Legislature(2001 - 2002)
03/16/2001 12:00 PM 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
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE
March 16, 2001
12:00 p.m.
MEMBERS PRESENT
Senator Lyda Green, Chair
Senator Loren Leman, Vice Chair
Senator Gary Wilken
Senator Jerry Ward
MEMBERS ABSENT
Senator Bettye Davis
COMMITTEE CALENDAR
SENATE BILL NO. 133
"An Act relating to a two-year transition for implementation of
the public high school competency examination and to establishing
an essential skills examination as a high school graduation
requirement; and providing for an effective date."
MOVED CSSB 133 (HES) OUT OF COMMITTEE
SENATE BILL NO. 67
"An Act relating to assisted living homes and to liability for
acts or omissions in the licensing, monitoring, or supervision of
assisted living homes; and providing for an effective date."
HEARD AND HELD
SENATE BILL NO. 86
"An Act relating to employment of teachers who have subject-
matter expertise; and providing for an effective date."
SCHEDULED BUT NOT HEARD
SENATE BILL NO. 94
"An Act relating to education funding; and providing for an
effective date."
HEARD AND HELD
SENATE BILL NO. 91
"An Act relating to information and services available to
pregnant women and other persons; and ensuring informed consent
before an abortion may be performed, except in cases of medical
emergency."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
Ms. Alison Elgee, Deputy Commissioner
Department of Administration
P.O. Box 110200
Juneau AK 99811
POSITION STATEMENT: Commented on SB 67.
Gary Ward, Manager
Assisted Living Licensing Program
Department of Administration
P.O. Box 110200
Juneau AK 99811
POSITION STATEMENT: Commented on SB 67.
Mr. Elmer Lindstrom
Special Assistant to the Commissioner
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Commented on SB 67.
Mr. Shelby Larson, Administrator
Health Facilities Licensing and Certification
4730 Business Park Blvd.
Anchorage AK 99503
POSITION STATEMENT: Commented on SB 67.
Mr. Ron Parke, Housing Administrator
Friendship Services Assisted Living
3935 Svedlund
Homer AK 99603
POSITION STATEMENT: Commented on SB 67.
Mr. Carl Rose, Executive Director
Association of Alaska School Boards
POSITION STATEMENT: Opposed SB 94.
Ms. Sandy Altland
Staff to Senator Ward
State Capitol Bldg.
Juneau AK 99811
POSITION STATEMENT: Presented SB 91.
Ms. Nancy Davis, Acting Director
Division of Public Health
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Opposed SB 91.
Ms. Karen Vosburgh, Executive Director
Alaskans Right to Life
PO Box 1847
Palmer AK 99645
POSITION STATEMENT: Supported SB 91.
Mr. Bob Lynn, President
Alaskan Right to Life
Anchorage AK
POSITION STATEMENT: Supported SB 91.
Dr. Colleen Murphy
Anchorage AK
POSITION STATEMENT: Opposed SB 91.
Ms. Sherry Goll
Alaska Pro Choice Alliance
Haines AK
POSITION STATEMENT: Opposed SB 91.
Ms. Anna Franks
Fairbanks AK
POSITION STATEMENT: Opposed SB 91.
Ms. Jennifer Rudinger, Executive Director
Alaska Civil Liberties Union (ACLU)
POSITION STATEMENT: Opposed SB 91.
Ms. Dietrick Sitler
Anchorage AK
POSITION STATEMENT: Opposed SB 91.
Ms. Mary Dye
Citizen of Alaska
POSITION STATEMENT: Supported SB 91.
Mr. Sid Heidersdorf
Juneau Resident
POSITION STATEMENT: Supported SB 91.
Ms. Mary Horton
Juneau AK
POSITION STATEMENT: Supported SB 91.
WITNESS REGISTER
ACTION NARRATIVE
TAPE 01-23, SIDE A
Number 001
SB 133-PUBLIC SCHOOL COMPETENCY EXAM/REPORTS
CHAIRWOMAN LYDA GREEN called the Senate Health, Education &
Social Services Committee meeting to order at 12:00 p.m. and
announced SB 133 to be up for consideration. She said they had
language from the Department that dealt with two of their
concerns regarding the waiver.
AMENDMENT 1
Page 1, line 16: following "rates,"; insert "including the number
of students who received a diploma under a waiver from the
competency examination required under AS 14.03.075(a),"
Page 3, line 27: following "student": insert "; criteria
regarding granting a waiver must include provisions requiring
that a student satisfy the performance standards developed under
AS 14.07.020(b) to the maximum extent possible" - She said they
would also have a reporting section that would bring this issue
back before the legislature in 2003.
Page 4, line 26: delete "Sections 2 - 4" and insert "Sections 2 -
5"
Page 4, line 30: delete "Sections 5 and 8" and insert "Sections 6
and 9"
Page 4, line 31: delete "Sections 9 and 10" and insert "Sections
10 and 11"
SENATOR WARD moved to adopt Amendment 1, version 0.4 to CSSB 133
(HES). There were no objections and it was so adopted.
AMENDMENT 2
Page 4, following line 28: Insert a new bill section to read:
"*Sect.9. The uncodified law of the State of Alaska is
amended by adding a new section to read:
REPORT. The Department of Education and Early Development
shall, by January 31, 2003, deliver a report to the Alaska State
Legislature that describes the proposed criteria and procedure
under which a school district could use a waiver to grant a
diploma to a student."
Page 4, line 31: delete "9 and 10" and insert "10 and 11"
SENATOR WARD moved to adopt Amendment 2, version 0.3, to CSSB 133
(HES). There were no objections and it was so adopted.
SENATOR WILKEN said he was concerned about the requirement in the
exit exam to be proficient in the English language. He hoped the
State Board of Education would consider his language when they
enact SB 133. He read for the record:
In regard to the waivers, that each student achieve
competency in the English language before graduation
from high school and that the waiver process enacted
and the regulations governing the issuance of a waiver
for the secondary student competency examination
adopted by the Department of Education and Early
Development should not be used to allow a diploma to be
given to a student who lacks a minimal level of
competency in the English language.
CHAIRWOMAN GREEN thanked the members of the committee, the
agencies, the departments and the many other people for their
work on this issue.
Number 577
SENATOR DAVIS said she appreciated the Senator's statement, but
she didn't know what they were doing with it. It is not part of
the bill.
CHAIRWOMAN GREEN said that is correct. She thought it was
reasonable for them to be able to have their interests on the
record and how they would continue to be reviewed.
SENATOR DAVIS said that she wanted to go on record not supporting
that statement.
SENATOR LEMAN said he appreciated the Chair's leadership in
pulling this issue together. He moved to pass CSSB 133 (HES) from
committee with individual recommendations. There were no
objections and it was so ordered.
CHAIRWOMAN GREEN announced an at ease from 12:10 - 12:14.
SB 67-ASSISTED LIVING HOMES
CHAIRWOMAN GREEN announced SB 67 to be up for consideration. She
said she did not intend to pass it out today and wanted people to
have time to work on it.
MS. ALISON ELGEE, Deputy Commissioner, Department of
Administration, explained that SB 67 is the outgrowth of a
regulation project that they worked on with the Department of
Health and Social Services (DHSS) on assisted living licensing.
She said:
Our two departments have joint responsibility. The
Department of Administration licenses homes for senior
residents and the DHSS licenses homes under their
Division of Mental Health and Developmental
Disabilities for those two population groups.
