Legislature(1997 - 1998)
03/05/1997 09:06 AM Senate HES
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SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE
March 5, 1997
9:06 a.m.
MEMBERS PRESENT
Senator Gary Wilken, Chairman
Senator Lyda Green
Senator Jerry Ward
MEMBERS ABSENT
Senator Loren Leman, Vice Chairman
Senator Johnny Ellis
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 45(HES)
"An Act relating to runaway and missing minors; and providing for
an effective date."
- MOVED HB 45 OUT OF COMMITTEE
SENATE BILL NO. 99
"An Act relating to health care data and registration of births."
- MOVED SB 99 OUT OF COMMITTEE
SENATE BILL NO. 100
"An Act relating to grant authority for services for
developmentally delayed or disabled children and their families."
- MOVED SB 100 OUT OF COMMITTEE
PREVIOUS SENATE COMMITTEE ACTION
HB 45 - No previous Senate action to record.
SB 99 - No previous Senate action to record.
SB 100 - No previous Senate action to record.
WITNESS REGISTER
Representative Kelly
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Prime Sponsor of HB 45.
Monica Owen
980 Snowhill Avenue #1
Wasilla, Alaska 99654
POSITION STATEMENT: Disagreed portions of HB 45.
Venessa Grenung
980 Snowhill Avenue #1
Wasilla, Alaska 99654
POSITION STATEMENT: Agreed with Ms. Owen's testimony
Angela Salerno, Executive Director
Alaska Chapter of the National Association of Social Workers
525 Main Street
Juneau, Alaska 99801
POSITION STATEMENT: Discussed a flaw in HB 45.
Al Zangri, Chief
Vital Statistics
Division of Public Health
Department of Health & Social Services
PO Box 110675
Juneau, Alaska 99811-0675
POSITION STATEMENT: Reviewed SB 99.
Dr. John Middaugh, Chief
Epidemiology Section
Division of Public Health
Department of Health & Social Services
PO Box 240249
Anchorage, Alaska 99524-0249
POSITION STATEMENT: Answered questions.
Mary Diven
Department of Health & Social Services
PO Box 110612
Juneau, Alaska 99811
POSITION STATEMENT: Reviewed SB 100.
Elmer Lindstrom, Special Assistant
Office of the Commissioner
Department of Health & Social Services
PO Box 110601
Juneau, Alaska 99811-0601
POSITION STATEMENT: Discussed SB 100.
Gigi Pilcher, Parent
Ketchikan, Alaska
POSITION STATEMENT: Urged passage of SB 100.
ACTION NARRATIVE
TAPE 97-21, SIDE A
HB 45 RUNAWAY AND MISSING MINORS
Number 001
CHAIRMAN WILKEN called the Senate Health, Education & Social
Services Committee (HES) to order at 9:06 a.m. and announced that
the meeting scheduled for Friday would be cancelled. Chairman
Wilken introduced HB 45 as the first order of business.
REPRESENTATIVE KELLY , Prime Sponsor, informed the committee that
last year there were a number of bills dealing with juvenile
issues, among those bills was SB 289 which became effective this
past September. SB 289 sought to bring runaways into a protective
environment by designating the child as a child in need of aid. SB
289 established a scenario in which a police officer could take
custody of a child, bring the child to the parents, and if the
parents agreed, the child would be accepted back into the home or
placed in a shelter. The police officer could also decide whether
there was an abusive situation in which case the child would be
taken to a shelter. Representative Kelly explained that HB 45 is
before the committee because last year HB 387, a rewrite of the
juvenile code, separated in statute what constituted a child in
need of aid or a delinquent child. HB 387 took statutes from
Chapter 10 and created Chapter 12 in order to deal with delinquent
children in one manner and abused children in another. When those
statutes were moved a key portion of SB 289 was lost.
Representative Kelly said that it was not intended for the statutes
to read that a runaway minor must first consent to return home.
The main thrust of SB 289 was to place a minor in a safe
environment where monitoring could occur while the court or
department determined what to do.
