Legislature(2003 - 2004)
04/09/2003 01:31 PM Senate HES
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
April 9, 2003
1:31 p.m.
TAPE(S) 03-18, 19
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Lyda Green, Vice Chair
Senator Gary Wilken
Senator Bettye Davis
Senator Gretchen Guess
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
SENATE BILL NO. 121
"An Act relating to community schools; and providing for an
effective date."
MOVED SB 121 OUT OF COMMITTEE
SENATE BILL NO. 30
"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
SENATE BILL NO. 157
"An Act relating to inpatient psychiatric services for persons
who are under 21 years of age and are either eligible for
medical assistance or are in the custody of the Department of
Health and Social Services."
MOVED CSSB 157(HES) OUT OF COMMITTEE
SENATE BILL NO. 84
"An Act relating to the Alaska teacher recruitment loan
repayment program; and providing for an effective date."
MOVED CSSB 84(HES) OUT OF COMMITTEE
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 154
"An Act relating to a student loan repayment program for nurses,
and amending the duties of the Board of Nursing that relate to
this program; and providing for an effective date."
MOVED SSSB 154 OUT OF COMMITTEE
PREVIOUS ACTION
SB 121 - See HESS minutes dated 4/7/03.
SB 30 - See HESS minutes dated 3/17/03, 3/26/03 and 4/3/03.
SB 157 - No previous action to record.
SB 84 - No previous action to record.
SB 154 - No previous action to record.
WITNESS REGISTER
Mr. Curt Ledford, Director
Community Schools
Sitka AK
POSITION STATEMENT: Opposed SB 121.
Ms. Janice DeLand
Offnet - No address provided
POSITION STATEMENT: Supported SB 30.
Mr. Sid Heidersdorf
PO Box 658
Juneau AK
POSITION STATEMENT: Supported SB 30.
Ms. Karleen Jackson, Deputy Commissioner
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Supported SB 30.
Ms. Linda Bowdre
PO Box 1048
Delta Junction AK 99737
POSITION STATEMENT: Supported SB 30.
Ms. Kari Thomas
PO Box 165
Delta Junction AK 99737
POSITION STATEMENT: Supported SB 30.
Ms. Roseanne Curran
PO Box 42
Cordova AK 99574
POSITION STATEMENT: Supported SB 30.
Ms. Karen Vosburgh
PO Box 1847
Palmer AK 99645
POSITION STATEMENT: Supported SB 30.
Dr. Coleen Murphy
No address provided
POSITION STATEMENT: Opposed SB 30.
Ms. Thea Pitmann
No address provided
POSITION STATEMENT: Opposed SB 30.
Ms. Dietrick Stitler
No address provided
POSITION STATEMENT: Opposed SB 30.
Ms. Robin Smith
No address provided
POSITION STATEMENT: Opposed SB 30.
Ms. Pauline Udder
No address provided
POSITION STATEMENT: Opposed SB 30.
Mr. Bill Hogan, Director
Division of Mental Health and Developmental Disabilities
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Supported the concept of SB 157.
Mr. John Duffy, Manager
Mat-Su Borough
350 E. Dahlia
Palmer AK 99645
POSITION STATEMENT: Supported SB 157.
Ms. Catherine Rapoport, Regional Vice President
Universal Health Services
POSITION STATEMENT: Supported SB 157.
Ms. Terry Keklak
No address provided
POSITION STATEMENT: Supported SB 157.
Mr. Richard Rainery, Executive Director
Alaska Mental Health Board
550 W 7th Ave., Suite 1820
Anchorage AK 99501
POSITION STATEMENT: Supported SB 157.
Ms. Diane Barrans, Executive Director
Postsecondary Education Commission
Department of Education &
Early Development
th
801 W 10 St.
Juneau, AK 99801-1894
POSITION STATEMENT: Supported SB 84.
Ms. Mary Francis, Executive Director
Alaska Association of School Administrators
326 4th, Suite 404
Juneau AK 99801
POSITION STATEMENT: Supported SB 84.
Mr. John Alcantra, Government Relations Director
National Education Association
POSITION STATEMENT: Supported SB 84.