When the licensing law was passed in about 1995, this
was a brand new venture for us and we decided that it
was important that we review the operations of the
assisted living industry against our regulations at the
time and our statutes to see whether everything was
working, whether there were areas that needed to be
strengthened and/or changed.
Public hearings were held throughout the state and they came up
with several items that were recommendations and couldn't be
dealt with in regulation. They required some statutory
modification. SB 67 addresses those areas. The regulation package
has been publicly noticed and is just beginning the adoption
process.
This particular bill requires that any assisted living home that
receives public funding be licensed. Current statute requires
homes with three or more residents to be licensed. The Division
of Senior Services has been licensing any home that receives
public funding just as a matter of policy. This would be a new
effort on the part of the Division of Mental Health and
Developmental Disabilities. It also sets some standards against
which background checks would be conducted. This is required for
employees of an assisted living home. This would expand the
number of people that would be subject to background checks so
that they could pick up other people who had unsupervised access
to residents of an assisted living home on a regular basis. It
would include family members who actually live in the home along
with the assisted living residents. It would include contractors
so that they don't have a loophole where somebody is not subject
to a background check because they are put on a contract instead
of being set up as an employee. Regular volunteers would also get
a background check where they have unsupervised access. It also
identified those people who would not be subject to background
checks, like occasional visitors or people who are only in the
home along with the professional staff.
Number 916
CHAIRWOMAN GREEN asked where that section was.
MS. ELGEE replied that Section 3 says who is not required. She
said:
The bill also provides provisions that the assisted
living industry has been very interested in obtaining.
The bill sets out the conditions under which an
assisted living provider could terminate a resident's
contract. Often times, the smaller assisted living
homes are not capable of managing every type of
behavior or medical condition and they need an
opportunity when an individual progresses beyond their
capability to handle, and subsequently, then, is at
risk, or has a behavioral issue that puts other
residents at risk. They need a process through which
they can terminate the contract of the resident and
find more suitable placement.
The primary mechanism through which this would be
addressed is contained in Section 4 and would allow for
a 30-day process for these determination proceedings.
It lays out specific activities that would generate the
assisted living providers right to terminate the
contract.
Section 5 essentially continues this process for
termination and it lays out the residents' rights to
have a conference with the assisted living provider
along with any advocates or family members to contest
that determination and show why that determination
should not occur.
There are occasions where an emergency termination of
contract may be necessary and Section 7 addresses the
emergency termination of contract and again lays out
what would constitute the emergency and sets out a much
shorter time frame than the normal involuntary
termination.
The bill also includes in Section 8 an immunity
provision for liability for acts or omissions in the
licensing, monitoring or supervision of a licensed
home.
Section 9 addresses the situation, which has occurred
and we determined we did not have the legal authority
to go in an assisted living environment and actually
take over the operation of the home. Where the home is
not being operated in a way that is safe for the
residents of the home, but where some time is needed in
order to place those individuals in another setting.
So, this addresses a real situation that occurred a few
years ago in the Anchorage area where we had two fairly
good-sized homes with approximately 16 residents each,
both operated by the same operator who ran into
financial difficulties. It was impossible to place the
30-some residents in other settings over night. So, we
need this window of opportunity and this is actually
modeled after a provision that's currently in statute
for nursing homes that allows the Department of Health
and Social Services the same kind of opportunity if
there is a similar situation with nursing homes.
CHAIRWOMAN GREEN asked if there was an appeal process, if
someone's license was being revoked for unfair reasons, for
instance.
Number 1178
MR. GARY WARD, Manager, Assisted Living Licensing Program,
answered:
The home does have an appeal process if the Division
takes action to revoke the license either on an
emergency basis or through routine procedures
revocation. The home is issued a notice of violation
with the intent to impose an administrative sanction.
That administrative sanction would be the revocation of
a license. The home, then, has 10 days in which to
request a hearing to appeal the revocation. Unless it's
an imminent situation, the home is allowed to continue
to operate. If they submit a request for an appeal or a
request for a hearing, then a hearing officer would be
assigned and it really depends on the schedule of the
hearing officer and then an administrative hearing is
held. That is usually down the road several months. The
home, unless it's an emergency situation where the
residents are at imminent risk of harm, would be
allowed to continue to operate pending the outcome of
the hearing.
CHAIRWOMAN GREEN referred to the immunity in Section 8 and asked
if that was typical language.
MR. WADE said he thought it was.
CHAIRWOMAN GREEN asked what that language was designed after.
MS. ELGEE answered that is was language very similar to that that
protects child protection workers.
SENATOR LEMAN wanted clarification on how an assisted living home
was taken over if it was in imminent danger.
MR. WADE replied:
In terms of the court order, administration of
receivership, you would have to petition the superior
court for temporary administration or receivership of
the home, in which case, the administration of the home
would be present at that hearing to defend their
situation. So, it's not something we can walk right in
and take over the home. We would have to petition the
court for receivership or temporary administration.
SENATOR LEMAN asked what the timeline was for when the department
decides that needs to be done and when it actually gets done.
MR. WADE replied that it is new language and they don't have
experience with this procedure. Previously, the options they had
were to do an emergency revocation of the license. He said:
In other words, go in, serve a notice to the home,
notify all the residents and/or their representatives
and inform that the license was being revoke under
emergency conditions. The reason, as Ms. Elgee stated,
was that in those situations, it's very difficult to
find especially if you have a large home with a fairly
large number of residents, it's very hard to find
alternative places for them on very short notice. It's
very difficult for senior citizens, elders, anyone, to
make a move like that even though it's required because
they are at imminent risk. So, the court ordered
administration would allow us to potentially go in and
take over temporary administration of the home or at
least allow enough time for the residents of the home
and/or the families and their representatives to look
for alternative placements.
SENATOR LEMAN said that much of this was patterned after things
in child welfare and he just wanted an understanding.
MS. ELGEE responded that if this language was in effect in the
instance she told them about, they would have tried to do some
court receivership. They worked for several months with the
administrator of the homes to try to correct the problems. It
became obvious that he could not overcome all the underlying
financial difficulties. "It's a last resort effort and we
wouldn't be attempting the other kinds of things that we can do
in terms of working with the homes first."
MR. SHELBY LARSON, Administrator, Health Facilities Licensing and
Certification, said they hadn't had circumstances like that in
the 12 years he had been with the agency. They didn't have
similar language either on nursing home licensure.
SENATOR LEMAN said it seemed like no one could answer that
question very well and he then asked Ms. Elgee if this also
applies to family members who take care of their related family.
MS. ELGEE answered:
In an assisted living home where the family resides
along with the assisted living residents, the family
members that may not provide direct care, but are in
the home and, therefore, have access on an unsupervised
basis to the residents, would also require a background
check unless they're younger than 16.
SENATOR LEMAN asked about language on page 2, line 10, referring
to a family member who is maybe off at school, but moves back
into the home. Would that family member, if they were not there
and then moves back into the home, be subject to a background
check?
MS. ELGEE replied that the background checks would apply to
visitors, and he could think of that family member as a visitor,
who are residing in the home for more than 14 days. A student who
is residing in a home for the summer would be subject to the
background check, as well.
SENATOR LEMAN said he thought to think about that area a little
bit more.
