01/28/2004 01:35 PM Senate HES
| Audio | Topic |
|---|
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
January 28, 2004
1:35 p.m.
TAPE(S) 04-2&3
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Lyda Green, Vice Chair
Senator Gary Wilken
Senator Gretchen Guess
MEMBERS ABSENT
Senator Bettye Davis
OTHER LEGISLATORS PRESENT
Senator Con Bunde
COMMITTEE CALENDAR
OVERVIEW: IMPROVING ALASKA'S ASSESSMENT SYSTEM
COMMISSIONER ROGER SAMPSON, DEPARTMENT OF EDUCATION AND EARLY
DEVELOPMENT
CS FOR HOUSE BILL NO. 260(JUD)
"An Act relating to immunity for free health care services
provided by certain health care providers; and providing for an
effective date."
MOVED SCS CSHB 260(HES) OUT OF COMMITTEE
SENATE BILL NO. 217
"An Act relating to genetic privacy; and amending Rule 82,
Alaska Rules of Civil Procedure, and Rule 508, Alaska Rules of
Appellate Procedure."
MOVED CSSB 217(HES) OUT OF COMMITTEE
PREVIOUS ACTION
BILL: HB 260
SHORT TITLE: IMMUNITY FOR PROVIDING FREE HEALTH CARE
SPONSOR(s): REPRESENTATIVE(s) SEATON
04/11/03 (H) READ THE FIRST TIME - REFERRALS
04/11/03 (H) L&C, JUD
04/28/03 (H) L&C AT 3:15 PM CAPITOL 17
04/28/03 (H) Moved CSHB 260(L&C) Out of Committee
04/28/03 (H) MINUTE(L&C)
04/30/03 (H) L&C RPT CS(L&C) 2NR 5AM
04/30/03 (H) NR: LYNN, ROKEBERG; AM: GATTO,
04/30/03 (H) CRAWFORD,GUTTENBERG, DAHLSTROM,
04/30/03 (H) ANDERSON
05/09/03 (H) JUD AT 1:00 PM CAPITOL 120
05/09/03 (H) Moved CSHB 260(JUD) Out of Committee
05/09/03 (H) MINUTE(JUD)
05/10/03 (H) JUD RPT CS(JUD) 6DP
05/10/03 (H) DP: HOLM, GARA, OGG, GRUENBERG,
05/10/03 (H) SAMUELS, MCGUIRE
05/19/03 (H) TRANSMITTED TO (S)
05/19/03 (H) VERSION: CSHB 260(JUD)
05/20/03 (S) READ THE FIRST TIME - REFERRALS
05/20/03 (S) HES, JUD
01/28/04 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 217
SHORT TITLE: GENETIC PRIVACY
SPONSOR(s): SENATOR(s) OLSON
05/09/03 (S) READ THE FIRST TIME - REFERRALS
05/09/03 (S) HES, JUD
01/28/04 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
MS. PATRICIA SENNER, Advanced Nurse Practitioner (ANP);
Chair of the legislative committee,
Alaska Nurses Association (ANA)
POSITION STATEMENT: Supports HB 260, with concerns.
DR. MICHAEL NORMAN, Physician
Alaska Physicians and Surgeons
Anchorage, AK
POSITION STATEMENT: Supports HB 260.
REPRESENTATIVE PAUL SEATON
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of HB 260.
MR. CAMERON YOURKOWSKI
Staff to Representative Paul Seaton
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Provided information pertaining to HB 260.
MS. KARA NYQUIST, Attorney
Director of Advocacy,
Covenant House Alaska;
Legislative chair,
Alaska Association of Homes for Children (AAHC)
POSITION STATEMENT: Supports HB 260.
MR. CHIP WAGONER
Alaska Association of Homes for Children (AAHC);
Alaska Catholic Conference
POSITION STATEMENT: Supports HB 260.
SENATOR DONNY OLSON
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of SB 217.
MR. JOHN GEORGE
American Council of Life Insurers (ACLI)
POSITION STATEMENT: Testified that ACLI has substantial
problems with SB 217.
MR. JOHN MALLONEE
Child Support Enforcement Division (CSED)
Department of Revenue (DOR)
th
550 W. 7 Ave. Suite 310
Anchorage, AK 99501
POSITION STATEMENT: Answered questions pertaining to SB 217.