Mr. Rick Urion, Director
Division of Occupational Licensing
Department of Community & Economic Development
PO Box 110800
Juneau, AK 99811-0800
POSITION STATEMENT: Supported SB 154.
Ms. Camille Soleil
Alaska Nurses Association
2207 E. Tudor Rd. Ste. 34
Anchorage AK 99507
POSITION STATEMENT: Supported SB 154.
Ms. Catherine Geissel
Alaska Nurse Practitioner's Association
Anchorage AK
POSITION STATEMENT: Supported SB 154.
Ms. Pat Senner, President
Alaska Nurses Association
2207 E. Tudor Rd. Ste. 34
Anchorage AK 99507
POSITION STATEMENT: Supported SB 154.
Ms. Deb Erickson, Deputy Director
Division of Public Health
Department of Health &
Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Supported SB 154.
Ms. Angel Rick
PO Box 71727
Fairbanks AK 99707
POSITION STATEMENT: Supported SB 154.
ACTION NARRATIVE
TAPE 03-18, SIDE A
SB 121-COMMUNITY SCHOOLS
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 1:31 p.m. All
members were present. He announced SB 121 to be up for
consideration.
SENATOR GRETCHEN GUESS reminded the committee that Senator
Wilken wanted her to find out about fees for the Anchorage
community schools programs. She said last year Anchorage
collected $65,000 in fees and spent approximately $700,000. She
stated:
Although there were some questions and we did get some
faxes, I do think that Eddy Jeans' sheet was wrong,
because in the accounting of community schools,
multiple things go into community schools. This is
just one of, I think, of five or six. So, the sheet we
got was incorrect on how much money is being spent.
SENATOR GARY WILKEN moved to report SB 121 from committee with
individual recommendations and its attached fiscal note.
SENATOR GUESS objected.
MR. CURT LEDFORD, Director, Community Schools, Sitka, said
although the state's portion of Sitka's overall budget is small,
it's seen by the community as state support of the program.
CHAIR DYSON said he supports community schools and that using
unused community facilities along with community talent to
provide a multitude of services is a wonderful deal. He noted:
It's one of the ones the governor highlighted; I wish
it wasn't so. I am willing to pass it on to the
consideration of the Finance Committee and this is not
the end of the track for this.
CHAIR DYSON called for a roll call vote.
SENATORS GREEN, WILKEN, and DYSON voted yea; SENATORS GUESS and
DAVIS voted nay; and SB 121 moved from committee.
SB 30-ABORTION: INFORMED CONSENT; INFORMATION
CHAIR FRED DYSON announced SB 30 to be up for consideration and
called an at-ease from 1:36 to 1:38 p.m. He said the Department
of Health and Social Services (DHSS) and the Department of Law
(DOL) provided conceptual notes about the amendments to SB 30.
The first two notes concern typos. DHSS suggested that it create
a website to keep the pamphlet information updated with access
by agencies to update their particular information as it became
available. That approach decreases the fiscal note from $120,000
to $10,000 and he had not heard a good argument against it.
The DOL suggested offering immunity from prosecution to
providers who distribute the pamphlet or a printout as incentive
for fulfilling the requirements for getting information to the
patient/client.
MS. JANICE DELAND supported SB 30. She related her experience 27
years ago when a doctor told her she had to have an abortion
because she was miscarrying.
MR. SID HEIDERSDORF, Juneau resident, said, "This is much needed
legislation to protect women from unscrupulous abortion
practices."
He thought that abortion counseling was a sham and that most
women are not adequately informed. Many states already require
informed consent of this type. He also added that the 24-hour
waiting period is important because a woman needs some breathing
room from the intimidating atmosphere of a clinic after getting
their information.
MS. KARLEEN JACKSON, Deputy Commissioner, Department of Health
and Social Services, supported SB 30. DHSS is particularly
excited about making the information available on its website.
That would not only allow physicians to download and print out
the information, but it would allow women who have access to an
Internet connection to get the information as they try to figure
out what to do regarding a pregnancy. The fiscal note would be
much lower if the information was on a website.
MS. LINDA BOWDRE, Delta Junction resident, supported SB 30 and
commented that she can't understand why the state has to have a
bill to require doctors to explain a very serious medical
procedure to their patients.