MR. ELMER LINDSTROM, Special Assistant to the Commissioner, DHSS,
said they had a memo to him from Mr. Larson relating to
background checks in nursing homes. They did not suggest that
background check information be added to the nursing home
statute, but it has been Mr. Larson's intention to adopt, in
regulation, the same background check standards that they have
now developed for assisted living and in order to do that, they
would need some statutory revisions for the nursing home statutes
that are parallel to those already included in the bill relative
to assisted living homes.
CHAIRWOMAN GREEN said they would continue to work on this bill.
MR. RON PARKS, Housing Administrator, Friendship Services
Assisted Living, said they were a nonprofit organization and used
volunteers. The fingerprint requirements would add $94 per
volunteer to their budget, which they can't afford. Every year
they have 50 - 60 volunteers come through their establishment. He
asked them to clarify the difference between a regular volunteer
and an occasional volunteer. In Section 2, line 10, he was
concerned specifically when volunteers are in direct contact with
staff and how that would work with church groups that do
fellowship with some of his residents. He was concerned that they
might be overprotecting the residents and violating their rights
if they want to invite one of those persons into their rooms to
have their services. He wanted to know when they would come into
violation as far as a criminal background check.
CHAIRWOMAN GREEN asked Ms. Elgee and Mr. Lindstrom to see if
there was a better definition and if regulations would cover that
more clearly that the language before them.
MR. PARKS said he had a hard time understanding some of the
terms. He asked if they could define 'contractor.'
MR. LINDSTROM replied that the exceptions in Section 3 say it
doesn't include a contractor who comes into the home who is
telephone repairman repairing utilities. A contractor is really
people who are providing services to the residents in the home,
not a contractor in the sense of a building repairperson.
CHAIRWOMAN GREEN asked if a contractor could be a therapist or
someone who provided food services.
MR. LINDSTROM replied yes. In his department, for instance, there
would be other Health and Human Services providers who would
likely be contractors providing services to people in the home
and that is what they are speaking to.
CHAIRWOMAN GREEN asked if those people weren't already under the
requirement of a background check.
MR. LINDSTROM replied that some of them might already be by
virtue of licensure requirements, but he couldn't say that all of
them would be.
CHAIRWOMAN GREEN asked if that helped Mr. Parks.
MR. PARKS replied that helped him somewhat and asked if they
could change "regular volunteers" to "care providers". He asked
since these people are coming into his facility, since he can't
use other agency's background checks for their purposes, does a
health care provider who comes into a room and closes the door to
take blood for blood work need to have a background check?
MS. ELGEE responded that Section 3 (2) specifically exempts from
the background check requirement an individual who is providing
services to the resident as an employee of a care providing
entity that is not affiliated with the assisted living home.
CHAIRWOMAN GREEN asked if this could be an RN or a doctor.
MS. ELGEE said the example of a physical therapist was a good
one. They contract with physical therapists in the Pioneers'
Homes, but the physical therapist is usually affiliated with a
hospital or another medical practice.
MR. PARKS asked if they are already health care providers, they
already have their own background checks.
MS. ELGEE responded that the assisted living home would not be
required to provide a background check as a part of their
licensure for those individuals.
MR. PARKS said the volunteer program is very important in their
facility and are important in their socialization programs and
getting people out. The wording in SB 67 in regards to volunteers
would be so restrictive that it would cripple their program and
he asked if language could be put in that would cover the
background checks for their volunteers.
MR. WARD responded that Mr. Parks had some good questions. He
said there was quite a bit of discussion about them. The key
piece in terms of volunteer, is if the volunteer was going to be
in direct contact with a resident in an unsupervised situation.
Groups from schools and groups to provide entertainment, etc.
would probably be in a public area in a situation where staff
would be in close proximity and those would not be subject to a
background check. They are most concerned about an individual who
is coming in on a one on one basis. He thought the larger
percentage of volunteers would not be required to have background
checks.
MR. PARKS said their senior companion program could be arranged
in a public area where staff is present, but if a resident
invites someone they have befriended into their room where they
have the right to close the door if they wish, this is the main
gray area of his concern.
CHAIRWOMAN GREEN said there was nothing in their fiscal note that
would cover the cost of background checks.
MS. ELGEE said that was right. The individuals, before
employment, are asked to get the name check and they cover those
costs. They cover the costs for people in the Pioneer Homes.
MR. PARKS agreed that they do cover the cost for employees, but
criminal background checks are very restrictive. Just fingerprint
checks are $94 and he doesn't have that in the budget.
CHAIRWOMAN GREEN said she hoped they could work through this
problem and not have it burdensome to the people who provide
services and set SB 67 aside.
CHAIRWOMAN GREEN said that SB 86 would not be heard today at the
request of the Chair.
SB 94-EDUCATION FUNDING
CHAIRWOMAN GREEN announced SB 97 to be up for consideration. She
announced a brief at ease.
TAPE 01-23, SIDE B
SENATOR TAYLOR, sponsor, said he first filed aspects of this bill
as amendments submitted by Ron Larson in 1986 and 87 as they
tried to change an inequitable formula for funding education. It
was his intention that all residents of Alaska who pay taxes
towards education would share the same level of pain and the
funds would be distributed throughout the state and every school
district would receive benefit.
He said in Wrangell, they pay almost 9 mils of local property
taxes to support education and he considered this a low level. He
didn't think that there were any nurses in his schools and there
weren't coaches in his elementary schools. There were no music
programs or art programs. This is because of an inequitable
formula that grants area cost differentials to school districts
across the state, but basically leaves all of the school
districts in Southeast Alaska, with a very small exception in
Juneau, at the same funding base that Anchorage receives money.
Anchorage has almost half of the children in the state, so
through volumes of scale their school board can make
discretionary appropriations to other activities in their
community from their school district budget. His school boards
wrestle with the question of maintaining the one or two janitors
they have when they used to have five or six or do they have to
"can" another one of them. He said they are receiving about
$7,000 per student in Wrangell. The North Slope Borough receives
$21,000 per student and has a student teacher ratio of 10 to 1.
He has about 18 to 1.
He explained that under the bill before them, every child in the
North Slope Borough will receive an increase in funding, so will
every child in Wrangell. Anchorage would receive the largest
increase in funding. Senator Taylor explained:
This bill increases funding across the board to
education by over $47 million. It carries a state
fiscal note against the general fund of about $29
million, maybe $27 million. There is no bill that is
before you or that has been submitted so far that will
cost the general fund less money than this one does nor
is there any bill that will distribute this amount of
money to the children of Alaska. How do we do that? We
do that by expecting every citizen in the state who
lives in a tax-based district to pay the same minimum
amount. Forty-eight school districts in this state
today either have full support or provide local support
themselves. They provide that support up to a minimum
of 4 mils. Each of you three members live in tax-based
communities where you are paying a minimum of 4 mils on
your home or other property you own in your town and
that 4 mils has to be dedicated by the community of
Anchorage, the community of Palmer, the community of
Wasilla, the community of Wrangell, we all have to pay
a minimum of 4 mils before we receive one thin dime of
money from the state of Alaska. So, that's the rule
under which all of us have to play.
If you're a wealthy district and you have a tax base
that is just extraordinary, you don't have to play by
that rule. You get to play by a different rule. You
only have to pay 45 percent of the cost of educating
your children. You don't have to pay 4 mils. All this
bill does is it asks that everyone in the state play on
the same playing field - that everybody pays 4 mils on
their house towards education. It doesn't seem to me
like a lot to ask.
