04/28/2006 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB442 | |
| SB287 | |
| HB393 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 281 | TELECONFERENCED | |
| += | HB 442 | TELECONFERENCED | |
| += | SB 287 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | HB 393 | ||
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
April 28, 2006
1:34 p.m.
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Gary Wilken, Vice Chair
Senator Lyda Green
Senator Kim Elton
Senator Donny Olson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 442(JUD) am
"An Act relating to the validity of advance health care
directives, individual health care instructions, and do not
resuscitate orders; relating to the revocation of advance health
care directives; relating to do not resuscitate orders; relating
to resuscitative measures; relating to the liability and
discipline of health care providers, institutions, and
facilities; relating to proceedings for judicial relief;
relating to an individual's capacity for making health care
decisions; and providing for an effective date."
MOVED CSHB 442(JUD) am OUT OF COMMITTEE
SENATE BILL NO. 287
"An Act establishing a higher education savings program for
eligible persons who were placed in foster care by the state;
and providing for confidentiality of identifying information of
a beneficiary under the program."
HEARD AND HELD
CS FOR HOUSE BILL NO. 393(HES)
"An Act requiring that certain health care insurance plans
provide coverage for the costs of colorectal cancer screening
examinations and laboratory tests; and providing for an
effective date."
MOVED SCS CSHB 393(HES) OUT OF COMMITTEE
SENATE BILL NO. 281
"An Act relating to interdistrict operation of public schools;
relating to enrollment of students by school districts and
regional educational attendance areas; and relating to charter
schools and correspondence programs."
SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 442
SHORT TITLE: HEALTH CARE DECISIONS
SPONSOR(s): REPRESENTATIVE(s) WEYHRAUCH
02/10/06 (H) READ THE FIRST TIME - REFERRALS
02/10/06 (H) HES, JUD
02/21/06 (H) HES AT 3:00 PM CAPITOL 106
02/21/06 (H) Scheduled But Not Heard
02/23/06 (H) HES AT 3:00 PM CAPITOL 106
02/23/06 (H) Heard & Held
02/23/06 (H) MINUTE(HES)
02/28/06 (H) HES AT 3:00 PM CAPITOL 106
02/28/06 (H) Moved CSHB 442(HES) Out of Committee
02/28/06 (H) MINUTE(HES)
03/03/06 (H) HES RPT CS(HES) NT 4DP 1NR
03/03/06 (H) DP: SEATON, GARDNER, KOHRING, WILSON;
03/03/06 (H) NR: CISSNA
03/24/06 (H) JUD AT 1:00 PM CAPITOL 120
03/24/06 (H) Scheduled But Not Heard
03/27/06 (H) JUD AT 1:00 PM CAPITOL 120
03/27/06 (H) Moved CSHB 442(JUD) Out of Committee
03/27/06 (H) MINUTE(JUD)
03/29/06 (H) JUD RPT CS(JUD) NT 5DP
03/29/06 (H) DP: GARA, COGHILL, GRUENBERG, KOTT,
MCGUIRE
04/10/06 (H) TRANSMITTED TO (S)
04/10/06 (H) VERSION: CSHB 442(JUD) AM
04/12/06 (S) READ THE FIRST TIME - REFERRALS
04/12/06 (S) HES, JUD
04/21/06 (S) HES AT 1:30 PM BUTROVICH 205
