Legislature(2009 - 2010)BUTROVICH 205
03/17/2010 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB193 | |
| SB172 | |
| SB295 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 193 | TELECONFERENCED | |
| *+ | SB 295 | TELECONFERENCED | |
| += | SB 172 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 17, 2010
1:36 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Paskvan, Vice Chair
Senator Johnny Ellis
Senator Fred Dyson
MEMBERS ABSENT
Senator Joe Thomas
COMMITTEE CALENDAR
SENATE BILL NO. 193
"An Act relating to licensure as an optometrist; establishing a
retired status optometrist license; and providing for an
effective date."
- MOVED SB 193 OUT OF COMMITTEE
SENATE BILL NO. 172
"An Act establishing the Alaska Health Care Commission in the
Department of Health and Social Services; and providing for an
effective date."
- MOVED CSSB 172(HSS) OUT OF COMMITTEE
SENATE BILL NO. 295
"An Act relating to flame retardants and to the manufacture,
sale, and distribution of products containing flame retardants;
relating to bioaccumulative toxic chemicals; and providing for
an effective date."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 193
SHORT TITLE: LICENSING FOR OPTOMETRY
SPONSOR(s): LABOR & COMMERCE BY REQUEST
04/17/09 (S) READ THE FIRST TIME - REFERRALS
04/17/09 (S) HSS, L&C
03/17/10 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 172
SHORT TITLE: ALASKA HEALTH CARE COMMISSION
SPONSOR(s): OLSON
03/27/09 (S) READ THE FIRST TIME - REFERRALS
03/27/09 (S) HSS, FIN
04/17/09 (S) HSS AT 1:30 PM BUTROVICH 205
04/17/09 (S) Scheduled But Not Heard
04/18/09 (S) HSS AT 10:00 AM BUTROVICH 205
04/18/09 (S) -- MEETING CANCELED --
02/03/10 (S) HSS AT 1:30 PM BUTROVICH 205
02/03/10 (S) Heard & Held
02/03/10 (S) MINUTE(HSS)
03/10/10 (S) HSS AT 1:30 PM BELTZ 105 (TSBldg)
03/10/10 (S) Heard & Held
03/10/10 (S) MINUTE(HSS)
03/17/10 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 295
SHORT TITLE: FLAME RETARDANTS AND TOXIC CHEMICALS
SPONSOR(s): WIELECHOWSKI
02/24/10 (S) READ THE FIRST TIME - REFERRALS
02/24/10 (S) HSS, FIN
03/17/10 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
JILL MATHESON, OD, Chair
Alaska State Optometry Board
Juneau, AK
POSITION STATEMENT: Supported SB 193.
DENISE LICCIOLI
Staff to Senator Olson
State Capitol
Juneau, AK
POSITION STATEMENT: Presented SB 172.
BILL HOGAN, Commissioner
Department of Health and Social Services (DHSS)
Anchorage, AK
POSITION STATEMENT: Supported SB 172.
D. TYRELL MCGIRT
Alaska Primary Care Association
Iliuliuk Family & Health Services, Inc
Unalaska/Dutch Harbor, AK
POSITION STATEMENT: Supported SB 172 and requested that
community health care be represented on the commission.
MARIE DARLIN
AARP Capital City Taskforce
Juneau, AK
POSITION STATEMENT: Supported SB 172.
J. KATE BURKHART, Executive Director
Alaska Mental Health Board (AMHB) and Advisory Board on
Alcoholism and Drug Abuse (ABADA)
Juneau, AK
POSITION STATEMENT: Supported SB 172.
SONIA HANDFORTH-KOME, Acting President
Alaska Primary Care Association and
Executive Director
Iliuliuk Family & Health Services, Inc
Unalaska/Dutch Harbor, AK
POSITION STATEMENT: Supported SB 172
SENATOR WIELECHOWSKI
Alaska State Legislature
Juneau, AK
POSITION STATEMENT: Sponsor of SB 295.
MEGAN ROGERS
Intern to Senator Wielechowski
State Capitol
Juneau, AK
POSITION STATEMENT: Presented SB 295.
LORI VERBRUGGE
Department of Health and Social Services (DHSS)
Anchorage, AK
POSITION STATEMENT: Was available to answer questions.
DR. DAVID HEIMBACH, Professor of Surgery
University of Washington
Seattle, WA
POSITION STATEMENT: Opposed SB 295.
PATTI SAUNDERS, Director of Development
ARC of Anchorage
Anchorage, AK
POSITION STATEMENT: Supported SB 295.
JIM GILL, representing himself
POSITION STATEMENT: Opposed SB 295.
GREG PATTERSON, representing himself
POSITION STATEMENT: Opposed SB 295.
KRISTIN RYAN, Director
Division of Environmental Health
Department of Environmental Conservation (DEC)
Anchorage, AK
POSITION STATEMENT: Was available for questions on SB 295.