What does that do to your formula? That allows you,
because you would not be subsidizing with state general
fund money the North Slope Borough and a couple of
other school districts in this state fully. They would
be paying their own cost of education and they don't
even come near 4 mils….
SENATOR TAYLOR explained that Section 1 modifies the Public
School Account that is already set up by including municipal
contributions within it. It would be a contribution returned to
the state by a municipality that had so much money left over
after paying the minimum amount that each of you pay, that that
money would be redistributed back through this formula for poorer
tax-based districts.
Section 2 says the state of Alaska will receive credit for
federal impact aid funds that are received by REAAs. Today they
receive 100 percent of the money that comes from the federal
government, but the state is requiring them to only count 90
percent of it. "So, basically, they receive a 10 percent slush
fund from the feds over and above the amount of money we're going
to send to them."
SENATOR TAYLOR said that the only thing he has asked is for all
the dollars to be counted 90 - 100 percent. The other numbers in
the section would provide for both vocational education special
needs funding. At the bottom of the second section the words "not
to exceed 45 percent of" [a district's cost of education] from
the existing formula. This provides then for the full amount of 4
mils to be redistributed back across the state.
He said the next section provides for the money that is left over
or excess to come back into this formula that will distributed as
indicated in Section 3.
SENATOR TAYLOR said he had heard concerns expressed across the
state by educators and others especially in the business
community, that the state isn't spending very much money on
vocational education. He said that the state isn't spending it
because when SB 36 passed, they provided 20 percent over and
above what people get in the regular formula for gifted children,
young children that are challenged or having some difficulties,
bi-lingual programs and voc-ed. They were all rolled into one and
the districts had to figure out how to spend it.
Because of federal mandates, the legislation where they
are required to provider certain levels of funding and
certain types of programs for those of our most
challenged students, the vast majority of this money
gets eaten up for those programs. A little bit may be
there for bi-lingual and what's left over may be there
available for a voc-ed program. As a consequence, what
I've done here is I have provided a specific funding
level for voc-ed at 3 percent. These numbers, by the
way, Madame Chair, are just ideas thrown out for you.
Some are very fearful of categorically funding voc-ed
because they say every other program, then, will want
to come in and have a specific funding category just
like voc-ed does and that we should not fund voc-ed
because somebody else might come and ask for the same
thing. I think if it's justifiable, maybe we should be
specifically and categorically funding or else you're
never going to get it.
An amendment that I wish to offer as this bill moves
through is to also add categorical funding for school
nurses. That's the only way I believe I can ever get a
school nurse back into any district school that I
represent.
He said he would probably add that back into Section 4, which
provides for voc-ed funding. Section 5 is just cleanup adding
that new section. Section 6 brings the formula back into
compliance with the numbers that have been provided for voc-ed.
Section 8 is what we call the declining fund
adjustment. For the last five or six years across this
state, we have seen declining enrollments occurring in
various communities. For the first time, I think, in
several years, we're now seeing an overall increase in
student population estimates and that's why for the
first time in several years we're seeing an indication
that the formula will actually have to go up by about
$10 million next year just to fund at the same basic
level that you currently have that formula set. For
those schools, however, that are still suffering
declining enrollments, under this formula - you are all
familiar with the Wrangell Petersburg problem - because
of student declines causing major shifts in the way the
funding levels are applied, it can have a devastating
impact on a district to just loose a very few students.
SENATOR TAYLOR said he decided to submit a bill that said it
doesn't matter what the decline is, whether it's only one student
or 10 students, it shouldn't make any difference. It's still a
loss of funding for that next year. He explained further:
So rather than have a school district fall off a cliff,
what we've provided for here is that even though that
child wasn't there the next year, the school district
would still receive 75 percent funding for that phantom
child. The next year after that it would be 50 percent,
the next year 25 percent and then zero. That would at
least allow school boards the opportunity to adjust
those budgets on a much gentler slope…"
He said that Sitka lost 140 students last year and the impacts on
their budget are so severe that they're contemplating terminating
14 - 17 staff people.
He said that Section 9 is the most expensive part of this bill.
He went with $4,150 to apply to all students across the state -
an increase of $210. Section 10 provides for the Wrangell
Petersburg "fix" and drops the number from 750 to 400 on student
count for a school funding formula for three funding schools. In
Wrangell and Petersburg, he said, they have three buildings, but
are under a funding formula mechanism that funds them for as if
they were only two.
Section 11 repeals the 40 percent penalty provision, where new
students moving into a rural school district, which as its
enrollment increased would only receive 60 percent of the funding
that student would have brought under the old formula.
I believe that provision is illegal. I think it
violates equal protection and I think sooner or later,
we in the legislature are going to be sued over that
one and when we do I don't think we have a leg to stand
on.
CHAIRWOMAN GREEN said she had vaguely remembered some of the
rationale and had also voted against SB 36.
Number 1584
SENATOR WARD asked how this bill affected charter schools.
SENATOR TAYLOR replied that it doesn't affect them, but it
provides additional funding. He added that he was frustrated
because the old formula contains an area cost differential, which
was based upon studies done of what it cost to live in various
areas of the state. He does not want to provide for another
study, but he wanted to tell the Department of Education
professionals who actually audit every single school district
every year to go out and use consumer price indexing and give the
legislature an objective report of what it truly costs in the
various regions and communities and adjust the formula
accordingly. He said this had never been done. This would be done
every two years.
He recollected that rationale for the 40 percent concept came up
because no one could understand how the numbers had gotten so
distorted that some school districts were receiving $20,000 per
student and others were receiving $6,000. "When you actually look
at the formula, much of it is driven by the area cost
differential that everything is multiplied against at the end of
the formula."
SENATOR TAYLOR said that this redistributes and appropriates over
$47 million for kids. "I know that is a huge amount, but it also
the lowest amount from the general fund of any of the bills that
you'll be presented with this year…."
He said that the poorer communities of California were faced with
the same problem about 12 years ago. Poor agricultural families
used the equal protection argument and asked why they were
getting paid a certain amount for education, but the ones who
were rich in Hollywood were getting paid more. The judge couldn't
find a good reason for it other than power politics. "The same
thing has happened to us…."
MR. CARL ROSE, Executive Director, Association of Alaska School
Boards, opposed SB 94. They do not positioned to scaling back a
system of education for some to provide more for others. He
thought that repealing the funding floor was a critical issue. He
said:
My recollection of SB 35 is similar in some cases, but
different in others. As I recall the discussion behind
SB 36 was to first provide equity across the state
through a distribution of funds and once that was
accomplished, we would address adequacy. I'm not sure
that equity was accomplished, but nonetheless, that was
the reason for the passage of that bill and we still
struggle with adequacy. The issue back then was the
redistribution of state funds. The issue with SB 94
once again is a redistribution of funds…
He said he served on a task force that dealt with the adequacy
that was required under SB 36. He was concerned that they had
never recognized that PL874 dollars were in lieu of taxes, but
now they are being told that 100 percent of that money will now
be withheld in lieu of taxes. He didn't know why people would
file for that money if they get no benefit from it, other than to
create a huge hole in the foundation formula if those monies are
not generated.
MR. ROSE did not recommend that as a strategy, because they loose
on both ends of that argument. The reason people will eventually
apply for this money is because they get some credit for it as a
result of the 90 percent deduct. He said there is a long-standing
state policy that said that four school districts - North Slope
Borough, Valdez, Unalaska and Skagway - were an anomaly. "We were
trying to create a foundation formula for the entire state and
didn't know how to deal with the anomaly of wealth divided by
population.