MR. CHRIS BEHEIM
Scientific Crime Detection Laboratory
Department of Public Safety (DPS)
5500 E. Tudor Rd.
Anchorage, AK 99507-1221
POSITION STATEMENT: Answered questions pertaining to SB 217.
TAPE 04-2, SIDE A
CHAIR FRED DYSON convened the meeting of the Senate Health,
Education and Social Services Standing Committee at 1:35 p.m.
Present were Senators Green, Wilken and Chair Dyson. Senator
Guess arrived shortly thereafter. Also present was Senator
Bunde.
SUMMARY OF INFORMATION
ROGER SAMPSON, COMMISSIONER, Department of Education and Early
Development (DEED), announced that the PowerPoint presentation
was a response to questions from a number of legislators
concerning the reasons that the department went to a competitive
bidding process for the Alaska assessment system. For purposes
of history, in June 2003, Mr. Sampson was appointed to the
position of commissioner. Immediately, he was faced with urgent
issues such as the federal No Child Left Behind Act (NCLB) and
the state testing system. It became clear that several common
themes were present in the state testing system: testing occurs
too early in the school year; excessive delays in receiving
results from testing; time windows for retaking tests are too
limited and inflexible; the state is not in compliance with NCLB
concerning assessments; and the state's contract costs for
assessments are high and escalating. In addition, the State
Board of Education and Early Development recently adopted a goal
to reform the state's testing system to: provide instructional
value; align with state standards, provide a method to measure
growth; and to ensure timely receipt of results.
COMMISSIONER SAMPSON said he attempted to address concerns by
first working with the state's current contractor, CTB/McGraw-
Hill, who responded that little could be done to ameliorate
these concerns. Commissioner Sampson was faced with a choice: to
continue with the current sole source contractor, who was
unwilling or unable to make necessary improvements, or to use
the competitive bid process. Before choosing between these
alternatives, he contacted other states to find out if their
contractors were addressing similar issues. He learned that
since NCLB was enacted, many more companies are beginning to
offer testing services, which created a competitive atmosphere
that benefits states, especially in the areas of scheduling,
scoring, turnaround time of results, data collection, reporting,
and lower costs.
COMMISSIONER SAMPSON continued that currently, NCLB imposes
several requirements on state testing systems. States must
annually test all students in grades 3-8 and one high school
level in reading and math. State assessments must be aligned
with state standards, not national standards. Also, testing will
demonstrate accountability of schools and school districts, not
accountability for students. Alaska's current Benchmark test in
grades 3, 6, and 8 operates according to Alaska standards and
will need additional questions in order to fulfill NCLB
requirements. The Terra Nova program uses national standards in
testing grades 4, 5, 7, and 9. This program also falls short of
NCLB requirements and will require a second test based on state
standards. Finally, the High School Graduation Qualifying
Examination (HSGQE) is based on Alaska standards, but will need
to include an advanced level in order to comply with NCLB.
COMMISSIONER SAMPSON maintained that although these testing
programs are currently noncompliant with NCLB, the tests are
effective in that they achieve the goals for which they were
designed. These tests were created by Alaskans to focus on
Alaska standards, to provide comparison with national test
scores, and to ensure students had minimal reading, writing, and
math skills before receiving a diploma. The NCLB requirements
came after, without considering the current goals of the state.
He said Alaska could meet each requirement of NCLB and still
fail to improve student performance. The needs of students,
teachers, and parents should not be sacrificed in order to reach
compliance with NCLB.
COMMISSIONER SAMPSON told members that the competitive bid
process will not change Alaska standards, district curriculum or
instructional materials, performance bars, or the amount of work
completed previously with the testing system. Other
misconceptions exist as well, such as: Alaska's assessment
system is compliant with NCLB; Alaska will discontinue testing
that references national norms; new tests will not contain
responses other than multiple choice; and competitive bidding
will increase costs to the state. In actuality, the competitive
bid process will benefit the state in several aspects. The
process will provide increased instructional value and ability
to track student progress from year to year. Alaska standards
will be more widespread. Results will be received in a timelier
manner. Compliance with NCLB will be achieved, and costs will be
decreased. Initiating the competitive bid process, Commissioner
Sampson concluded, has been logical, sequential, and founded in
"basic common sense."