SARA HANNON, RN, representing herself
Anchorage, AK
POSITION STATEMENT: Supported SB 295.
Pamela K. Miller Executive Director
Alaska Community Action on Toxics (ACAT)
Anchorage, AK
POSITION STATEMENT: Supported SB 295.
SHARON WHYTAL, RN, representing herself
Homer, AK
POSITION STATEMENT: Supported SB 295.
ACTION NARRATIVE
1:36:42 PM
CHAIR BETTYE DAVIS called the Senate Health and Social Services
Standing Committee meeting to order at 1:36 p.m. Present at the
call to order were Senators Ellis, Paskvan, and Davis.
SB 193-LICENSING FOR OPTOMETRY
1:37:00 PM
Chair Davis announced consideration of SB 193.
1:37:32 PM
SENATOR PASKVAN, sponsor of SB 193, said this bill updates
optometric licensure criteria by standardizing the level of
optometric licensure as opposed to the current three levels of
licensure. This will align Alaska statutes with current
education levels that are standard in most optometric schools
nationwide. Many states have already passed similar legislation.
Alaskans deserve the most current care possible and continuing
to license less than the standard education levels puts citizens
at risk, he said. The Labor and Commerce Committee introduced
the bill at the request of the Board of Optometry.
1:39:00 PM
JILL MATHESON, OD and Chair, Alaska State Optometry Board, said
the Optometric Association is also advocating for SB 193 on the
board's behalf. She related the bill contains some housekeeping
changes but the focus is to have one uniform level of licensure.
It's in the best interest of the public to have all optometrists
qualified at the same level. The bill does not change the scope
of practice or allow any more privileges and it doesn't remove
the requirements that the Legislature put in place several years
ago. A grandfather clause is included so that current lower
level licensees could continue to practice under a restricted
license. The restricted license could be upgraded once the
educational requirements have been met.
1:40:07 PM
SENATOR DYSON joined the meeting.
CHAIR DAVIS closed public testimony and noted that the bill
didn't appear to have any opposition.
SENATOR PASKVAN moved to report SB 193 from committee with
individual recommendations and attached zero fiscal note(s).
There being no objection, SB 193 moved from the Senate Health
and Social Services Standing Committee.
At ease from 1:42 p.m. to 1:43 p.m.
SB 172-ALASKA HEALTH CARE COMMISSION
1:43:54 PM
Chair Davis announced consideration of SB 172. It was heard
previously.
DENISE LICCIOLI, Staff to Senator Donald Olson, sponsor of SB
172, said the sponsor has seen the proposed committee substitute
and has no objection.
CHAIR DAVIS moved to adopt the work draft committee substitute
(CS) for SB 172, labeled 26-LS0790\P as the working document.
There being no objection, version P was before the committee.
1:47:04 PM
BILL HOGAN, Commissioner, Department of Health and Social
Services (DHSS), spoke in favor of CSSB 172 to create the Alaska
Health Care Commission in statute. The temporary commission has
been focusing on how to improve access to the health care
system, contain the growth of cost, improve quality and safety,
and put increased emphasis on prevention programs like tobacco
cessation and obesity prevention. He stated his belief that
having the Alaska Health Care Commission in place will help
position the state to address costs related to the Medicaid
budget and to prepare for the national health care reform.
1:48:43 PM
D. TYRELL MCGIRT, Alaska Primary Care Association (APCA), said
he is also a board member with the Iliuliuk Family & Health
Services Clinic Inc., the community health care (CHC) center in
Unalaska/Dutch Harbor. While APCA believes the committee has
done an outstanding job identifying different health care
representatives to sit on the commission, they would point out
that specific representation by community health care centers is
missing and could offer a great deal. Community health centers
are a proven model of primary and preventative care in Alaska
and nationwide. They never turn patients away, 42 percent of
their users are uninsured, and 72 percent of their users are low
income. Alaska has 26 CHCs with 146 sites and in rural Alaska
they are often the only option for primary and preventative
health care. He reiterated support for a seat on the commission
specifically for community health centers.
1:51:44 PM
MARIE DARLIN, AARP Capital City Taskforce, Juneau, Alaska, said
AARP adds its voice to those supporting SB 172 to make permanent
the Alaska Health Care Commission. Not all of the decisions
regarding health care will be made in Washington DC; Alaska has
to decide how national health care will be applied here so that
it works for everybody.
1:53:38 PM
J. KATE BURKHART, Executive Director, Alaska Mental Health Board
(AMHB) and the Advisory Board on Alcoholism and Drug Abuse
(ABADA), thanked the committee for including a representative of
the Alaska Mental Health Trust Authority in the CS and echoed
previous testimony from the Primary Care Association regarding
the importance of dedicating a specific seat to community health
centers. Most indigent Alaskans receive health care through CHCs
so having someone familiar with practicing in that context will
be imperative to addressing the issue of rising health care
costs, particularly the Medicaid budget.