04/21/06 (S) -- Meeting Canceled --
04/24/06 (S) HES AT 1:30 PM BUTROVICH 205
04/24/06 (S) POSTSECONDARY TUITION FOR FOSTER
CHILDREN
04/25/06 (S) JUD AT 8:30 AM BUTROVICH 205
04/25/06 (S) Scheduled But Not Heard
04/28/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 287
SHORT TITLE: POSTSECONDARY TUITION FOR FOSTER CHILDREN
SPONSOR(s): SENATOR(s) ELLIS
02/13/06 (S) READ THE FIRST TIME - REFERRALS
02/13/06 (S) HES, FIN
04/21/06 (S) HES AT 1:30 PM BUTROVICH 205
04/21/06 (S) -- Meeting Canceled --
04/24/06 (S) HES AT 1:30 PM BUTROVICH 205
04/24/06 (S) Bills Previously Heard/Scheduled
04/28/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: HB 393
SHORT TITLE: INSURANCE FOR COLORECTAL CANCER SCREENING
SPONSOR(s): REPRESENTATIVE(s) ANDERSON
01/25/06 (H) READ THE FIRST TIME - REFERRALS
01/25/06 (H) L&C, HES
02/03/06 (H) L&C AT 4:15 PM CAPITOL 17
02/03/06 (H) -- Meeting Canceled --
02/06/06 (H) L&C AT 3:15 PM CAPITOL 17
02/06/06 (H) Moved CSHB 393(L&C) Out of Committee
02/06/06 (H) MINUTE(L&C)
02/08/06 (H) L&C RPT CS(L&C) 5DP 1NR 1AM
02/08/06 (H) DP: CRAWFORD, LYNN, LEDOUX, GUTTENBERG,
ANDERSON;
02/08/06 (H) NR: KOTT;
02/08/06 (H) AM: ROKEBERG
02/14/06 (H) HES AT 3:00 PM CAPITOL 106
02/14/06 (H) Moved CSHB 393(HES) Out of Committee
02/14/06 (H) MINUTE(HES)
02/17/06 (H) HES RPT CS(HES) 6DP
02/17/06 (H) DP: GARDNER, CISSNA, ANDERSON, GATTO,
SEATON, WILSON
02/22/06 (H) TRANSMITTED TO (S)
02/22/06 (H) VERSION: CSHB 393(HES)
02/23/06 (S) READ THE FIRST TIME - REFERRALS
02/23/06 (S) L&C, HES
03/09/06 (S) L&C AT 1:30 PM BELTZ 211
03/09/06 (S) Heard & Held
03/09/06 (S) MINUTE(L&C)
04/04/06 (S) L&C AT 1:30 PM BELTZ 211
04/04/06 (S) Moved CSHB 393(HES) Out of Committee
04/04/06 (S) MINUTE(L&C)
04/05/06 (S) L&C RPT 5DP
04/05/06 (S) DP: BUNDE, DAVIS, ELLIS, SEEKINS,
STEVENS B
04/26/06 (S) HES AT 1:30 PM BUTROVICH 205
04/26/06 (S) Heard & Held
04/26/06 (S) MINUTE(HES)
WITNESS REGISTER
Jacqueline Tupou, Legislative Aide
Staff to Representative Bruce Weyhrauch
Alaska State Legislature
Alaska State Capitol
Juneau AK 99801-1182
POSITION STATEMENT: Presented sponsor statement for HB 442.
Eric Jenkins, Attorney at Law
Representing Providence Anchorage Anesthesia Medical Group
Davis Wright Tremaine, LLP
Suite 800, 701 W. 8th Avenue
Anchorage AK 99501-3468
POSITION STATEMENT: Supported HB 442.
Senator Johnny Ellis
State Capitol Bldg.
Juneau AK 99801
POSITION STATEMENT: Sponsor of SB 287.
Gabriel Aceves, Legislative Aide
Staff to Senator Johnny Ellis
State Capitol Bldg.
Juneau AK 99801
POSITION STATEMENT: Sponsor of SB 287.
Julie Morris, Council
Office of Faith-Based and Community Initiatives
Department of Health & Social Services
PO Box 110601
Juneau AK 99801-0601
POSITION STATEMENT: Supported SB 287.
Mike Lesmann, Community Relations Manager
Department of Health and Social Services
Office of Children's Services
130 Seward Street, Room 406
P.O. Box 110630
Juneau AK 99811-0630
POSITION STATEMENT: Supported SB 287.