Number 125
MONICA OWEN , testifying from Mat-Su, did not agree with the portion
of the bill that would allow police to place minors in a shelter or
back in the home. Shelters can be just as bad as the home. Ms.
Owen mentioned that mental abuse as well as physical abuse can
occur.
VENESSA GRENUNG , testifying from Mat-Su, agreed with Ms. Owen's
testimony. She mentioned that perhaps a mutual agreement to place
the minor in a friend's house could occur.
ANGELA SALERNO , Executive Director for the National Association of
Social Workers, said that HB 45 has a flaw regarding the language
pertaining to the officer's decision whether or not to bring a
minor home. Ms. Salerno believed that in this case caution should
be taken. Police officer's are not qualified to assess the
presence of physical or sexual abuse. HB 45 could be improved by
changing the language to "cause to suspect physical or sexual
abuse." National research reports that 60-75 percent of runaways
report serious physical abuse, furthermore sexual abuse is higher
among young women. The 1988 Governor's Interim Commission on
Children and Youth in Alaska reported that at least two-thirds of
runaway youth say they have been abused at home. Each year in
Alaska, there are 3,575 cases of abuse which have been verified.
Ms. Salerno believed that the state could be opened up to some
liabilities with the current language; liability, if a minor is
returned to the home and suffers a serious injury or worse from the
parents. Ms. Salerno was concerned with dysfunctional families.
Number 201
REPRESENTATIVE KELLY said that police officers are recognized in
statute as persons with a level of authority and experience in
determining child abuse. Police officers are trained and must
report such abuse.
ANGELA SALERNO agree with Representative Kelly's comment regarding
the physical manifestations of abuse, however sexual abuse is
another matter. Ms. Salerno clarified that her testimony referred
to sexual abuse.
CHAIRMAN WILKEN asked Ms. Salerno if her suggestion was to change
the word "believe" to "suspect" on page 1, line 14. He asked Ms.
Salerno if she wanted the officer to take the child for an advanced
interview to determine whether a problem exists at home. ANGELA
SALERNO replied yes. If the police officer suspected child abuse,
the officer would be compelled to report that abuse to DFYS and
take the child to a safe environment.
In response to Chairman Wilken, REPRESENTATIVE KELLY specified that
he had referred to Title 47 Chapter 17.020.
SENATOR GREEN moved to report HB 45 out of committee with
individual recommendations and accompanying fiscal notes. Without
objection, it was so ordered.
SB 99 HEALTH CARE DATA; BIRTH REGISTRATIONS
Number 252
CHAIRMAN WILKEN introduced SB 99 as the next order of business
before the committee.
AL ZANGRI , Chief of the Bureau of Vital Statistics for DHSS,
explained that Sections 1 and 2 of SB 99 establish civil immunity
for institutions and providers who report diseases and conditions
to the department as required under other portions of the statute.
Without SB 99, the department could lose $300,000 to $400,000 per
year in cancer grants. Sections 3 and 4 clarify the language in
the Vital Statistics Act regarding the reporting requirements for
births and institutions as well as shortening the time period from
seven to five days. There is also a language change in determining
how reports are made for moving conveyances. Mr. Zangri noted the
most important change as being the elimination of a signature for
every birth certificate produced in a hospital. This would allow
the bureau to operate its electronic birth certificate system. All
but two hospitals in the state have electronic birth certificate
systems. Currently, each hospital must send a paper copy of the
birth certificate with a hand signature. SB 99 would allow
electronic signatures or group signatures for all the births during
a week.
In response to Senator Green, AL ZANGRI clarified that SB 99 does
not release information. SB 99 grants civil immunity to facilities
already required to report that information. Current law requires
that providers report this information to the department, however
if the information has not been properly used then the individual
can be sued. SB 99 grants civil immunity for providing that
information unless the case is pure negligence. Mr. Zangri pointed
out that this immunity is required under federal statutes if the
cancer grant is to continue.