SENATOR WILKEN shared that the Fairbanks School District is
unsupportive of this move to a competitive bid process and asked
how it could be proven that this move will not lower
proficiency.
LES MORSE, Director, Assessment and Accountability, DEED,
offered that the department has declared and attempted to not
change test scores. Potential contractors were asked to develop
strategies to ensure accurate comparison between scores.
SENATOR WILKEN reported that Alaska's current position was
achieved over five years with the massive efforts of hundreds of
people and state costs of $18 million. Considering the current
controversy surrounding the HSGQE, moving to a competitive bid
process seems abrupt and wasteful of previous efforts. He asked
about the department consultation process.
COMMISSIONER SAMPSON responded that the department has met with
principals, superintendents, school board members, and the
National Education Association - Alaska. Senator Wilken
continued that he has received much feedback suggesting that the
department has not actively sought stakeholder involvement and
collaboration in the discussions and plans to initiate a
competitive bid process. Mr. Morse explained his contact with
consultants in September through November 2003. In response to a
question from Senator Wilken, Commissioner Sampson maintained
that although it has taken the state five years and $18 million
dollars to get to our current status, our plan-to change
direction and reach a different goal in nine months-is
achievable and defensible. Mr. Morse continued that such a
challenge has been in focus since the beginning of the
consultation process, and each request for proposal asked each
potential contractor how he or she would respond to that
challenge. He also reported that consultants have offered
strategies to develop methodologies that use data from current
testing programs to meet new requirements. In response to
questions from Senator Wilken, Commissioner Sampson reaffirmed
the state's commitment to maintaining some form of nationally
normed test.
SENATOR GUESS asked whether students in grades 4, 5, 7, and 9
would be tested twice annually.
COMMISSIONER SAMPSON responded "not necessarily." This issue has
not been resolved at this point. In response to a question from
Senator Wilken, Mr. Morse spoke to the need to change testing
dates for Benchmark tests to more accurately measure skills
learned during specific years of study. In response to another
question from Senator Wilken, Commissioner Sampson explained the
dramatic escalation of testing costs as due to increased exit
examinations, Benchmark testing, field testing, and compliance
with NCLB. Senator Wilken restated his concern that most people
do not understand the Department's recent change in light of
past time and expenditures. Also, he continued, there is great
need to proceed with consideration of the amount of unsatisfied
feedback and attention to accountability for students, teachers,
parents, and schools. Commissioner Sampson offered his belief
that the testing atmosphere will experience continual change in
the future. In response to a question from CHAIR DYSON,
Commissioner Sampson stated that, in terms of turnaround time,
new proposals indicate that results maybe received from two to
four weeks after testing, depending on priority. The current
system often takes two to four months.
ANNOUNCEMENTS
During the above question-and-answer session of DEED's
presentation on Alaska's assessment system, CHAIR DYSON informed
members that due to time constraints, the committee would hear
testimony from medical professionals pertaining to HB 260. Then
the committee would take up HB 260, followed by SB 217. [The
committee heard testimony from the following two medical
professionals.]
MS. PATRICIA SENNER, advanced nurse practitioner, and chair of
the legislative committee for the Alaska Nurses Association
(ANA), testified via teleconference in support of HB 260. ANA's
interest in the bill stems from efforts over the past two years
to set up a network of nurses willing to volunteer in the event
of an emergency. The issue of liability coverage for volunteers
repeatedly arises during these planning efforts. She testified
as follows:
Our primary concern with HB 260 concerns the wording
the section 09.65.290(3) where the immunity for
providing free health care services applies to
services provided in a "medical clinic, medical
facility, non-profit facility or facility owned by a
municipality, the state or the US government. This
attaches the exemption from civil damages to a
physical location.
Our concern is that in an event of an emergency,
services might be provided in a physical location
other than defined above. A good example occurred
this last summer when the wildfires hit Southern
California. There the Red Cross set up emergency
shelters in a warehouse. The actual facility may have
been owned by a private for-profit entity, but the
services were provided by the non-profit Red Cross.