Chip Waggoner, Executive Director
Alaska Conference of Catholic Bishops
Archdiocese of Anchorage
Anchorage AK
POSITION STATEMENT: Supported SB 287.
James F. Lynch
Associate Vice President for Finance
University of Alaska Fairbanks
P.O. Box 757500
Fairbanks, AK 99775
POSITION STATEMENT: Supported SB 287
Amanda Metivier, Student
University of Alaska Anchorage
POSITION STATEMENT: Supported SB 287
Emily Nenon
Alaska Government Relations Director
American Cancer Society
1057 W Fireweed Lane # 204
Anchorage AK 99503-1760
POSITION STATEMENT: Supported CSHB 393.
ACTION NARRATIVE
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 1:34:39 PM.
Present were Senators Gary Wilken, Donny Olson, Kim Elton and
Chair Fred Dyson. Senator Lyda Green joined the meeting in
progress.
CSHB 442(JUD) am - HEALTH CARE DECISIONS
CHAIR DYSON announced CSHB 442(JUD) am to be up for
consideration.
1:35:17 PM
JACQUELINE TUPOU, Staff to Representative Bruce Weyhrauch,
Alaska State Legislature, presented the sponsor statement. She
said that this narrowly crafted cleanup bill is simply for
liability relating to people who carry out Advance Health Care
Directives, and that the sponsor does not want to open the whole
issue again.
MS. TUPOU explained that the bill amends the legal standard to
which doctors are held, from "reasonable" to "good-faith". It
also allows doctors to correct their own mistakes when people
have an Advance Health Care Directive. For example, if a patient
with cancer had a Do Not Resuscitate (DNR) directive but broke
his hip and required surgery under anesthesia, the doctor could
revive him if necessary due to a problem resulting from medical
error during that procedure. Furthermore, doctors honoring
Advance Health Care Directives would not be subject to civil
liability if, for instance, relatives disagreed with a decision.
Ms. Tupou emphasized the importance of having the wishes of
people who have an Advance Health Care Directive carried out by
their families and loved ones.
1:37:57 PM
CHAIR DYSON asked whether there had been any opposition to the
bill.
MS. TUPOU answered that there was minor opposition among
attorneys about providing indemnity, but Representative
Weyhrauch, a former president of the Alaska Bar Association, was
familiar with that, and decided that was the best policy.
SENATOR GREEN arrived at 1:38:22 PM.
1:38:28 PM
SENATOR OLSON asked whether the medical community had offered an
opinion on the bill.
MS. TUPOU replied that physicians brought this issue forward and
added that Eric Jenkins Esq. was available via teleconference to
answer questions for the Alaska State Medical Association and
the "physicians and anesthesiologists groups."
1:39:09 PM
ERIC JENKINS, Attorney-at-Law, Davis Wright Tremaine LLP, said
that he was representing Providence Anchorage Anesthesia Medical
Group, and confirmed that his association is very much in favor
of this bill.
SENATOR OLSON asked why the term "attending physician" was
replaced by the term "physician".
MS. TUPOU replied that, as she understands it, the term
"attending physician" is passé, since numerous doctors might see
a patient once he is admitted to a hospital. The sponsor wanted
to clarify that any physician attending a patient would honor
his Advance Health Care Directives.
1:41:34 PM
SENATOR WILKEN moved to report CSHB 442(JUD) am from committee
with individual recommendations and no fiscal note. Without
objection, CSHB 442(JUD) am was reported from the Senate Health,
Education and Social Services Standing Committee.
1:41:59 PM
SB 287-POSTSECONDARY TUITION FOR FOSTER CHILDREN
CHAIR DYSON announced SB 287 to be up for consideration.
