATOR ELLIS asked Senator Taylor if he contemplated that there
would be a sticker indicating a living will on the license and if
no sticker was present, then normal medical care would be given.
SENATOR TAYLOR expressed concern with the sticker falling off.
Senator Taylor would like to place this information on the back of
the license before the license is laminated. Perhaps, the entire
living will could be placed on the license so that when the license
was swiped the information would be available. Before that can be
achieved, the care providers should at least be able to see an
indicator on a license which would prompt a call to a local
dispatcher who can access the information.
SENATOR ELLIS asked if there was any change in the nature of the
living will. SENATOR TAYLOR replied, no, and explained that now
the living will and organ donor application would be on the same
form.
CHAIRMAN WILKEN noted that he had just renewed his license and has
a sticker which he did not believe would come off.
SENATOR TAYLOR emphasized that this procedure will take a number of
years before it becomes effective on licenses due to the fact that
licenses are good for five years.
SENATOR ELLIS asked if the bill required the DMV to talk to people
or have information in the mail-in for license renewals. SENATOR
TAYLOR believed that the DMV would ask a person if they have a
living will just as the DMV already asks if a person is interested
in being an organ donor.
CHAIRMAN WILKEN invited Mr. Anderson to give his testimony.
Chairman Wilken also informed the committee that SSSB 38 would be
voted on Monday.
Number 121
MATT ANDERSON , Emergency Medical Services Training Coordinator for
the Section of Community Health & Emergency Medical Services,
informed the committee that he was involved in Alaska's Do Not
Resuscitate protocols. As a result, he was in frequent contact
with EMS agencies, fire departments, and hospice organizations.
Therefore, SSSB 38 became of interest to Mr. Anderson. Mr.
Anderson identified the following two goals as the most important:
the visibility of the program and the ease with which on-scene
responders can identify those persons who have executed these
provisions. Mr. Anderson noted that DHSS would have to develop
symptoms and designs for cards and jewelry indicating a persons
participation in these procedures. No national insignias have been
identified.
Mr. Anderson pointed out that with the development of these
standardized designs, the public will expect there to be a system
in place to deal with the procedures. Currently, the bill does not
address this aspect nor does DHSS' fiscal note. Providing very
clear guidelines to the 4,000 licensed and certified emergency
responders is of major importance. Mr. Anderson informed the
committee that there is a Do Not Resuscitate (DNR) program in place
with a standardized insignia and requested that program be left in
place and only enhanced by this legislation. Perhaps, this would
be an appropriate time to add language requiring the State Medical
Examiner's permission prior to the decedent's tissue and organs
being released for donation. In conclusion, DHSS is in support of
the intent of SSSB 38.
Number 174
JUANITA HENSLEY , Chief of Drivers Services for the Division of
Motor Vehicles, explained that when a person is at the DMV counter
to apply or renew a drivers' license the counter person is
instructed by law to ask the individual if he/she would like to be
an organ donor. If the individual wants to be an organ donor, a
card is signed by the individual and witnessed by the counter
person and subsequently laminated. The individual receives the
laminated card with his/her license and a sticker indicating the
individual is an organ donor is placed on the drivers' license.
Ms. Hensley informed the committee that the organ donor notation is
not placed inside the laminate of the drivers' license because the
DMV believes that a person can revoke the organ donor choice at any
time during the license period. The living will identification
could be added to the card with the organ donor information. Ms.
Hensley stated that this information cannot be placed on the back
of the license because there is not enough room. Further, the
separate card allows the individual to retain the ability to revoke
a living will, a do not resuscitate order, and an organ donor
notification.
With regards to the indicator on the system so that a dispatcher
would have access to this information, that could be programmed
into the system. Ms. Hensley pointed out that if this information
is programmed into the system, then the individual would have to
contact DMV in order to revoke one or all of these specifications.
The DMV wants to keep people out of the office, therefore Ms.
Hensley said that she would want to discuss that with the sponsor
in order to determine how to make the process viable.
Number 224
SENATOR ELLIS asked if a sticker on the license would still be
used. JUANITA HENSLEY explained that the sticker would still be
used indicating an organ donor and now there would be a sticker
indicating the presence of a living will. Ms. Hensley reiterated
that there would be nothing added to the back of the license. The
individual would receive a separate laminated card specifying an
organ donor, a living will and/or a do not resuscitate order. The
individual could revoke these specifications at any time by
destroying the card and the sticker, there is no need to contact
the DMV because there is no record of the specifications.
SENATOR ELLIS believed that the bill, as the sponsor statements
indicated, goes further than the second laminated card and the
stickers. SENATOR TAYLOR interjected that his previous comments
spoke to his hope for the future. In response to Senator Ellis,
JUANITA HENSLEY said that there would be no additional record
keeping required on the part of DMV under this legislation. If the
desire is to have these specifications in a database, that would
require program changes and funding for those changes.
SENATOR TAYLOR inquired as to what happens to the separate laminate
card. JUANITA HENSLEY reiterated that the separate laminated card
is given to the individual to carry with their drivers' license.
There is no information on who is an organ donor at the DMV.
SENATOR ELLIS did not recall being informed of his ability to
revoke his designations; he thought that the DMV kept a record.
SENATOR TAYLOR clarified that this legislation would merely add
another sticker on the front of the license with the separate
laminated card.
CHAIRMAN WILKEN informed everyone that votes on SB 24, SB 51, and
SSSB38 would be taken at Monday's meeting. There being no further
business before the committee, the meeting was adjourned at 10:55
a.m.
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