Because we know that lawyers are great getting very
literal in their interpretation of statute wording, we
would prefer that the term "temporary emergency
facility" be added to the list of places where the
exempt health care is provided.
We also wish to state that the Alaska Nurses
Association is in favor of the Section 09.65.290(5)A
requiring informed consent from individuals receiving
free health care services. This should be easily
implemented in all but the most extreme emergencies.
CHAIR DYSON asked if Alaska's "Good Samaritan" law protects
voluntary rendering of assistance in emergencies.
MS. SENNER responded that there is a section that deals with a
person or hospital rendering emergency care or emergency
counseling. This section would be fine in a severe disaster
because the person rendering aid determines that the person
needs aid to avoid serious harm or death. A lot of the services
offered in Red Cross shelters are for people who have chronic
health care situations who are not in serious immediate danger
or harm. With chronic illnesses such as diabetes, access to
normal healthcare supplies have been displaced; that's a
different type of service.
DR. MICHAEL NORMAN, physician in Anchorage representing Alaska
Physicians and Surgeons, testified that he is a 59-year old
anesthesiologist who has lived in Alaska for 24 years and hopes
to stay in Alaska and to provide community services after
retirement. There is an untapped resource in Alaska of retired
physicians capable of rendering service but who cannot afford
medical malpractice insurance. This legislation would free up
many healthcare providers, allowing for a win-win situation for
both healthcare providers and patients.
CSHB 260(JUD)-IMMUNITY FOR PROVIDING FREE HEALTH CARE
REPRESENTATIVE PAUL SEATON, sponsor of HB 260, explained that
this measure is an attempt to encourage health care workers and
providers of volunteer services to Alaskan residents who would
otherwise be unable to afford proper health care. HB 260
encourages volunteerism by providing immunity from liability for
civil damages, "resulting from an act or omission in providing
health care services," that are provided free of charge.
REPRESENTATIVE SEATON said CSHB 260(JUD) does not provide
immunity from civil damages resulting from gross negligence,
recklessness, or intentional misconduct. Consumers would be
protected by the requirement that providers must still act
within the scope of their current licenses, must provide
services at an appropriate facility, and must provide advance
written notice of immunity and obtain written consent. CSHB
260(JUD) is consistent with the Volunteer Protection Act that
passed Congress in 1997. Forty-three other states have adopted
similar legislation. This bill has the support of Alaska
Physicians [Association], Covenant House, Alaska Nurses
Association, AARP, the Naturopathic Physicians, the Alaska State
Hospital and Nursing Home Association, and many others.
REPRESENTATIVE SEATON added that all providers under this act
must be licensed by the Division of Occupational Licensing.
Those providers are regulated by boards, except dental
hygienists and naturopaths; dental hygienists are regulated by
the Board of Dental Examiners and naturopaths must have four
years of college and pass the national naturopath licensing
examination. He noted that nurse midwives are covered as
advanced nurse practitioners and are regulated by the Board of
Nursing. He offered to answer questions.
CHAIR DYSON asked Representative Seaton to respond to Ms.
Senner's question about adding "temporary emergency facility" to
AS 09.65.290 (page 2, section 3).
REPRESENTATIVE SEATON said he thought that was covered under AS
09.65.090(a), but it might need further clarification.
Subsection (a) provides immunity to a person at a hospital or at
any other location who renders emergency care or emergency
counsel to an injured, ill or emotionally distraught person. He
said he is agreeable to further clarification if the committee
wishes to do that.
CHAIR DYSON asked Representative Seaton if the section he quoted
was the "Good Samaritan stuff."
REPRESENTATIVE SEATON said it is.
CHAIR DYSON noted Ms. Senner's point was that the Good Samaritan
provision applies to a person who might stop to help a victim
alongside the road, not necessarily a temporary facility set up
at the scene of an emergency.
REPRESENTATIVE SEATON said he did not intend to exclude such
facilities.
CHAIR DYSON asked that he and staff consider additional
clarifying language.
SENATOR GUESS suggested using the phrase, "temporary medical
facility."
2:38 p.m.
SENATOR GREEN asked if this act would bring Alaska under the
Volunteer Protection Act as passed by Congress and questioned
why the state must do anything.