SENATOR JOHNNY ELLIS, sponsor, presented the bill. He said that
in any given year there are approximately 1500 children in some
form of foster care in the state due to abuse or neglect in
their homes. Of that number, approximately 300 are 16, 17, and
18 year olds who are aging out of the foster care system and
that the state offers very little, if any, support for these
individuals. He said that SB 287 proposes using existing
agencies and establishing a statute that would allow cooperation
among state agencies, the University of Alaska (UA), the Office
of Children's Services (OCS), and the Office of Faith-Based and
Community Initiatives (OFBCI), to establish education savings
accounts for these children.
SENATOR ELLIS said that the University of Alaska 529 college
savings accounts are managed by T. Rowe Price and are said by
experts to be among the finest educational savings programs in
the nation. He remarked that the 529 savings accounts are a
great tool for getting these children off to a good start.
He emphasized that the proposed arrangement would require
nothing more than a statute and cooperation among existing state
agencies and would not require the establishment of a new
program or new government funding.
1:46:03 PM
CHAIR DYSON moved to adopt SB 287 Version F, as the working
document, and objected for the purpose of discussion.
1:46:18 PM
CHAIR DYSON asked whether people are permitted to establish the
scholarship funds for foster children at the present time.
GABRIEL ACEVES, staff to Senator Johnny Ellis, replied that the
University of Alaska College Savings Plan accepts donations to
open 529 accounts. However, the state does not have a program to
advertise the opportunity for a friend or relation of the
beneficiary to make donations.
1:47:23 PM
SENATOR ELLIS remarked that currently, someone interested in
making such a donation would have no way of knowing who the
foster children are, due to privacy and protection issues. He
said that is why it is necessary to establish cooperation
between the University, OCS, which knows the identities of the
foster children, and OFBCI, which would be responsible for
promoting the idea.
1:48:02 PM
JULIE MORRIS, from the Office of Faith-Based and Community
Initiatives, asked Mike Lesmann, Community Relations Manager for
the Department of Health and Social Services (DHSS), Office of
Children's Services, to join her before the committee.
1:48:42 PM
MIKE LESMANN, introduced himself.
1:48:54 PM
MS. MORRIS said that she is excited about this bill because she
sees the OFBCI as the vehicle to target foster children who have
aged out of the system at 18 and might otherwise end up
homeless, with nothing, and nowhere to go.
She said that the bill would allow the OFBCI to target non-
profits, community and faith-based organizations that would
donate to these programs so that, working together with the the
OCS, they could create a program that is not an entitlement
program. She added that there are a lot of people who want to
contribute to foster care children but have no way to do it.
1:50:35 PM
CHAIR DYSON asked what prevents the OFBCI from doing this now.
MS. MORRIS replied that the office, which has only three
employees, is heavily burdened by the current demands of that
office. She added that it has a tremendous need for technical
assistance and for assistance applying for grants since many
non-profits and faith-based organizations do not know how to
partner with government.
She said that partnering with the OCS makes sense because the
privacy laws governing foster children and children in state
custody are very strict and, through their partnership, OFBCI
could maintain that confidentiality and still provide a service
to these kids.
1:52:23 PM
CHAIR DYSON said that his question was "What keeps you from
doing it?" and part of her answer was that OFBCI does not have
the manpower. He remarked that he does not see how this bill
would change that.
MS. MORRIS replied that their office has only been in existence
for a year and is still trying to establish itself. She said
that about $275,000 was cut from the House and that money was
needed to put an office together and hire a program officer to
work with OCS.
1:53:31 PM
SENATOR GREEN asked why there is no fiscal note.
CHAIR DYSON said that he is not clear on that.
1:53:50 PM
MR. LESMANN said that the Office of Children's Services is also
excited about this program, and supports SB 287. He said that it
has two suggestions for consideration. First, adding an age
requirement to focus on youth who have been in custody on or
after age 16. The existing language states that "eligibility for
the program is contingent on having been placed in foster care
for not less than two years", so a child who was in foster care,
for example, from age one to age three, would be eligible.