MS. KARI THOMAS, Delta Junction resident, supported SB 30 and
thought the website was a great idea, except that providers need
to be held accountable to make sure they give the information to
the patient.
MS. ROSEANNE CURRAN, Cordova resident, supported SB 30. She
noted, "It just makes sense to have as many facts as possible
before any type of surgery or medical procedure, especially one
as life changing as an abortion."
MS. KAREN VOSBURGH, Mat-Su resident, supported SB 30 saying,
"It's always a good idea to have more information rather than
none or less."
DR. COLEEN MURPHY, OB-GYN, said she has been practicing in
Alaska since 1987 and is an active abortion provider. She has
undergone credentialing and review by the National Abortion
Federation to provide such services. She is currently undergoing
her annual board certification for the American College of OB-
GYN to provide many high quality services, including menopausal
care, gynecologic services, contraceptive services, abortion and
others. She noted that she just paid $10,000 on a premium for
malpractice coverage to practice here. She is accountable to the
American Medical Association's code of ethics for providing
appropriate informed consent and she is held to a preexisting
statute, AS 05.09.555, which discusses informed consent for all
surgical and invasive medical procedures. She concluded by
saying this bill is unnecessary and meddles with private
discussions between a patient and a doctor. She said this would
place obstructions to health care, as many women in Alaska have
to travel from remote places to get abortion services; requiring
a 24-hour wait only raises the cost of the care.
CHAIR DYSON appreciated her mentioning that the Legislature is
putting the language now in the Alaska Administrative Code about
informed consent into statute.
DR. MURPHY interrupted to say that she had just done a vaginal
hysterectomy on a Jehovah's Witness who didn't want blood
products. She suggested if the Legislature is going to
specifically include abortion in statute, it should put all
procedures, like that one, in as well.
CHAIR DYSON replied the difference is that the human rights
issue makes abortion different from other surgical procedures.
He said he might agree that the 24-hour waiting period is an
unfortunate choice and asked whether doctors still inject
laminaria and then wait for a couple of hours as a procedure.
DR. MURPHY replied that the National Abortion Federation does
not recommend the use of cervical dilatation. She explained
that the moment a foreign body is put in the cervix, basically,
the abortion starts. The informed consent for people who use
laminaria actually states that the minute laminaria is used, the
abortion starts.
CHAIR DYSON asked the standard length of time a patient stays
for observation after the procedure.
DR. MURPHY replied that the majority of patients are immediately
observed for excessive blood loss. She explained that there are
two different types of abortions now available - medical and
surgical. The medical procedure involves giving a patient
medicine. The patient can then safely deliver at home as an
abortion. That procedure is growing in usage. The surgical
procedure is done in the office and the patient is observed for
signs of blood loss for approximately a half to one hour
afterwards. She also said that more and more non-obstetrician
gynecologists are getting trained in the use of medical abortion
so they can offer it, if they haven't been surgically trained.
She pointed out, "So, more and more women are actually doing
this at home and it's going to be really hard for you to
regulate that."
CHAIR DYSON said he appreciated her information. He asked if a
patient who flies in from rural Alaska would be able to fly home
on the same day.
DR. MURPHY replied if it's a surgical procedure, patients can
generally fly home the same day. If they have to wait 24-hours
and are using a laminaria procedure, they can return home 48
hours later. She noted that Medicaid pays for a minority of the
abortions done in her office because most women pay for them out
of pocket to avoid creating a paper trail.
MS. THEA PITMANN, Anchorage resident, opposed SB 30, but was not
opposed to trying to reduce the number of abortions that take
place. She said the bad thing about this bill is that it
addresses the issue after a woman is pregnant, instead of
providing opportunities to prevent unwanted pregnancies in the
first place. She urged the committee to do more research on this
issue.
MS. DIETRICH STITLER, Anchorage resident, opposed SB 30. She
related how she was diagnosed with hemophilia at the age of 14
and it is medically dangerous for her to carry a pregnancy to
term because a loss of blood during delivery could potentially
be fatal. She didn't think the government should have a place in
any pregnancy decision she might have to make. Her biggest
concern is with their definition of medical necessity. She might
not fall under that section, because having an abortion at the
very moment would probably not be a life saving measure or an
emergency situation. Her doctor would probably say that a delay
in abortion could create a serious risk or that there is a
significant chance that a delay may create a serious risk. She
said this bill would add costs for additional office visits and
create a waiting period that could increase the risk of
complication.