REPRESENTATIVE SEATON explained that CSHB 260(JUD) is consistent
with the provisions of the Volunteer Protection Act. However,
civil liability suits can be in state as well as federal courts.
That is why 43 other states have adopted similar legislation.
SENATOR GREEN asked if the federal act is cited in HB 260.
REPRESENTATIVE SEATON said it is not.
SENATOR GREEN noted that the federal act is actually quite
different.
SENATOR GUESS said she appreciates Representative Seaton's
intent but pointed out the bigger issue is that CSHB 260(JUD)
limits a person's rights so that providers can offer health
care. She referred to the findings on page 2, lines 4 through
10, and asked whether any proof exists that increased access to
free health care has caused these problems in other states.
MR. CAMERON YOURKOWSKI, staff to Representative Seaton, said he
does not have data on the effect of similar bills in other
states. Medical professionals have told him that some providers
are waiting to utilize this bill and volunteer their services.
SENATOR GUESS asked what a provider would continue to be liable
for and whether medical incompetence would be included in the
exemption.
REPRESENTATIVE SEATON said the provider must be operating within
the scope of his or her current license. He indicated that the
definition of "gross negligence" is in statute and where it is
not defined, the court determines the definition on a case-by-
case basis. He stated:
The whole thrust of this is to take it out of an act
of omission or simple negligence because gross
negligence - I mean somebody can always sue and if the
court determines it's gross negligence, the person is
liable. The reason it was put in on the House side -
we added the language about informed consent - was
that we have it so that anybody that comes into a
clinic or any other place and receives free medical
services must sign that they understand that they are
... receiving this from a health care professional who
will not be liable for not doing enough tests, ... and
those kinds of things, which are the normal kind of
suits that are experienced.
SENATOR GUESS responded, "I'll let Judiciary handle this but
there is still some liability in this for people who are just
incompetent."
REPRESENTATIVE SEATON agreed and said nothing in CSHB 260(JUD)
exempts the facility itself. Therefore, a clinic that offers
services has oversight responsibility for any patients served
there and would be liable.
SENATOR GUESS referred to the language on page 2, line 29, and
asked if a standard definition exists of "advance written
notice." She expressed concern about language barriers and
illiteracy.
MR. YOURKOWSKI replied that the standards for advance written
notice are in statute.
SENATOR GREEN asked if advance written notice could be a placard
on the counter.
MR. YOURKOWSKI said, basically, the patient must sign an
acknowledgement provided by the physician or nurse.
SENATOR GUESS asked for a copy of one. She then asked how this
might apply to a person who has health insurance or the means to
pay even though the health provider is not being paid. She
agreed this might sound odd but said in some communities the
local clinic might be the closest place to get care.
REPRESENTATIVE SEATON said this bill does not address the issue
of needs-based services; it simply addresses liability for the
health care provider. He presumed that a clinic would look at
the financial means of the people it serves.
SENATOR GUESS said her district has a variety of clinics, some
are free and some are not. Having clients with insurance
coverage sometimes helps a facility to provide services to
others who do not. She clarified that she was speaking to a
situation in which a person went to a clinic and showed proof of
insurance and did not ask for free services. However, after
feeling wronged by the provider, that person lost in court
because the doctor volunteered his or her services and was
exempted.
REPRESENTATIVE SEATON said he believes that situation would be
covered by the fact that the client must receive and sign a
written notice before receiving services.
SENATOR GREEN asked if any other professions are exempt from
liability if its members provide free services.
REPRESENTATIVE SEATON replied that several immunity bills have
passed the Legislature, one provided immunity from certain
liabilities for pilots who transport people for no pay. He said
most professions, such as plumbers, do not offer volunteer
services.
SENATOR GUESS referred to the language on page 3, line 4, and
expressed concern that the following language is ambiguous:
This section does not preclude a health care provider
from receiving payment or being reimbursed for
expenses, including travel and room and board while
providing voluntary services;
She questioned whether that language is tight enough to be
defined as a volunteer service.
REPRESENTATIVE SEATON told members the legislative drafter
believes it is. The intent of that language is to provide
immunity to health care providers who travel to villages to
offer free services but are reimbursed for travel expenses.