Second, the OCS understands that the sponsors do not intend to
restrict eligibility for children who have been placed with a
relative who may not be a licensed foster parent or in a
residential treatment facility, but language on page 2, line 14
talks about the "child who has been placed in a foster home". It
would recommend replacing "a foster home" with "out-of-home
care", so that it is clear that the language applies to any
child who was taken into state custody and placed outside of his
or her own home.
1:55:48 PM
CHAIR DYSON asked him how long he has been with the department.
MR. LESMANN replied that he had been with the OCS since May 20,
2000.
CHAIR DYSON recalled working with Karen Perdue, the previous
commissioner, on other things for kids who are "aging out" and
said he believed that one of them addressed postsecondary
education. He asked if he had any knowledge of that.
MR. LESMANN responded that OCS has a program called the
Education and Training Voucher Program (Alaska ETV Program) that
began in 2001 when the federal government passed the Federal
Chaffee Foster Care Independence Act. It set up money for
postsecondary education for children in the foster care system.
Students can receive up to $5,000 per year for academic expenses
through it. Also, the University offers up to five Foster Youth
Tuition Waiver Scholarships per year. The OCS has a program
coordinator in the deputy commissioner's office who is
responsible for an independent living program and, in each of 4
regions in the state, they have a dedicated caseworker who is
assigned to each of the children aging out of foster care.
1:58:11 PM
CHAIR DYSON asked if he could provide documentation to explain
those programs.
MR. LESMANN replied that he would be happy to do so.
CHAIR DYSON asked what keeps the things that Senator Ellis is
talking about in SB 287 from happening now.
MR. LESMANN answered he is not sure how to answer that question,
because he doesn't understand the University's current program.
The Office of Faith-Based and Community Initiatives, because it
is part of DHSS, as is OCS, has no confidentiality issues within
the department. The OCS obviously knows who the kids are and who
might be appropriate for a savings account, but the procedures
are not set up and they are not referenced in state law.
1:59:46 PM
SENATOR ELTON said that it seems important to include younger
children because foster parents and out-of-home care providers
often form attachments with a foster child and may be
particularly interested in providing for the education of that
child.
MR. LESMANN replied that it is probably a public policy call and
the OCS's recommendation is based on criteria from the Chaffee
Foster Care Independence Act, which established that the child
th
must have been in custody on or after his 16 birthday to be
eligible for the Education and Training Voucher Program. He
asked the committee to consider a young child who has been in
state custody and placed outside his home from age one to age
three, and who is then reunited with his parents and dismissed
from state custody. The OCS would have to track that child for
the next 15 years, until he became eligible for the benefit.
2:02:17 PM
CHAIR DYSON remarked that the Senate passed HB 408 yesterday or
the day before, which cleaned up a lot of child-related issues.
One section of that bill stipulated that the permanent fund
dividend (PFD) belonging to a child in out-of-home placement
must be held in an interest-bearing trust or escrow account
until the child is adopted. He asked how the OCS anticipates
disbursing PFD funds and accumulated interest to the 18-year-old
who is just getting out of state custody.
MR. LESMANN replied that a number of scenarios must be
considered. If a child were released from state custody and
reunited with his parents before the age of 18, the PFD trust
account would be released to the biological parents. If
reunification with the biological parents was not possible and a
legal guardian was named, HB 408 stipulated that the trust
account would remain protected until the child reached 18 and
would then be released to the child.
CHAIR DYSON asked how the funds would be released to the child.
MR. LESMANN responded that if the child was no longer in state
custody and no caseworker or independent living specialist had
been assigned, there would be little or no further oversight.
CHAIR DYSON said he appreciates that for most purposes this
state considers an 18-year-old an emancipated adult, but he
wondered under what circumstances the state would offer
additional services to a child after age 18. He said that his
understanding was that, unless he were of diminished capacity,
the state would offer a child additional services only if he
specifically asked for them.
MR. LESMANN confirmed that understanding.
2:06:08 PM
CHAIR DYSON asked whether there are any limits on the federal
money that Mr. Lesmann mentioned earlier in his testimony.