MS. ROBIN SMITH opposed SB 30. She said it is far more than an
informed consent bill. The 24-hour waiting period makes it
totally biased against rural women by increasing the cost of
whatever stay they have to make in the city. Abortions cost more
than $500 and one of the main reasons second trimester abortions
occur is that women are trying to get funds together to pay for
them. She pointed out the parental consent requirement has
already been struck down by Alaska courts (although it is now in
the Supreme Court, but she thought it would be struck down
again).
MS. SMITH also pointed out that this bill requires the facility
to be state and federally approved and at this point the only
facility that fits that description is Valley hospital. Most
abortions are now conducted in a doctor's office.
MS. PAULINE UDDER opposed SB 30 saying they should not place any
more impediments in front of women who, according to our Supreme
Court, still have the right to choose. She related how her 43-
year old friend will have to fly to Seattle to get an abortion
if it turns out that she is carrying a Downs-syndrome fetus.
TAPE 03-18, SIDE B
CHAIR DYSON thanked all participants for their testimony and set
SB 30 aside.
SB 157-INPATIENT PSYCHIATRIC SERVICES
CHAIR FRED DYSON announced SB 157 to be up for consideration.
SENATOR LYDA GREEN, sponsor, said SB 157 addresses instate and
out-of-state psychiatric facilities, and is particularly
directed toward the children of the state who are either on
Medicaid or in state custody and must leave Alaska to receive
services. This bill requires that those children be placed
instate for psychiatric care as long as a suitable place can be
found.
SENATOR GRETCHEN GUESS asked if the terms "appropriately
address" and "unavailable" are strong enough words to use to
decide if the clinical diagnosis can be addressed in the state.
SENATOR GREEN replied that she thought they provide a moveable
target for each individual that would require a very personal
evaluation.
CHAIR DYSON said he supports this bill, but it seems that the
department would never send someone out of state if an instate
facility was available and that the bill might be superfluous.
He asked what the bill changes.
SENATOR GREEN explained that currently the department cannot
disallow a person from choosing the facility to which he or she
wishes to go, particularly if the person is receiving health
care through the Denali Kid Care program. A little over 200
individuals have been placed in outside facilities with no
review by a state entity. This bill would require that instate
services be exhausted before they are sent outside. It would
also encourage groups to either add on to a current facility,
like a juvenile psychiatric facility, or do some other form of
instate upgrading.
MR. BILL HOGAN, Director, Division of Mental Health and
Developmental Disabilities, DHSS, supported the concept of SB
157, which affirms the current process the department uses to
ensure that instate options are explored before a child is
placed out of state. They feel the bill supports and enhances
the monitoring of those children once they are placed out of
state to determine if they are ready to come back and, if they
are, that there is an instate option available. It supports the
department's view that children should be served in Alaska, in
their own community and as close as possible to their own
family.
CHAIR DYSON asked why these instate services evolved in the past
and whether this piece of legislation removed some of those
impediments.
MR. HOGAN replied he understands that on occasion, instate
options are available and for some reason they are not being
taken advantage of at the time. Another issue is whether or not
adequate funding is available to build instate capacity.
MR. JOHN DUFFY, Manager, Mat-Su Borough, supported SB 157 for
all the reasons stated. He said the state is presently sending
350 children out of state. SB 157 will save the state large
amounts of money as instate treatment is much less expensive and
improves the chances of success in allowing children to be
closer to their family support networks. In addition, SB 157
will bring jobs back to Alaska and reduces the risk for
additional private sector investment in residential treatment
centers by assuring that the state will consider use of them
before sending children out of state.
CHAIR DYSON asked if he anticipates that a state facility might
be started or enhanced in the Mat-Su Valley.
MR. DUFFY replied that the borough has been approached by at
least two firms that are interested in constructing such
facilities out there.
MS. KATHY CRONIN RAPOPORT, Regional Vice President, Universal
Health Services, supported SB 157. She said she is also
responsible for the Universal Health Care facilities in Utah.