SENATOR GUESS shared Senator Green's concern and asked
Representative Seaton to consider specifying in a future draft
that the payment be for travel, room and board only.
SENATOR GREEN felt the language was too broad because most
people traveling to a village would be providing services at a
government run or Native corporation health care facility.
2:47 p.m.
CHAIR DYSON took public testimony.
MS. KARA NYQUIST, Director of Advocacy at Covenant House Alaska
and a licensed attorney in Alaska, told members she provides pro
bono services for youth at the Covenant House and is the
legislative chair for the Alaska Association of Homes for
Children (AAHC). She explained that the Association is made up
of 20 different service providers throughout the state.
Collectively, those providers offer a continuum of care for
homeless and at-risk youth and children and youth in need of
mental health services. She stated support for CSHB 260(JUD) and
noted that Covenant House and several other agencies are already
providing free health care to homeless youth, who are obviously
low-income as well. Covenant House employs a full-time nurse
practitioner and has received requests from others who would
like to volunteer. They have been prevented from volunteering
because of their concerns about medical malpractice. For
example, last year a military doctor wanted to provide services
at Covenant House but her malpractice insurance did not cover
civilian care.
MS. NYQUIST said the Covenant House provides services 24 hours
per day to homeless youth at its crisis center. It also provides
health care on a walk-in basis to youth and has two transitional
living programs at which it provides free health care to youth
in transitional living. She hopes this bill will encourage more
people to volunteer. The bill also covers chiropractic care,
ophthalmologists, dental assistants and dentists. CSHB 260(JUD)
is necessary because it will help protect the health, safety and
welfare of Covenant House clients and other citizens. Its
clients are often in need of immediate medical care and are
unlikely to make appointments at clinics. Many clients have
communicable diseases and STDs. Covenant House is able to
provide services to those clients to minimize risk to others.
MS. NYQUIST told members that Covenant House has been
experiencing an increase in the request for services at its free
clinic. Several family practitioners in Anchorage do not accept
Medicare or Medicaid patients so, although some of Covenant
House's clients do have coverage, they have difficulty finding
practitioners who will provide services. The clinics that
provide services on a drop-in basis are often full with middle
class citizens. Volunteer providers will help Covenant House
offer more service to those in need.
MS. NYQUIST told members that as an attorney, she feels
comfortable with the language in the bill. Citizens are
frequently asked to waive their rights for free services and
those waivers of immunity are often much more inclusive than the
waiver requested in the bill. Waivers for other services often
include immunity from gross negligence or intentional
misconduct. This bill does not request such broad limitation of
liability.
MR. CHIP WAGONER, also representing the Alaska Association of
Homes for Children, told members the AAHC endorsed this
legislation at its spring meeting. He said he is also
representing the Alaska Catholic Conference, which met last week
and also supports CSHB 260(JUD).
SENATOR GUESS asked if providers of free mental health services
are also immune from liability.
REPRESENTATIVE SEATON affirmed that they are. He clarified that
the federal legislation defines "volunteer" as:
an individual performing services for a non-profit
organization or a governmental entity who does not
receive a compensation other than reasonable
reimbursement or allowance for expenses actually
incurred.
SENATOR GUESS questioned whether that is referenced in CSHB
260(JUD).
SENATOR GREEN noted that she would look into that question.
CHAIR DYSON noted that psychiatrists are licensed doctors so
they would be covered under the words "licensed physician" in
the definition in the bill.
CHAIR DYSON proposed the following housekeeping amendment
[Amendment 1]:
On page 1, line 7, delete 2003 and replace with 2004
On page 3, line 20, delete July 1, 2003 and insert
"immediately under AS 01.10.070(c)"
He noted that without objection, Amendment 1 was adopted.
CHAIR DYSON then moved Amendment 2:
On page 2, line 20, after "nonprofit facility," insert the
words "temporary emergency site"
REPRESENTATIVE SEATON said he was agreeable to that change.
CHAIR DYSON asked if anyone objected.
SENATOR GUESS asked Chair Dyson if he was confident that "emergency"
is defined in statute.
SENATOR GREEN believed that to be a problem because, "It'd always be
an emergency."