MR. LESMANN responded that the federal government gave OCS
$176,000 during the past year for the Alaska ETV Program, a
little less than during the prior year.
CHAIR DYSON calculated that OCS could give $6,000 to 28 kids or
$3,000 to 50 kids and asked how many children are actually aging
out each year with no guardian, no reunification with biological
parents, and no adoption.
MR. LESMANN responded that he doesn't have that number; he knows
how many children age out each year based on age range, but not
in terms of status and a permanency plan.
MS. MORRIS showed Mr. Lesmann the sponsor statement.
MR. LESMANN said that the sponsor statement indicates that
nearly 500 children in state custody age out each year with no
permanency plan.
CHAIR DYSON said that he questions that number, but does not
have the information. He asked Mr. Lesmann if he could stay to
answer questions later in the meeting.
MR. LESMANN said yes.
2:07:58 PM
CHIP WAGGONER, Executive Director, Alaska Conference of Catholic
Bishops, the public policy arm of the Roman Catholic Church in
Alaska, commended Senator Ellis for his innovative idea to
assist foster children who want to attend postsecondary
education and thanked members of the committee who have been
involved with foster care issues both professionally and
personally. Mr. Waggoner pointed out that children need many
things: love, an adult who cares for them, continuity and
certainty, which provide a sense of security. He related the
story of a foster child who was assigned to a group home and had
the opportunity to get into a better academic environment
through the assistance of a caring adult. He said that this bill
would allow other foster children to have the same opportunity
by bringing the issue forward to people who are in a financial
position to donate. Also, this bill would make it clear that the
OCS could share information with the University to ensure that
the program gets implemented. He stressed his support for the
bill and urged the committee to push it through.
2:12:09 PM
CHAIR DYSON said that nothing precludes Mr. Waggoner and the
Archdiocese from setting up scholarships now and making them
available to kids who are aging out.
MR. WAGGONER responded that is probably correct, but that the
Alaska Conference of Catholic Bishops didn't know about it and
he doubted that members of his church knew about it. He said
that the instruction to "identify donors and beneficiaries" is
important, because it would allow the OFBCI to put it on its
website.
CHAIR DYSON asked Mr. Waggoner whose website he had referred to.
MR. WAGGONER responded that the Office of Faith-Based and
Community Initiatives, OCS, University of Alaska, and the Alaska
Conference of Catholic Bishops could put it on their websites.
CHAIR DYSON said he does not mean to argue, but he is not aware
of anything that prevents any of those groups from doing that
now.
2:13:34 PM
JAMES F. LYNCH, Associate Vice President for Finance, University
of Alaska, Fairbanks, testified by teleconference in favor of SB
287. He was the drafter of the original college-savings program
for the University in 1991, and of the current college savings
program, the goal of which is to create access to continuing
education, and to change the mindset of children and parents
from "if I go to college" to "when I go to college." He said
that the University of Alaska contributes five four-year
scholarships every year through the federal program.
2:16:19 PM
He said that, as a result of the permanent fund dividend and
promotion of the college savings program, approximately 56
percent of their participants come from families with annual
household incomes of less than $52,000. A similar national
program shows only 17 percent of participants with annual
household incomes of less than $52,000.
MR. LYNCH said that the college savings program has a provision
for state agencies and non-profits to open and maintain accounts
for beneficiaries and has special provisions for un-named
accounts on which the opening agency is the owner; but he thinks
it is desirable to have a program structured specifically to
meet the goals of OCS with regard to foster children. He also
pointed out that this type of program is long-term and it may be
20 or more years before the money is taken out and used for
education, so it is important that the program be administered
by an organization or agency that is going to be around that
long. A non-profit could administer the program, but its
objectives may not be the same as the OCS, and there is less
assurance that it will be in existence long enough to serve the
participants. He views this program as a fairly low-cost tool
the department can use to meet its objectives.