She concurred that there are over 350 children in residential
psychiatric treatment centers in the Lower 48. Northstar
Hospital is their inpatient acute care hospital and has 58
patients. Four of them are pending discharge in the next few
days. All four are children on Alaska State Medicaid who are
being referred to treatment centers outside the state on the
recommendation of their caseworker and the outside placement
committee. This is happening while Northstar has nine available
residential treatment beds. She continued:
Referring these kids to treatment centers outside the
state has devastating long-term impacts on the
children, their families, and ultimately on our state.
Mental health treatment should be provided close to
home where we can have good coordination for follow-up
care with the residential treatment provider and the
outpatient provider who will see the patient after
discharge. Most importantly, treatment should involve
the family. Family treatment is a critical element of
children's mental health treatment. Their treatment in
the local community is good for the children, their
family, and it increases their chances for long-term
success...
MS. RAPOPORT agreed that bringing children home for treatment
will encourage providers in the state to expand existing
residential facilities and services and will encourage new
providers to enter the market.
MS. TERRY KEKLAK said she would answer questions.
CHAIR DYSON asked her how much out-of-state placement costs per
day.
MS. KEKLAK replied that she didn't have any specifics, but most
out-of-state rates are in the $325 per day or lower range. She
knew of one child who had a rate of $600 per day, based on
additional medical needs.
SENATOR DAVIS asked her to comment on why children are placed
out-of-state.
MS. KEKLAK replied that for a service to be paid by the Medicaid
program, an interdisciplinary team is required to review the
placement and make a recommendation regarding what is in the
best interest of the child. They look at whether existing state
services are appropriate for that child. With Medicaid, the
child travels to the closest available facility that is found to
meet their medical needs. All inpatient stays are authorized by
an outside contractor who is looking at all the criteria before
an out-of-state admission would be approved for payment.
SENATOR DAVIS asked if the available instate facility can be
turned down in lieu of outside placement and still be covered.
MS. KEKLAK replied no.
SENATOR GUESS asked if they use the same process for state
custody children.
MS. KEKLAK replied that those children have a placement
committee in addition to the Medicaid requirements.
MR. RICHARD RAINERY, Executive Director, Alaska Mental Health
Board, stated that the amendment is in concert with the Board's
philosophy that the community should be involved with the mental
health system.
SENATOR GREEN moved to adopt Amendment 1.
23-LS0179\D.1
Lauterbach
12/1/04
A M E N D M E N T
OFFERED IN THE SENATE BY SENATOR GREEN
TO: SB 157
Page 2, following line 12:
Insert a new subsection to read:
"(c) When determining whether to authorize admission
of a person under 21 years of age to a psychiatric hospital
facility or residential psychiatric treatment center,
either located within the state or outside the state, the
department shall include in its consideration the
recommendations of a person selected by the Alaska Mental
Health Board established by AS 47.30.661 who is selected
for this duty by the board on the basis of being
knowledgeable about the availability of beds in the state
for inpatient psychiatric services for persons under 21
years of age. The board may not select an employee of the
department for this duty."
Page 3, following line 10:
Insert a new subsection to read:
"(m) When determining whether to authorize admission
of a person under 21 years of age to a psychiatric hospital
facility or residential psychiatric treatment center,
either located within the state or outside the state, the
department shall include in its consideration the
recommendations of a person selected by the Alaska Mental
Health Board established by AS 47.30.661 who is selected
for this duty by the board on the basis of being
knowledgeable about the availability of beds in the state
for inpatient psychiatric services for persons under 21
years of age. The board may not select an employee of the
department for this duty."
There were no objections and it was adopted.
MR. RAINERY pointed out that one of the reasons the state
doesn't have facilities like this is because sending kids out-
of-state is a relatively recent phenomenon and, also, the number
of children being sent is no longer a question.
SENATOR GUESS moved to pass CSSB 157(HES) from committee with
individual recommendations and zero fiscal note. There were no
objections and it was so ordered.
SB 84-TEACHER LOAN REPAYMENT PROGRAM
CHAIR FRED DYSON announced SB 84 to be up for consideration.