SENATOR GUESS asked Representative Seaton to be prepared to address
that question in the Senate Judiciary Committee.
CHAIR DYSON asked Senators Guess and Green if either had language
they would prefer to insert on page 3, line 4.
Neither did.
CHAIR DYSON asked if they preferred to hold the bill in committee or
if they would agree to allow the Senate Judiciary Committee to
address it.
SENATOR GREEN said she did not object to moving it out but believes
that language needs to be discussed.
REPRESENTATIVE SEATON said he would ask the legal drafter to address
that question.
CHAIR DYSON noted that without further objection to Amendment 2, it
was adopted.
SENATOR WILKEN moved to report SCS CSHB 260(HES) from committee with
individual recommendations.
CHAIR DYSON announced that without objection, the motion carried.
3:00 p.m.
SB 217-GENETIC PRIVACY
The committee took up SB 217.
CHAIR DYSON asked for a motion to adopt Version D as the work draft
before the committee.
SENATOR WILKEN so moved.
CHAIR DYSON announced that without objection, Version D was before
the committee.
SENATOR DONNY OLSON, sponsor of SB 217, explained to members this
legislation is his attempt to get a handle on the complicated issue
of genetic privacy. His sponsor statement follows:
On June 26, 2000, The Human Genome Project, a public
consortium, and Celera Genomics, a private company, jointly
announced the completion of a 'working draft of the human
genome,' spelling out the 3 billion 'letters' of the human
genome - the biochemical messages encoded in our DNA for
manufacturing and operating a complete human being.
This is the stepping-stone in deciphering the blueprint
that makes us human. Every human cell - hair, blood,
fingernail parings, and body tissue - carries a complete
set of our genes. Consequently, these genetic profiles
will yield information that could be used against us. For
example, insurance companies can decide whether to issue
life insurance based upon our gene make-up, i.e.,
predisposition to cancer, alcoholism, or other health
concerns.
We have state laws to restrict access to medical records;
however, the State of Alaska has yet to specify any
protection of genetic information. Medical information is
presumed confidential, but the increasing capability to
store and rapidly transfer data escalates the challenge of
protecting privacy.
At the present time, there is no national statute regarding
genetic privacy laws. Fifteen states have required informed
consent for a third party to perform or require a genetic
test or to obtain genetic information. Twenty-three states
require informed consent to disclose genetic information.
TAPE 04-3, SIDE B
SENATOR OLSON continued:
I have introduced SB 217 to give special consideration to
the advancing biotechnology and protect our genetic privacy
rights.
SENATOR OLSON told members his intention is not to interfere with law
enforcement, medical necessity, or paternity determination. He said
this is the first step in a multi-step action to try to make sure
each resident in the state has protection for his/her genetic
privacy. He informed members that SB 217 covers all genetic
material.
There being no questions from members, CHAIR DYSON took public
testimony.
MR. JOHN GEORGE, American Council of Life Insurers (ACLI), told
members that SB 217 is aimed largely at insurance companies to
prohibit discrimination. He said by definition in the Alaska
Insurance Code, AS 21, discrimination is permitted but cannot be
unfair. Rates must be adequate and not unfairly discriminatory.
However, anyone can recognize that some people should pay more for
auto insurance based on their characteristics. Although every 16-
year-old male driver may not have an accident, that driver falls
within a class of people with a higher risk than 35-year-old male
drivers. Therefore, insurance, by definition, does discriminate. Life
insurance rates differ for males and females. Companies cannot
discriminate based on rates, but mortality tables show that men and
women have different life expectancies. That information is used to
determine rates.
MR. GEORGE told members that genetic information indicates a person's
propensity [for diseases]. He said the ACLI is very concerned that
"genetic information" is defined broadly enough to exclude any
medical information. The ACLI believes in confidentiality of genetic
information and insurance regulations deal with that issue. However,
once an insurance company has appropriate underwriting information,
it will need to keep that information for the life of the policy to
justify why it put a person in a particular underwriting class. SB
217 indicates that once the information is used, it must be disposed
of. He said the ACLI has substantial problems with the bill. He spoke
with Senator Olson and is in the process of providing suggested
language changes. He noted the sponsor indicated that insurance
underwriting is a main reason for the introduction of the bill. He
said he has not seen Version D before today and is not prepared to
address it. He repeated that the ACLI has some serious problems with
the original bill and that he is willing to work with the sponsor to
come up with some compromise language.