1:55:27 PM
SONIA HANDFORTH-KOME, Acting President, Alaska Primary Care
Association (APCA), and Executive Director, Iliuliuk Family &
Health Services Clinic Inc. in Unalaska/Dutch Harbor, said she
is speaking in favor of SB 172 but she believes that there has
been a little oversight in not providing a specific seat for
community health centers. The commission is looking for varied
view points and ways to reduce health care costs and CHCs have a
proven track record for doing that on a national level. Their
perspective is different than the hospital perspective, the
tribal perspective, or the for-profit perspective so it would be
useful for the commission to have this representation. In Alaska
CHCs see 1 in 9 patients in 142 sites so they're a solution that
works. APCA would like that to be represented on this
commission, she concluded.
1:57:21 PM
SENATOR PASKVAN asked how many of the 142 sites are tribal
health community sites.
MS. HANDFORTH-KOME replied she isn't sure, but 13 of the 26
community health center organizations are tribal.
SENATOR ELLIS commented that he went to Unalaska 18 years ago
when the clinic opened and last fall he visited again and was
impressed with their outstanding work in the community.
MS. HANDFORTH-KOME said they're getting ready to do a community
health needs assessment in an effort to do more with less.
SENATOR DYSON commented that they must have the world's most
interesting clientele.
MS. HANDFORTH-KOME agreed; providers actually visit because of
the interesting clientele, she said.
1:59:24 PM
CHAIR DAVIS closed public testimony. She stated that while she
agrees with the statements about the community health centers
she believes that can be addressed in a subsequent committee.
SENATOR PASKVAN moved to report CSSB 172, labeled 26-LS0790\P,
from the committee with individual recommendations and attached
fiscal note(s). There being no objection, CSSB 172 (HSS) moved
from Senate Health and Social Services Standing Committee.
At ease from 2:01 p.m. to 2:03 p.m.
SB 295-FLAME RETARDANTS AND TOXIC CHEMICALS
2:03:04 PM
Chair Davis announced the consideration of SB 295.
MEGAN ROGERS, Intern to Senator Bill Wielechowski, said SB 295
will ban the use of Polybrominated diphenyl ethers (PBDEs) as
flame retardants in consumer products like mattresses, textiles,
and electronics. These chemicals are bio-accumulative and toxic
to humans and the environment. When PBDEs burn they can
potentially create more toxic substances, including a form of
dioxin, making them highly dangerous for firefighters battling a
blaze. Alternatives to their use are available and cost-
effective. Eleven states have proposed and four have enacted
PDBE policies prohibiting the manufacture, distribution and use
of products containing PBDEs.
SB 295 will empower the Department of Environmental Conservation
(DEC) to educate retailers to identify products that contain
these chemicals and fine companies that fail to comply with the
ban. The Department of Environmental Conservation (DEC) must
develop a list of chemicals of concern along with other
alternatives and every three years report on the progress of the
ban. Exemptions apply if the prohibited product is part of a
transportation vehicle or if the product is used in an
industrial mining process or a resold item.
Every year 50 million pounds of PBDEs are built into products in
North America even though it's a developmental toxin and
possible carcinogen. SB 295 attempts to protect Alaskans from
preventable exposure to these toxins.
2:07:28 PM
SENATOR PASKVAN asked if the intent is that this will apply to
household products or if it is intended to be more broadly
applicable to public buildings.
MS. ROGERS said most major name-brand companies already use
alternatives to PDBEs.
SENATOR WIELECHOWSKI added that the bill essentially says that
the use, manufacture or distribution of PBDE chemicals is
prohibited with the limited exceptions listed on page 2, lines
21-30. It just so happens that the majority of the products that
contain these chemicals are in households.
SENATOR PASKVAN asked if there's any evidence that banning these
chemicals would increase the frequency of fires or related
injuries.
MS. ROGERS deferred the question to Ms. Verbrugge with the
Department of Health and Social Services (DHSS).
2:11:00 PM
LORI VERBRUGGE, Department of Health and Social Services (DHSS),
said she is a toxicologist so her expertise relates to the
environmental behavior of PBDE chemicals and their effect on the
health on humans and animals. She doesn't have expertise to
answer the specific question regarding the possible increased
risk of fire and related injuries.
SENATOR PASKVAN asked if she has any anecdotal information that
would indicate an unintended consequence of banning PBDE
chemicals.
MS VERBRUGGE replied she hasn't heard anything to that effect.