2:19:49 PM
MR. LYNCH said the university manages 176,000 college savings
accounts, so it is important, administratively, not to have a
subgroup of accounts with special rules.
2:21:29 PM
He said that very little information would be needed regarding
the beneficiaries.
MR. LYNCH requested a change on page 1, Section 1, AS
47.05.400(a)(2) which reads, "create a mechanism for the
University of Alaska to establish and maintain accounts". He
said it should read, "create a mechanism for the department to
establish and maintain accounts".
2:22:31 PM
CHAIR DYSON said that there are two places in the bill where it
adds language about confidentiality: page 4, line 5...
MR. LYNCH replied that the college savings programs are exempt
from the Public Records Act and that those records are
maintained on a confidential basis.
CHAIR DYSON asked if state code needed amending to make what the
committee is trying to do happen.
MR. LYNCH replied no, that the records will be confidential,
however the OCS might need authorization to give the University
the names.
2:23:31 PM
SENATOR WILKEN commented that Mr. Lynch crafted the 1991
legislation that created the college savings plan and helped
Senator Tim Kelly in 1998 to reauthorize and expand it. It was
recently recognized by either Financial World or the Wall Street
Journal as the best in the nation. He commended Mr. Lynch for
his work and thanked him for his effort.
CHAIR DYSON asked Mr. Lynch if, in his opinion, this legislation
is necessary to enable private donations to foster children
MR. LYNCH replied that it would be extremely helpful.
2:25:03 PM
CHAIR DYSON asked Mr. Lesmann to convince the committee that his
department can handle the coordination and maintenance of
records for this program with existing manpower and without
additional expense, in order to deal with the matter without a
fiscal note.
MR. LESMANN said that he would not try to persuade the committee
in that regard. He admitted that the department's failure to
provide a fiscal note was an oversight and accepted
responsibility for that. The OFBCI would probably need
approximately $80,000 to add one full-time program coordinator,
if the money that was removed from the House budget is not
restored. He said that the department would submit an $80,000
fiscal note.
2:26:41 PM
MR. LYNCH interjected that once an account is established, the
college-savings program would do all the recordkeeping.
CHAIR DYSON stated he was having trouble reconciling that with
what Mr. Lynch said earlier. He pointed out that Mr. Lynch
wanted the committee to amend page 1, line 12.
MR. LYNCH stated that the OCS would be the account owner, and
the University would seek approval from the department to
withdraw funds. If the funds weren't claimed by the beneficiary
for whom they were originally intended, they would be available
to the department for use by another claimant.
2:28:19 PM
CHAIR DYSON said that he would hear from one more person and
then the committee would set the matter aside for a few minutes,
to allow the sponsor to decide what to do with the proposed
amendments and/or the fiscal note.
2:28:48 PM
AMANDA METIVIER a former foster child and a student at the
University of Alaska, Anchorage, testified in support of the
bill. She said that, although there are opportunities available
through the Alaska ETV Program and the tuition waiver, they are
not enough. She disagreed with the implementation of an age-
eligibility requirement of 16 or over and cited her sister's
experience as an example. Her sister was placed in foster care
at age 12 and placed with a legal guardian at 15, so she would
not be eligible for this program even though she is now 18 and
without educational resources.
2:30:46 PM
CHAIR DYSON thanked Ms. Metivier for her testimony.
He announced that SB 287 would be set aside.
SCS CSHB 393 (HES)-INSURANCE FOR COLORECTAL CANCER SCREENING
2:31:37 PM
CHAIR DYSON announced SCS CSHB 393(HES) to be up for
consideration.
EMILY NENON, Alaska Government Relations Director, American
Cancer Society, said that she had spoken with committee members
and staff in advance to ensure that her testimony would address
all of the questions that they might have, but that she would be
happy to answer any additional questions that might arise.
She said that when Heath Hilyard presented the bill on
Wednesday, he talked about the fact that, if colon cancer is
identified before symptoms appear, there is a greater than 90
percent survival rate.