SENATOR GUESS asked for an explanation of how the genetic information
of groups is currently being used by insurance companies.
MR. GEORGE stated:
...first of all, in the broad definition of what is genetic
information, if we're talking about looking at a specific
gene, a propensity for cancer for instance, that is more
specific than information you might find on a questionnaire
- has anyone in your family ever had cancer - but it's
still genetic information. Any information you get from a
blood test - I'm certainly not an expert and I've come late
to the table on this, but they are very concerned that the
information they are getting now they would not be able to.
We don't know what kind of information is going to be
available - readily available in the future.
I think, as the Senator described, they have made vast
progress in unwinding the helix and I guess you come down
to a fundamental question of should people pay a rate for
their insurance based on what their real characteristics
are or should everybody pay the same rate or should we only
have three classes or 12 classes. If we're really talking
about protecting the information, that's already being done
largely. The Division of Insurance has regulations that do
that. If we're talking about future uses, who knows what
that's going to be.
But, they are concerned that information they are getting
now [indisc.] that the consent form would be unique to
Alaska and so that would create an additional
administrative burden because they deal in all 50 states.
They do have a form now that H&SS comes up with that
they're using. They would have to have a separate form.
Failing to do that, if they had an error then there's
fairly substantial penalties. I mean there are lots of
things that just don't quite work here.
SENATOR GUESS asked for a specific example of genetic information the
insurance companies use now that they do not believe they could use
in the future if SB 217 is enacted.
MR. GEORGE said he could not provide one but he would get back to her
with an answer.
CHAIR DYSON said he assumes the Senator's concern is that a huge data
bank could be created in the future involuntarily.
SENATOR GUESS said that is one of her concerns. She also questioned
at what point it would become an involuntary act so that a person
will not be able to purchase insurance without a DNA test.
CHAIR DYSON asked Mr. Mallonee if DNA information is used to prove
and disprove paternity.
MR. JOHN MALLONEE, testifying on behalf of the Child Support
Enforcement Division (CSED), Department of Revenue (DOR), said it is.
CHAIR DYSON asked Mr. Mallonee if anything in this legislation would
inhibit CSED's present use of DNA.
MR. MALLONEE said Version D is written in such a way to protect
CSED's right to use DNA to establish paternity.
CHAIR DYSON asked Mr. Beheim if he is aware of anything in this
legislation that will inhibit crime investigation.
MR. CHRIS BEHEIM, Scientific Crime Detection Laboratory, Department
of Public Safety (DPS), said he is not; the bill appears to exempt
law enforcement from any [restricted use] of DNA in criminal
investigation.
CHAIR DYSON said he is torn between holding the bill in committee for
a week to give Senator Olson and the insurance companies the chance
to weigh in with further suggestions or moving it to the Senate
Judiciary Committee.
SENATOR GUESS stated if the sponsor is willing to work with the
insurance company to come up with better language, the Senate
Judiciary Committee could address that language.
SENATOR GREEN said she would prefer that the sponsor and the
insurance representative report back to the Senate HESS Committee but
she would not hold it up.
SENATOR GUESS moved CSSB 217(HES) and its attached fiscal notes from
committee with individual recommendations.
CHAIR DYSON announced that without objection, the motion carried.
CHAIR DYSON then told members that a group that works with folks who
have lost their drivers' licenses because of alcohol and substance
abuse violations and have served their sentences and are under court
supervision, would like the Legislature to enact legislation allowing
them to get provisional drivers' licenses to drive to work. He has
been asked whether the committee would consider sponsoring such
legislation. He offered to distribute a copy of draft legislation to
members for their consideration.
SENATOR WILKEN announced that Marty Meyer was present today and that
she would be handling all health and social services issues for him.
He noted that Sheila Peterson would continue to handle education
issues for him.
With no further business to come before the committee, CHAIR DYSON
adjourned the meeting at 3:20 p.m.
| Document Name | Date/Time | Subjects |
|---|