In the case of Skagway, when the railroad shut down in 1983, they
were left in an economic disaster, but they created a tourism
corridor and as a result of that effort they have a deep water
port, an ore terminal, hotels, a railroad and a thriving tourism
economy. Six-hundred people live in Skagway full-time and if you
take all of that wealth and divide it by 600 and it puts them
into a different category. They mayor of Skagway was there under
the SB 36 discussion and said that back then they were paying the
in excess of 53 percent of the school district budget. He didn't
know what the current figures were, but he guaranteed them that
the 45 percent figure they are under is being exceeded. They have
the ability to pay more and they have. "These school districts,
though this provision is a long standing public policy, this is a
radical change and a redistribution and I don't think many people
have had a chance to really think about it."
MR. ROSE said he supports vocational education. That was talked
about in the 20 percent categorical funding that was provided
under SB 36 for special education, bi-lingual and vocational
education.
An argument can be made equally well, if you're going
to take vocational education out and fund that, we have
tremendous special education needs that aren't being
met. The money that goes to special education is coming
directly out of regular instruction dollars. So, the
issue of the 20 percent, to begin with, is a larger
issue than just the vocational education. I don't
begrudge vocational education being treated separately,
but special ed and bi-lingual education are also paying
a price as well.
MR. ROSE said has seen many foundation rewrites and he agrees
with some of the studies. SB 36 was based on a study, but it was
based largely on expenditure data from 1996 and to his knowledge,
school districts were getting and spending all that they had and
it was inadequate. "To take that snapshot and project it forward
into a new foundation formula left us further behind."
The funding task force recognized that they actually need good
empirical data so they can make changes. They specifically said
they would not encourage any more changes to the current
foundation formula until they had the empirical data that would
underwrite those decisions. To turn over to the Department of
Education and Early Development the responsibility of coming up
with an appropriate cost factor without anything to hang that
decision on subjects them to quite a bit of lobbying.
My main concern in all this is we're talking about all
the things we didn't agree with SB 36 and we tried to
deal with it then and we couldn't get there. I think
what SB 94 does is brings all that back to the table,
again, but it's not doing it in an open fashion. What
we're talking about is redistribution of wealth here.
And so, I do have some concerns and I'm also sensitive
to the concerns that have been expressed for Wrangell
and Petersburg and I agree with these. In fact, these
were part of the discussion under SB 36 that didn't get
through. I don't think I come before you to say I just
want to trash on this bill. That's not the case. But I
think what we're doing is we're changing some long-
standing policies in this state in how we treat
districts that are a fiscal anomaly with the rest of
our districts. We're going to change that policy in one
fell swoop and redistribute that money.
Without the recapture clause that would require
districts to pay back, you don't have the money to pay
for this bill. So, I would just want to talk about the
recapture. The way you get the money for this bill is
take from those who are struggling right now and I know
you will say that the North Slope has a lot of money
along with Valdez, Unalaska and Skagway, but it's the
plight that they have and they are struggling to
provide an education as it right now. To alter that
ability for those school districts simply to
redistribute the money, what we need is a increase of
funding for the purpose of educating our children
state-wide. So, any time that we start to look at
increasing funding for education to try and imbed these
standards that we're trying to do, it requires an awful
lot of need that needs to be addressed. The suggestion
comes to me that we're just throwing more money at the
problem. I don't believe that. We've never invested in
the cure. There is a solution and it was going to
require us to align our systems to provide the
professional development that we need and assist kids
with intervention to help them take and successfully
pass their exam. We've done all this and we haven't
made the investment.
MR. ROSE said they would like to work on a funding bill that
meets the needs of all Alaska's students.
Number 655
SENATOR DAVIS asked him to elaborate on why those districts are
struggling to pay for education.
MR. ROSE replied that he could speak in the case of Skagway:
The amount of money that they receive in Skagway, even
under this bill, they would loose an additional
$65,000. I think that their budget right now is
somewhere in the area of $1.3 million and they receive
about $800,000 from the state. So, a good portion of
that money already comes locally. Local contribution is
severe, but they have the money and they readily put
forward what they can. It's not that they have an open
checkbook; they are limited to what they can
contribute.
CHAIRWOMAN GREEN said they would look this year at how they could
make improvements in education funding. She set the bill aside.
SB 91-ABORTION: INFORMED CONSENT;INFORMATION
CHAIRWOMAN GREEN announced SB 91 to be up for consideration.
MS. SANDY ALTLAND, staff to Senator Ward, sponsor, explained that
SB 91 provides more information to people who are considering an
abortion. It asks the Department of Health to prepare a handbook
with the information that is needed. Some people have emotional
problems after a procedure and more information in the beginning
might help them.
MS. NANCY DAVIS, Acting Director, Division of Public Health, said
she was presenting the prepared testimony of Karen Pearson,
Director as follows:
The Division of Public Health supports what appears to
be the intent of this bill insuring that all women
seeking a abortion are fully informed prior to signing
consent for the procedure to be done. Since this is
currently required to any surgical procedure being
performed and is considered essential by the medical
provider and the advocate communities, we question the
need for a law specific to the abortion procedure.
I believe we are in agreement that each woman seeking
an abortion needs information about the physical,
emotional, psychological and medical risks and benefits
of the procedure them personally. This bill seeks to
address this need by requiring each women be provided a
detailed and lengthy informational document and
requiring that the provider have the patient sign a
form indicating she has read and understands the
information in the document and its relevance to her.
Some women would find such material information, but
many who are of low literacy, illiterate or for whom
English is a second language would not be served well
by this process. Many individuals who have reading
problems are very skilled at hiding those problems from
those with whom they interact. Thus, it could be very
difficult for a provider to ascertain surely or with
any degree of certainty that a woman to whom the
written materials were provided was actually able to
read and comprehend the information.
Providers are accustomed to explaining procedures,
risks, and benefits relative to medication options,
treatment options of all kinds and being able to follow
up on questions and concerns as they arise. They are
used to tailoring the information given to meet the
specific needs of the patient being seen. There are
many individual health issues that a physician must
address with each patient no matter what the procedure
that will be performed. These needs are not well served
when large volumes of written information that may or
may not be relevant to that individual are required
first in order to verify that a person is informed. The
language, culture, age and other relevant factors of
the woman must be considered when deciding how to
provide information in the most usable form and manner
and only the provider working with the patient can
determine those individual needs. There are substantial
costs as reflected in the fiscal note related to the
Department of Health and Social Services staff
compiling and keeping current lists of providers,
agencies and organizations in each community that
provides support, aid or other services for women
contemplating parenting, adoption or abortion. Local
communities are well-versed in local resources and are
better able to keep the information current at
significantly lower costs. Thus, if these booklets do
not significantly improve the process of informing the
patient, and we believe they will not, then this money
could perhaps be used to fund needed services or to
educate women about avoiding unintended pregnancies
and, thus, avoiding contemplating having an abortion.
TAPE 01-24, SIDE A
CHAIRWOMAN GREEN asked if they generally refer people to a
physician, if possible.
MS. DAVIS answered that the Public Health Division, through
several different divisions, encounters women who are pregnant or
seeking a pregnancy test. Through some of their grantees, that
encounter is made through public health nurses in public health
centers at the local level. They do not provide any abortion
services at public health centers or by public health staff. They
refer clients to whatever services they need or seek. She said
further that public health services are primarily preventive in
nature and for on-going prenatal care or other things, they refer
them to an on-going provider.