According to Cancer Facts and Figures 2006, which publishes a
five-year average of cancer incident rates, Alaskan women have
had the highest colon cancer rate in the nation over the past
five years. The rate of colon cancer in Alaskan Native people is
nearly double that of the U.S. white population.
2:33:54 PM
MS. NENON said that this bill provides guidelines for colon
cancer screening. For the general population, anyone over age 50
should be screened, but people are generally not eligible for
Medicare until age 65, which leaves a 15-year window of time
when screening is recommended but may not be covered by
insurance.
The Institute of Medicine reports that the death rate from colon
cancer could drop by up to 80 percent if a majority of Americans
were screened regularly. The current annual expenditure in the
United States on colorectal cancer health care costs is $6.5
billion and part of the reason for that is that it is not being
identified early enough.
The New England Journal of Medicine published an article in July
of 2004 called "The Price tag on Progress," that is about
chemotherapy for colorectal cancer. It states that "the near
doubling of the median survival achieved over the past decade,
has been accompanied by a staggering 340 fold increase in drug
costs" just for the initial eight weeks of treatment. Assuming a
patient continues to receive treatment until the median time to
progression, eight months of front-line therapy followed by 4.1
months of Cetuximab and Irinotecan therapy would cost $161,000.
2:37:22 PM
CHAIR DYSON said that the issue the committee has to decide is
whether or not to mandate that insurance carriers provide this
service to their clients between the ages of 50 and 65.
MS. NENON said that is correct, and that 18 other states have
already taken this action. She recognizes that state government
doesn't regulate every insurance plan, but sees it as "a
critical piece of the puzzle." The American Cancer Society
worked hard to get Medicare coverage for screening added in 2001
and, working with federal employee health benefit plans over the
past three years, has increased the number of federal plans that
cover the full range of colon cancer screening from 25 to 70
percent.
2:38:37 PM
SENATOR OLSON asked how this would decrease the incidence of
colorectal cancer among Alaskan Natives, particularly women,
when they are dealing with issues such as a lack of clean water
and inadequate sewage treatment.
MS. NENON responded that DHSS has been working with the
Comprehensive Cancer Control (CCC) partnership to form a
colorectal cancer joint task force between the Alaska Native
Tribal Health consortium and the state's CCC program to consider
those issues. They are looking at, among other things, the
possibility of sending gastrointestinal doctors from Anchorage
to regional hospitals to do mass screenings.
SENATOR OLSON asked whether these would be private physicians or
doctors from Alaska Native Medical Center (ANMC) and who would
be paying for it.
MS. NENON responded that it would be a joint effort and they are
still working on the funding, but that some doctors in Anchorage
have offered to donate their time. They anticipate receiving
some regular reimbursement for those procedures.
SENATOR OLSON commented that he assumed these physicians would
be gastrointestinal internists who have already been trained and
are not going out for the experience.
MS. NENON replied yes.
2:40:48 PM
SENATOR WILKEN said that most of the committee is of an age to
consider this issue seriously and commented on an article he
read about a month ago in Scientific American about a new
digital screening procedure that may replace the existing
sigmoidoscopy and colonoscopy within the next 10 years.
MS. NENON said that she is looking forward to that.
2:42:23 PM
SENATOR WILKEN moved to report SCS CSHB 393(HES) from committee
with individual recommendations.
SENATOR GREEN said that she did not object, but was indisposed
to introduce anything that is a mandate on anyone.
CHAIR DYSON agreed that it presents a real concern for him also,
particularly when he considers the insurance companies' previous
remarks about this matter.
SENATOR GREEN commented that, unlike the lower 48 states, when
the legislature makes a law in Alaska that impacts private
programs and plans, a large part of the state is not impacted by
it.
CHAIR DYSON announced that without further comment SCS CSHB
393(HES) was reported from committee.
There being no further business to come before the committee,
Chair Dyson adjourned the meeting at 2:44:24 PM.
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