SENATOR GARY STEVENS, sponsor, said the teacher shortage will be
even more of a problem with passage of the federal No Child Left
Behind laws. SB 84 will set up the Alaska teacher recruitment
loan repayment program, which is designed to help school
districts recruit and retain teachers. It includes repayment of
education loans when the teachers are hired by Alaskan public
elementary or secondary schools. It limits the lifetime
financial award to $10,000 for an individual teacher. The
funding would come from the dividend, which would normally be
returned to the state through the Commission on Postsecondary
Education. The intent is that the program would operate when the
funds are available and if no funding is appropriated by the
Legislature, then no money would be spent. If an individual
leaves a teaching position, they would not receive the loan
repayment that would be made at the end of the school year.
SENATOR STEVENS explained that the proposed amendment is from
the Alaska Postsecondary Commission and clarifies some of the
language and expands the scope of funding sources to include
federal funds and other receipts. He said he didn't know of
anyone who was against this bill.
SENATOR GRETCHEN GUESS asked if this program could be used by
professionals in other shortage areas, like speech pathologists
who don't have teaching certificates.
SENATOR STEVENS replied that it's meant for certificated
teachers in elementary or high school.
SENATOR GUESS asked if they are only going to repay loans in
areas of shortage or is this for all teachers.
SENATOR STEVENS replied that the specifics would be developed by
the Postsecondary Commission. His intent is that it's for any
position.
SENATOR GARY WILKEN said he had some reservations with this
bill, as well as SB 154. He understands the financial burden of
going to school, but he was concerned that this is slippery
slope legislation. He came to the Legislature just as the
student loan program was starting to dig itself out of the
problems of the 80s and 90s when it was a give-away program. The
program is now robust and has brought money back to the state.
They have brought back about $5 million for the fourth year in a
row.
SENATOR STEVENS shared his concerns, but said this would not
make the fund any less healthy than it is now, but it would
simply reduce the dividend that the state receives. Every year
the Legislature would have to fund the program.
MS. DIANE BARRANS, Executive Director, Alaska Commission on
Postsecondary Education, explained the amendments and noted that
the sponsor was very proactive on getting the commission's input
on this bill. One of the amendments insures that the criteria is
efficient to administer and does not require costly activity.
The second amendment is on page 3, line 14, after "AS 14.42.295"
to insert "or any federal or other funds", the objective being
to capture any funding that is available for a program of this
kind. The others are technical changes.
SENATOR WILKEN moved to adopt Amendment 1. There were no
objections and it was so ordered.
MS. BARRANS responded to Senator Wilken's concerns saying that
this bill, rather than requiring additional funds to be expended
from the Student Loan Corporation to pay benefits under this
program, it would simply be an earmarking in statute that when
the dividend is calculated and goes back to the state, the
Legislature would use those funds to endow the fund from which
benefits are paid.
SENATOR WILKEN said that the fiscal note shows 807 new hires
would participate in the program each year.
MS. BARRAN responded that was correct and added that a recent
study of openings each year showed about 1,600 teacher vacancies
and about half of those are estimated to be new teachers who
would still have educational debt. They did not build in any
growth estimate and the details of the payments would have to be
worked out in regulation.
How I would recommend that it be structured is that
when someone agrees to participate in this program, we
identify what their total debt is at that time. We
actually set aside the amount of funds that we would
need to pay to meet its obligation to this participant
so we would essentially encumber funds on their
behalf. What I don't want to be in the position of
doing is telling someone there is going to be a
benefit for them and then not have the funds
available. I don't' want to come back to the
legislature...One of the things I see the commission
being charged with is to monitor the amount in the
fund and to monitor the amount that's been obligated
to current participants and only enroll new
participants when funding is available.
SENATOR WILKEN said that was where his concern lay - if one year
they needed all of the $5 million of the dividend, they would
not fund that particular year. There would be a clamor to
continue the funding over and above the $5 million. He asked if
they were funding at the $500,000 level, would she prorate that
through the debt or through the number of participants.
MS. BARRANS replied that she could see either scenario occurring
depending on a number of variables. The amount of controls put
in place will affect whether or not that can occur. Her
objective would be for it not to occur. Since the board is given
some latitude to set the criteria for the program, they might
define critical shortage areas and target the money to those
areas.