Number 318
DR. JOHN MIDDAUGH , Chief of the Epidemiology Section in DHSS,
explained that the immunity protection is only for those reporting
in compliance with state law. The data is being reported to the
Division of Public Health. The data is not disclosable under
Alaska's public records law and can only be released if there is an
eminent and direct public health threat to another person. Dr.
Middaugh noted that the data is provided with identifiers only so
that duplicate reporting can be eliminated. Dr. Middaugh
reiterated that the data is protected by the Alaska statutes
regarding confidentiality.
SENATOR GREEN expressed concern with the sectional analysis of
Section 1 which says that, "This immunity protects the person
reporting the information regardless of how the Department uses the
information." Senator Green did not know if that accurately
reflected the intent of the bill. Senator Green wanted to be sure
that a medical provider would not be required to provide
information that would not ordinarily be provided.
DR. JOHN MIDDAUGH said that the bill only provides protection for
the information required to be reported under Alaska statutes and
regulations.
CHAIRMAN WILKEN pointed out that he had a list of the diseases
required to be reported on a daily basis.
SENATOR WARD asked if this was necessary to receive the first of
five increments of $420,000; is this a new program? DR. JOHN
MIDDAUGH clarified that the grant was awarded in October of 1994.
During the first year, regulations were revised in order to be in
compliance with establishing the cancer registry component of the
reporting requirements. The regulations went into effect in
January of 1996. The first year of collection of this information
on cancer statewide has been completed. The other disease reports
for infectious disease in some cases go back to territorial days.
The funds received to establish the cancer registry are part of the
federal legislative program, the Cancer Registries Amendment Act,
which establishes uniform cancer registries in all 50 states. Dr.
Middaugh noted that work to establish a cancer registry in Alaska
had been going on for 20 years; these funds allowed such a
registry. In order to maintain compliance of the requirements of
the federal law, these three provisions require statutory changes
and cannot be dealt with in regulation. Dr. Middaugh informed the
committee that SB 99 has been endorsed by the Alaska Hospital &
Nursing Home Association, the Alaska State Medical Association, and
the Alaska Division of the American Cancer Society.
Number 375
SENATOR WARD asked if the program comes out of the $420,000 or is
this an additional program. Are there matching funds? DR. JOHN
MIDDAUGH said that there are no matching funds involved. This is
an ongoing grant which is now in the third year of a five year
project. Without these additional statutory changes, there may be
a risk in losing the award. Dr. Middaugh noted that this really
protects the data, the patients, and the providers. In response to
Senator Ward, Dr. Middaugh replied that there has not been any
implication that the money would be withdrawn without the
implementation. However as part of the federal law and the grant
award, the department has to certify that efforts attempting to
comply with the federal legislation have been made.
SENATOR WARD inquired as to what portion of the funds goes towards
the cancer reporting. DR. JOHN MIDDAUGH specified that all of the
funds are used for cancer reporting. All other diseases are
required to be reported to the Division of Public Health for public
health protection. Dr. Middaugh noted that the other diseases were
included due to the rationale for uniformity and protection for
patients, physicians, and the state. In response to Senator Ward,
Dr. John Middaugh agreed that the inclusion of the other diseases
was not necessary to receive the funds.
DR. MIDDAUGH reiterated the strong support for SB 99 from the
medical community.
CHAIRMAN WILKEN said that he would entertain a motion to report SB
99 to its next committee of referral.
SENATOR WARD moved to report SB 99 out of committee with individua
recommendations and a zero fiscal note. Without objection, it was
so ordered.
SB 100 DEVELOPMENTALLY DISABLED CHILDREN/GRANTS
Number 419
CHAIRMAN WILKEN announced that the final order of business before
the committee was SB 100 .
MARY DIVEN , with the Department of Health & Social Services,
explained that SB 100 is a technical change that would place the
grant authority for the Infant Learning Program into the
authorizing statute. This change was requested by the Department
of Law in order to have all the statutes consistent; so that the
grant authority is in the authorizing statute rather than the
general department authority to issue grants.