MS. IDA BARNICK, Alaskans for Life, Inc., supported SB 91. She
said, "Medical and scientific fact have proven that human life
begins at conception."
This is extremely important for a woman who is contemplating the
life of her unborn child to understand what she is doing.
Therefore, she deserves to know the age, the fetal
development of her unborn child, possible psychological
effects that she might experience if she ends the life
of this child and she needs to know what the other
options to abortion or other community services that
can help her if she decides to let her unborn child
live. She should never be coerced into having an
abortion. She should be required to sign a statement
that she was given the information…
MS. BARNICK said this is the same procedure she would have to go
through if she were going to have any other major or minor
medical procedure. If English is the second language, she would
usually have an interpreter with her who will explain the
information. She also didn't think it was unusual for a state
agency to have to provide brochures to the public for various
things and she didn't believe it would cost that much.
Number 460
MS. KAREN VOSBURGH, Executive Director, Alaska Right to Life,
said she didn't understand the opposition by pro-abortion forces
to allow women to have full and informed consent. She has found
that when women are considering abortion, very little factual
information is actually given. She said there are over 100
potential physical complications associated with abortion. She
presented some abortion statistics for Great Britain saying that
she new women were not aware of these. She said that many studies
have connected breast cancer and abortion and have also connected
it with the pill.
According to Calinborn (ph), based on the most
comprehensive medical evidence available, induced
abortion and the birth control pill are both
independent root factors for development of breast
cancer. This risk is especially great if the women have
participated in either of these factors at a young age…
She said that despite evidence of the dangers of breast cancer
from abortions and contraceptive use, "abortion clinics continue
to promote abortion on demand." She said that evidence of
psychological damage from having abortion is overwhelming.
Number 825
MR. BOB LYNN, President, Alaskans Right to Life, said that
passing a statute mandating informed consent is not about whether
abortion should or should not be legal or available or who should
pay for it. "My concern today is nothing more than a woman's
right to know the facts about any medical procedure including an
abortion procedure before consenting to it."
He said that informed consent is routine. If women knew some of
the risks of abortion, she might not consent. He noted that
abortion providers only get paid when a woman decides to abort.
MR. LYNN said that he sells real estate and that everyone who
sells a house must provide a disclosure statement to buyers.
Likewise, Alaska Right to Life thinks that anyone who
sells an abortion should provide the buyer of that
abortion with a full disclosure of facts. So there was
informed consent before the woman buys the abortion. I
hope the legislature thinks that the health of a woman
is more important than the health of a house.
DR. COLLEN MURHPY, Anchorage Obstetric Gynecologist, said she is
Board certified by the American College of OBGYN. She wanted to
reassure the audience and said:
The standard procedure for medical practice is to
provide informed consent. It currently constitutes
excellent patient care. It is currently required by all
professional organizations under all circumstances be
it for a medical or a surgical procedure of any nature.
Likewise, our professional ethical standards require it
and furthermore the lawyers demand it. I will say
repeatedly again and again, that this particular
attempt at informed consent is not required under state
law. This is something that is done in the privacy of
the office with an individual patient and client
talking about the serious nature of a condition be it
related to abortion, a hysterectomy, a colposcopy or a
gall bladder surgery. For the legislature to step in
between the privacy of a patient and a doctor is
inappropriate. We are practicing medicine and this does
not need to be legislated.
DR. MURPHY disagreed with the preceding scientific information by
someone describing breast cancer. That is not scientific fact and
is a subjective evaluation. She also wanted to discuss what they
could do about the tragedy of unintended pregnancy in Alaska.
Currently, 60 percent of pregnancies are unintended in
Alaska. It is estimated that half of those pregnancies
will go to termination of pregnancy. The other half may
miscarry or become live born. Some women will elect to
adopt them out. If we truly want to decrease the need
or the request for abortion, we should be directly our
attention towards decreasing the reasons unintended
pregnancy occurs in Alaska. Rather than fighting about
informed consent, which is something that is done
privately between a trained medical provider when a
surgical condition is being considered with a patient.
I would suggest that we direct our attention, just like
the World Health Organization has suggested elsewhere.
The best way to decrease the need for termination of
pregnancy is to increase the availability of
contraception. I would challenge this committee to look
at a bill that has currently been proposed by Senator
Johnny Ellis, SB 15, called the prescriptive fairness
act. This is a step in the right direction that is
concrete, that everyone can agree on - that women who
use contraception that is reliable and approved by the
FDA - have a lower risk of unintended pregnancy and the
need for termination.
DR. MURHPY said they should spend time doing something that they
know works rather than putting women and providers in additional
difficulties and expense based on the proposals in this bill.
CHAIRWOMAN GREEN said she had a question from someone who had to
leave earlier, but they refer to the term in the bill of
"gestational age", which is neither a medical nor scientific
concept and asked if there was better phrasing.
DR. MURPHY replied that gestational age varies. She explained:
There is something called Migel's Rule. It's when you
find out when the woman's last menstrual period is. You
add nine months plus one calendar week and it's the
estimated date of confinement. From that, we calculate
the supposed gestational age. The average pregnancy
will be approximately 40 weeks in duration. A normal
term pregnancy will deliver between 37 and 42 weeks. To
make a long story short, menstrual dating is
notoriously inaccurate. If you go ahead a
retrospectively date a pregnancy based on the baby's
size and weight and appearance at birth, 25 percent of
menstrual dates are inaccurate for gestational aged
dating. In modern obstetrics, we will often alter the
dating of the pregnancy based on ultrasonigraphic
findings in which we might go ahead and measure the
gestational sack size. We might measure the crown
growth points, the fetal fold, different measurements
of the skull or the femur length. This will alter the
gestational age such that we no longer rely on the last
menstrual period because a bleeding episode did not
occur exactly two weeks prior before the egg was
released from the ovary.
CHAIRWOMAN GREEN asked if the method of computing the gestational
age has been refined through time.
DR. MURPHY responded that it no longer relies on just the last
menstrual period. "It's invariably complemented with
ultrasonigraphic and physical exam."
CHAIRWOMAN GREEN asked if using those methods, was there a range
in which she could identify at what point of development the
unborn child is.
DR. MURHPY replied, "I don't know what an unborn child is. I'm
not familiar with the term unborn child. She is a physician and
medically trained and has never come across unborn child in my
medical training."
CHAIRWOMAN GREEN asked what phrase would she use for the before
delivery time.
DR. MURHPY said they don't use that phraseology. She explained:
When a fertilized egg divides, it changes into a
blastocyst and then it will implant into the uterus and
be called an embryo until eight weeks gestation. From
eight weeks gestation until the time of delivery, it is
called a fetus. There is no such thing as unborn child
in medical literature.
CHAIRWOMAN GREEN asked how she identified the number of weeks or
what the stage of development is. She asked, "If when you are
making those assumptions, are you basing that on a range of time
versus this is a specific day in the development versus it could
be within two weeks."
DR. MURHPY replied:
It gets pretty interesting. If you look at first
trimester, which according the American College of
OBGYN is up to 14 weeks in pregnancy, and then the
second trimester is 14 weeks to 28 weeks and third
trimester is 28 weeks to birth. Basically, we know if
we do ultrasound measurements of the fetus, that world
wide based on large statistical studies [indisc.] that
fetuses pretty much grow at a very similar rate in the
first trimester, through 14 weeks - such that you can
date the pregnancy within several days to about 10
days. Between 14 weeks [and 28 weeks] we start to get
such variation that it's two weeks difference. So,
we're not accurate. I think a lot of lay people give us
too much credit for being terribly accurate and we
really aren't. We guess pretty well.