SENATOR WILKEN asked her if she saw any problems with trying
this for five years.
MS. BARRANS answered that was more of a political question than
a financial question and, if it was structured correctly at the
outset, they would not be in a financial hole in terms of being
obligated to pay benefits.
SENATOR WILKEN complimented Ms. Barrans on running a great show.
MS. MARY FRANCIS, Executive Director, Alaska Association of
School Administrators, supported SB 84.
TAPE 03-19, SIDE A
MS. FRANCIS said that last year only about 300 educators came in
to look for Alaskan jobs.
MR. JOHN ALCANTRA, Government Relations Director, National
Education Association, supported SB 84 for all the reasons
stated previously.
SENATOR WILKEN moved to report SB 84 from committee with
individual recommendations and attached fiscal note. There were
no objections and it was so ordered.
SB 154-NURSE EDUC LOAN REPAYMENT PROGRAM
CHAIR FRED DYSON announced SB 154 to be up for consideration.
SENATOR HOLLIS FRENCH, sponsor, said that a main question for
him was to whom to make the loans available. Just making them
available to Alaskans wouldn't produce enough nurses to fill the
gap.
We're thousands and thousands of nurses behind where
we need to be and so we realized as we worked our way
through the problem and got familiarized with it is we
had to not only make it available to Alaskans going to
Alaskan nursing schools, but make it available to any
person who wanted to come here and become a nurse.
The next thing he thought about was the length of the repayment
period. Part of the reason they came up with paying someone back
for five years is by letting them work in the Alaskan economy
for that long, they would come to know and love the state and
stay. The available funding is capped at $10,000 because that is
about what it would cost to go to an Alaskan nursing school. To
the slippery slope issue he responded that most programs have
those problems and you just have to draw the line somewhere.
SENATOR GARY WILKEN said his comments on the prior bill apply to
this one as well.
MR. RICK URION, Director, Occupational Licensing, said the
administration hadn't taken a position on this bill, "But, it is
an exceptionally good idea."
He said the Board of Nursing is a good place for it to be and
pointed out that the cost of the board is born by the nurses.
But, the cost of this program is probably outside of that
purview and the legislature might want to find funding for the
program other than from the licensees, themselves.
MS. CAMILLE SOLEIL, Alaska Nursing Association, said she
appreciated their support of this bill.
MS. CATHERINE GEISSEL, Alaska Nurse Practitioner's Association,
supported SB 154. She said it is in the best interests of
Alaska's public safety to increase the number of nurses
positions that are currently being filled by unlicensed
personnel who make mistakes.
MS. PAT SENNER, President, Alaska Nurses Association, supported
SB 154. She showed them a graph indicating that the average age
of a nurse in this state is 45 to 46, with 72 percent of them
being over the age of 40. The graph should not be a bell curve.
Most hospital nurses have to retire in their 50s, because they
can no longer do the heavy work required of them. It is
estimated that in the next 5 to 10 years, 50 percent of the
nursing workforce will leave. The School of Nursing is doubling
their number of graduates by 2006. Part of the funding for that,
$2.25 million, came from the private sector and the other part
from the university. This bill is encouraging the individual to
consider a nursing career and to stay in it.
MS. DEB ERICKSON, Deputy Director, Division of Public Health,
supported SB 154 for all of the stated reasons. She added that
Alaska's senior population is expected to triple by 2025 and an
aging population has attendant increases in chronic diseases and
other health problems, which will add to the demand side of this
problem. The nursing shortage affects quality of care, access to
health care and cost of health care. "This program will provide
a financial incentive for recruitment and retention of nurses
that will benefit all Alaskans."
MS. ANGELA RICK, nursing student, asked if money was coming from
the federal program.
SENATOR FRENCH explained that they wrote the bill so that it
could some day receive money from that source, but it's not
anticipated they would get it at this point.
MS. RICK said she supported this bill.
SENATOR WILKEN moved to pass SB 154 from committee with
individual recommendations and attached fiscal note. There were
no objections and it was so ordered.
CHAIR DYSON adjourned the meeting at 3:23 p.m.
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