CHAIRMAN WILKEN requested that Ms. Diven give an example of what
SB 100 would accomplish. MARY DIVEN said that the department would
like to update the regulations making them consistent with federal
law. The regulations were last updated in 1982. The Department of
Law will not allow the regulations to be open to public comment
until this technical correction occurs. The bill will allow the
updating of regulations.
SENATOR GREEN asked what happens with the Infant Learning Program
(ILP) now. MARY DIVEN clarified that the department has general
grant authority to issue grants and the Legislature puts the funds
in the grant line. However, at this point, the department cannot
revise any regulations until this technical change is made.
SENATOR WARD asked if the current regulations were inadequate.
MARY DIVEN replied yes, the regulations were last updated over 15
years ago and the federal law has changed. Ms. Diven noted that
the statute was revised in 1992 or 1993, but the regulations need
to be revised in order to be consistent with the current statute.
In response to Senator Ward, Ms. Diven said that the regulations
are causing administrative problems and problems for local service
providers. There is a small list of eligible providers in the
existing regulations. The local providers must request waivers of
the state in order to be eligible providers. The federal statute
and regulations has a more extensive list.
Number 452
SENATOR WARD noted that Representative James has a Joint Regulatory
Task Force. He believed this would be an appropriate item for the
task force to review in order to determine that regulations that
are necessary are being created. Senator Ward did not believe that
more regulations were necessary if people were being served under
the existing regulations.
CHAIRMAN WILKEN informed the committee that he was a member of the
Joint Regulatory Task Force whose agenda is full. This bill seems
to be more of an alignment than a creation. If this bill was given
to the task force, the task force would most likely not have time
for its consideration.
ELMER LINDSTROM , Special Assistant in DHSS, agreed that SB 100 does
raise some questions because what is being done now, what has been
done in the past, and what is desired for the future is to run the
ILP as a grant program. When the need arose to update regulations
consistent with the recommendations of the regulations group, the
Department of Law said that the department did not have specific
statutory authority to make grants and therefore could not update
the regulations. The Department of Law denied such although, DHSS
has done that in the past and the Legislature has appropriated
those grant lines in the budget. Mr. Lindstrom believed that the
provisions in SB 100 were included in a bill that passed out of
Representative James' committee last year. This was also included
in an omnibus bill last year which created administrative
efficiencies and ultimately did not pass the Legislature. Mr.
Lindstrom pointed out that if this is not done, at some point the
programs would have to be implemented through a contract mechanism
which would be very inefficient.
SENATOR GREEN asked if there would be any increased cost if the
legislation did not pass. MARY DIVEN said that there was a
possibility that there would be questions from the federal funding
source because of the inconsistency of the regulations with the
federal regulations or existing statute. There has been no
indication that funding would cease, but the potential is present
if the inconsistency continues.
SENATOR GREEN asked if any exponential growth of the program could
occur once this is in statute. MARY DIVEN replied no.
Number 511
SENATOR WARD asked if anything in law would stop this grant process
and allow it to become an RFP. MARY DIVEN stated that the existing
grant regulations require nonprofits and believed that the
departments authorizing statute requires that it be nonprofits.
SENATOR WARD believed that an RFP could go out to profit
corporations in order to supply this service. Could the grant
process be issued in a public bidding process through RFPs to for-
profit corporations?
MARY DIVEN said that the existing departmental regulations do not
allow such nor do the ILP regulations.
ELMER LINDSTROM offered to provide that information to Senator
Ward.
In response to Chairman Wilken, MARY DIVEN specified that the ILP
served children ages zero to three.
GIGI PILCHER , parent, informed the committee that she was the
mother of six children two of which are disabled/developmentally
disabled children. Ms. Pilcher urged the passage of SB 100 in
order to comply with federal legislation and continue to serve
disabled children.
SENATOR GREEN moved to report SB 100 out of committee with
individual recommendations and accompanying fiscal notes. Without
objection, it was so ordered.
There being no further business before the committee, the meeting
was adjourned at 9:50 a.m.
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