Number 1486
MS. SHERRY GOLL, Alaska Pro Choice Alliance, Haines, said they
are a state wide coalition of diverse nonprofit organizations
with a mission of protecting reproductive rights and to promote
reproductive health services through education, advocacy and
community organizing. Although the group promoting this
legislation think it is informational, her organization thinks it
is trying to intimidate and harass women who are choosing to have
an abortion. She said:
Apparently, people are under the impression that women
take this kind of decision lightly instead of thinking
about it and dealing with it in the privacy of their
own lives, making their own constitutionally protected,
private pregnancy decision with their physician. As Dr.
Murphy just stated, physicians for all surgical
procedures provide informed consent. To suggest that
women in this particular instance have to be shown
photographs - I mean photographs of a developing fetus
would be more appropriate to show to a woman who is
planning to have a pregnancy and there are many books
in the library to help you understand child development
if you're going to have a baby.
If a man needs to have a cyst removed from his
testicles, do you think it would appropriate for the
legislature to put in law that this man should be shown
pictures of how that cyst would grow over a period of
time if he fails to remove it.
I think the bill is flawed in ways using terms that are
so charged, like unborn child, when as you know it is
not a medical term. If it's meant to be educational, if
you want to provide information, don't tell women that
the father of their child will be under obligation to
provide child support unless you're also going to tell
her what the statistics are that obligors pay their
child support. I am very much opposed to this
legislation. I think that it's just intended to harass
women who choose to have an abortion and it is clear
that it is that type of bill by the folks who have
shown up to testify on it. I appreciate your taking my
testimony. Thank you very much.
Number 1620
MS. ANNA FRANKS, Fairbanks, said she would be reading testimony
from Alicia Wells, Anchorage resident, who was home caring for
her children. The letter said preventing pregnancy sometimes is
just based on luck and that a woman can get pregnant using an
IUD. She said that she was never forced to have sex against her
will and that her parents shared with her information about
responsible sexual behavior. She read:
Not all women are that lucky, however, and for one
reason or another, many women find themselves pregnant
when they don't want to be. For these women, the
decision about what to do is not easy. I know from
having counseled several friends with this decision
that it is not one that any woman takes lightly. Women
who are in this situation need access to good quality
information and supportive non-judgmental counseling
about their actions.
She read further that:
SB 91 masquerades as something that will help women
make a decision at this critical time in their lives,
its main purpose is to intimidate women and make them
feel guilty for exercising their right to make choices
about their bodies and their lives. In addition to
being a blatant anti-choice attempt to restrict women's
rights, there are several major problems with the bill.
First, the legislature has no business telling doctors
the specifics of what they can and should be saying to
their patients. Doctors are already bound by the
standards of practice which include providing complete
and unbiased information and counseling about medical
procedures as well as insuring that a woman or any
patient freely consents to the procedure she will
undergo. These systems are already established and
working. There is not need for special information
consent forms just for abortion.
Second, the purposed intent of this so-called
counseling material is clearly biased and intended to
dissuade women.
Third, the proposed content of the so-called counseling
materials related to the psychological affects of
abortion is simply not supported by scientific
research.
Finally, SB 91 shows a lack of respect for women. It
assumes that women will not make the right choice
without an extra push in the right direction from the
state. Well, as a woman myself and someone who has
talked to many women, I can assure you that women do
have the ability to make thoughtful and moral decisions
about their lives. We need to respect that ability and
provide women with quality information and services so
that they may have the best possible outcome whatever
their choice. I urge you to vote against SB 91 and
allow women to make their own decisions with the
assistance and medical expertise of their own doctors.
MS. JENNIFER RUDINGER, Executive Director, Alaska Civil Liberties
Union (ACLU), opposed SB 91. She asked if the committee had
received testimony from Dr. Sharon Smith, Dr. Cathy Todd and Dr.
Jan Whitefield regarding this bill.
CHAIRWOMAN GREEN replied that they did receive it.
MS. RUDINGER summarized her testimony:
I want to first of all point out something that hasn't
been mentioned yet and that's that SB 91 requires that
the physician, him or herself, be the person delivering
these extraneous lectures to the patient. This is going
to have the effect of not only forcing doctors to give
information that may not be relevant to that particular
patient's circumstances, but also by using the doctor's
time to do this, is making access to quality health
care more difficult and more expensive. SB 91 will not
allow a trained counselor, a nurse or another health
care practitioner to provide the state's mandatory
lecture to the patient and there are very few doctors
already available. There's a shortage of doctors able
to help women in these circumstances. By taking the
doctors time and forcing them to deliver these lectures
when other healthcare practitioners could do it is
going to drive up the cost of healthcare and make
access more difficult.
Finally, I just want to address some of the medical
misinformation, actually, that's been put on the
record, to kind of correct the record. SB 91 refers to
possible psychological affects that have been
associated with having an abortion and as Dr. Murphy
testified, this is really substituting lay people and
politician's judgment for that of doctors. Practicing
medicine is something that should be left up to people
with a medical license. This reference to possible
psychological effects is misleading because no such
psychological harms have been proved to exist and in
fact to corroborate that, according to a 1987-88
investigation by former Surgeon General C. Everett
Coup, who is of course no champion of choice, as well
as another study by the World Health Organization,
there is no medical evidence that abortion causes
psychological injury. On the contrary, relief is the
most common reaction to a voluntary abortion whereas
women who are forced to continue unwanted pregnancies
suffer adverse and sometimes severe psychological
consequences. So, again this is where it should be left
to doctors to decide based on their best medical
judgment, based on the specifics of their patient, what
risks and benefits are relevant to that patient, what
medical information is scientifically sound.
And finally, I hadn't planned to discuss this, but I
must just briefly rebut the allegation that there's a
link shown between abortion and breast cancer. The
latest scare tactic initiated by anti-choice groups is
to link abortion with breast cancer. Ceasing upon scant
evidence in a 1994 research study, they have mounted a
bigger advertising and legislative campaigns to
convince the public that having an abortion increases a
woman's chance of contracting breast cancer. In fact,
this study they are referring to published in the
Journal of the National Cancer Institute reported a
small statistical connection between abortion and
breast cancer. Although cancer research experts have
characterized this study as inconclusive and
methodolically problematic, anti-choice activists
eagerly wield it as a new way to frighten women and
restrict their choices. Opponents of choice have
persuaded legislators in several states that there is
this link, that this is part of the information that
needs to be conveyed. It's not clear from this bill
whether, in fact, that's the case, but if anyone is
under the impression that there is such a link and that
this information is needed for informed consent, I'd
like to mention, and I can get this for you later, a
couple points that illustrate just the opposite. The
Natural Cancer Institute has charged that the study has
been interpreted inaccurately and, "There is no
evidence of a direct relationship between breast cancer
and either induced or spontaneous abortion."
Second, the American Cancer Society has concluded, "The
inconsistencies of existing research do not permit
definitive scientific conclusions."
Third, on the day this study was published, the Journal
of National Cancer Institute, the source of the study,
printed an editorial stating that, "The overall results
of the study as well as the particulars are far from
conclusive and it's difficult to see how they will be
informative to the public.
The study was particularly criticized because of the
methodological problem of possible inaccurate reporting
of a history of abortion by participants.
Fourth, four recent reviews published in scientific
journals have assessed more than 30 studies and
concluded that the available data on the relationship
between induced or spontaneous abortion in breast
cancer are inconclusive. Fifth, a 1995 article in
Cancer Causes and Controls reported in an article
entitled Abortion and Breast Cancer Causes in Seven
Countries the study of these countries concluded, "In
Summary, these data suggest that any overall relation
between abortion and risk of breast cancer is likely to
be weak at the most."
This list goes on and on and finally, one more point, a
widely noted 1997 study of more than 1.5 million women
in Denmark where abortion histories are corroborated by
a government sponsored medical registry, so there's no
chance of reporting bias, concluded that, "Induced
abortions have no overall affect on the risk of breast
cancer."
In a New England Journal of Medicine editorial, a
company in the Danish research I just quoted, Dr.
Patricia Harkey (ph) of the National Cancer Institute
said, "It provides important new evidence to resolve a
controversy that previous investigations have been
unable to settle." In short, a woman need not worry
about the risk of breast cancer when facing the
difficult decision of whether to terminate a pregnancy.
MS. GOLL said she appreciated the opportunity to read these
articles into the record and offered to provide them with further
information they might find helpful.
MS. DIETRICK SITLER, Anchorage resident, opposed SB 91. She
wanted to share with them why a bill like this could be very
detrimental to many women like her as follows:
At the age of 14 I was diagnosed with hemophilia, a
disease affecting the blood. As a result of this
condition, it is medically dangerous for me to carry a
pregnancy to term, because the loss of blood during
delivery could be potentially fatal to me. I am in a
long-term committed relationship and my partner and I
are very careful, but as you know, no form of birth
control is 100 percent effective. Were I to become
accidentally pregnant, it would be in my best medical
interests to terminate the pregnancy rather than carry
the pregnancy to term. I strongly feel this is a
decision between my partner and I with the advice and
consultation of my doctor. The government I feel has no
place in this personal painful choice that I would have
to make. Furthermore, my partner and I would find it
very painful to have to listen to a litany of
alternatives to abortion - alternatives that are not in
our best interest and that could actually threaten my
life before we would be deemed capable of consenting to
an abortion.
My greatest objection is in your definition of a
medical emergency. I would not fall under the medical
necessity exception to SB 91, because having the
abortion at that very moment would probably not be a
life saving measure or an emergency situation.
Therefore, I would be subject to this extra counseling
which would be wholly irrelevant in my individual
circumstances. I have also heard a lot of testimony
today stating that if many women knew more facts about
abortion, they would probably choose not to have this
procedure. This is not entirely true, especially in my
situation. Not every woman that is having an abortion
is having this procedure just because they do not want
to have the child. What about women like me? There is
no exception for women like me. I would remind you that
this decision would already be very painful for me and
I would be terminating this pregnancy to save my own
life. Why should these extra hurdles be placed on me,
especially when they are not placed before any other
patient seeking any other medical treatment. We urge
you to oppose this bill and thank you very much for
your time.
Number 2224
MS. MARY DYE, citizen of Alaska, supported SB 91 and read a
definition of informed consent that she got off the Internet:
In medicine a patient's written consent to a surgical
or medical procedure or other course of treatment given
after the physician has told the patient all of the
potential benefits, risks and alternatives involved.
She used an analogy of deciding whether or not to put gutters on
her home and gathering all the information available and deciding
if it was the thing to do. She said they could offer the
information to women and do the best you can.
MR. SID HEIDERSDORF, Juneau resident, supported SB 91.
TAPE 01-24, SIDE B
He said that informed consent is needed to protect women from
unscrupulous abortion practices. He pointed out this bill does
not attempt to outlaw abortion or place restrictions on a woman's
right to an abortion. He said, "Abortion is not an honorable or
an innocent medical procedure and those who are involved with it
are not likely to be very open and free about the information
when they are talking to their patient."
MR. HEIDERSDORF asked, "Why is abortion the only invasive medical
procedure for which full information is not given? It is well
known that abortion counseling is a sham."
Further he said:
If biased information results in an attitude of viewing
it as being anti abortion, I think there's something
there to look at. The fact is that scientific unbiased
information, which is required by this legislation, may
in fact speak against abortion and that's the way it
is. It's true if the child in the womb, which is the
crux of the issue, is what's discussed. That's what
women really must know.
We hear a lot said about RU486. In August of this past
year, Serle, the company that produces one of the drugs
used in the RU486 abortion procedure, wrote a letter to
200,000 medical practitioners in this country telling
them, "Don't use cytotech for abortions." They said
don't use it because it's dangerous. They didn't study
it for that purpose; this is a drug used to cure
ulcers, not to be used for producing contractions for a
woman to expel a dead baby.
He passed out an article to the committee on cytotech in which a
woman died who used it. He disagreed that there wasn't a link
between abortion and breast cancer. He said there are over two
dozen scientific articles that do show a strong link between
abortion and breast cancer, especially first pregnancy abortions.
He said, "The evidence is building."
Specifically, SB 91 does not include a waiting period. He thought
a 24-hour waiting period was critical because a woman needs to
get the information and get away from the doctor and the clinic
personnel, because they are out to sell an abortion. "They are in
the business of selling these abortions."
One final thing was on page 5, line 3. He was concerned that this
language did not require that the woman be given the information
produced by the Department of Health and Social Services.
CHAIRWOMAN GREEN said she thought page 5, line 8, addressed his
concern.
MR. HEIDERSDORF responded that he was concerned with language in
AS 18.05.032.
Number 1853
MS. MARY HORTON, Juneau resident, supported SB 91, because of a
recent experience she had bringing healing to two men and six
women who had experienced abortion in Juneau. Their ages were 17
- over 50 years. She said that a man begins to deal with an
abortion 5 - 7 years after it's happened. She said, "When we talk
about the abortion, it's not only the woman who carries the
child, the fetus, it's also the grandparents, the sisters and
brothers that come before or are still there, the man who
fathered the child."
She said there will be another opportunity for healing that is
called Project Rachael, Rachael's Vineyard. In her experience,
she found that women were very surprised to hear the other side
of the story, that men were carrying the guilt and what could
they have done about it. "Women need to know, but so do the men…"
She said that people who can't read can see pictures and can
understand clearly what's going on. It's hard for her to express
all the healing that happened and SB 91 would go a long way in
helping people think about it a little bit more clearly.
CHAIRWOMAN GREEN said she was chagrined at some of the comments.
She had undergone various surgeries and had seen pictures of body
parts on the doctor's office wall and what might be wrong with
them and how they could be corrected. She received a great deal
of information and the consent forms and waivers she signed were
all inclusive. She continues:
On the other hand, I would say that those who say that
government should not be involved in this decision
making and certainly in regulating and/or prohibiting
or allowing are the very same people who spend a great
deal of time challenging the fact that state Medicaid
money should indeed be used to fund abortions. So, I'm
a little conflicted on those.
SENATOR DAVIS asked if there would be time for more public
testimony.
SENATOR WARD said he had a lot of people who wanted to testify
and wanted to know if any state money had been spent on
psychological follow-ups or abortions; if so, how much. He was
trying to figure out if the state is liable.
CHAIRWOMAN GREEN adjourned the meeting at 2:55 p.m.
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