2:12:33 PM
DR. DAVID HEIMBACH, Professor of Surgery, University of
Washington, said he takes care of all of the Alaskan burn
patients and there were about 35 last year. He said that he has
very strong feelings that sort of flame retardant should be used
in sleepwear and mattresses because people who don't have this
protection are at significant risk in the event of fire. He
related a story of a six-week-old baby whose crib mattress did
not have flame retardant. A dog knocked a candle into the crib
and the baby sustained a devastating 75 percent burn, but a
pillow in the bed had flame retardant and did not catch fire.
DR. HEIMBACH stressed that he is not "in the pocket" of anyone
who produces flame retardant, but he believes that having some
kind of flame retardant in products that are at risk of catching
fire is imperative. He related another incident of a 70 year old
woman whose chenille robe caught fire when she leaned over her
gas stove. She sustained a 35 percent total body burn. This was
devastating for the woman and her grandchildren who watched her
catch fire.
He urged the committee to think very carefully before completely
banning fire retardants. The Environmental Protection Agency
(EPA) is working with manufacturers to remove deca-BDE from
flame retardants by 2013 and he believes that it would be highly
premature for a state to ban their use before an alternative is
available.
2:16:53 PM
PATTI SAUNDERS, Director of Development, ARC of Anchorage,
stated strong support for SB 295. She explained that ARC of
Anchorage is a private not-for-profit organization that serves
people with developmental disabilities and mental health issues
so that they can lead rich and productive lives. She said she
and her coworkers would be happy to go out of business because
all preventable disabilities have been prevented, but they need
legislative help to address prevention. Learning and
developmental disabilities impact the quality of life for people
and their families and impose a financial burden on the state
through special education and increased health care costs. The
incidence of learning and developmental disabilities has been
rising rapidly. In fact, 7.3 percent of the public school
students in the Anchorage School District have disabilities.
Scientific evidence has proven that certain chemicals, including
deca-BDE, can cause learning and developmental disorders. Young
children's developing brains and bodies are particularly
susceptible to exposure and the damage can be permanent. PBDE
residues have been consistently found in tissue samples of new
mothers and their infants. Ingesting contaminated breast milk is
one of two major sources of PBDE exposure in children. This is
an issue worldwide, although North American women have the
largest average body burden of PBDE's. SB 295 will help protect
children from needless exposure to this toxic chemical. So much
in life can't be controlled but adults do have an obligation to
their children to take responsibility for things that can make a
difference. SB 295 can make a difference.
MS. SAUNDERS referenced the previous testimony and noted that
the International Association of Firefighters has gone on record
opposing the use of PDBEs because their use puts firefighters at
much higher risk.
2:22:56 PM
JIM GILL, representing himself, stated opposition to SB 295. He
personally knows people whose lives were saved because of fire
retardants. Until there's a better solution, the costs can
outweigh whatever benefit might be achieved by passing SB 295.
2:24:07 PM
GREG PATTERSON, representing himself, said he has been a
volunteer fireman much of his life. He carries burn victims out
of buildings and he strongly believes that people need the
protection provided by flame retardants. He questioned why the
ban is placed on some but not all products if these chemicals
are so dangerous, and suggested it might be better to wait until
the definitive research is finished before making this a law.
The benefits of these life-saving retardants might outweigh the
dangers of using them, but that won't be clear until the
research is done. While studies of these bio-accumulative toxins
do indicate danger, the Center for Disease Control has stated
that the conditions have to be ideal to enter the environment
and the exposure has to be acute and repeated. He urged the
committee to wait until all of the information is in before
making these chemicals illegal.
2:28:19 PM
KRISTIN RYAN, Director, Division of Environmental Health,
Department of Environmental Conservation (DEC), Alaska, said she
is available for questions.
2:28:38 PM
SARA HANNON, representing herself, said she recently became a
registered nurse and she is speaking in strong support of SB
295. It will phase out PBDEs and support the use of safer
alternatives that are already on the market. PBDEs are linked to
thyroid problems, which is significant because changes in
thyroid hormone levels affect almost all the systems in the
body. Since safer alternatives are available, there should be a
law supporting their use. During clinical rotations she learned
that some babies and children may spend a year or more in
hospitals sleeping on mattresses that may contain PBDEs. The
first day she rotated in the emergency room a woman came in with
an inhalation injury from her couch that was treated with flame
retardant and didn't burn. She later died and the physician and
nurses speculated that it was because she inhaled toxic fumes
from the couch. SB 295 makes a lot of sense, she concluded.
2:31:28 PM
PAMELA K. MILLER Executive Director, Alaska Community Action on
Toxics (ACAT), said she is a biologist speaking in support of SB
295. ACAT is a statewide environmental health organization that
conducts research and provides educational programs, technical
assistance, and training. She noted that she provided written
information about the harms related to this class of chemicals
and the strong support firefighting and health organizations
have expressed for the ban.
PBDEs are used in plastic casings of consumer electronics,
upholstered furniture, and mattresses, but there are safer and
effective alternatives. PBDEs are chemically similar to PCBs,
which have been banned for 30 years. They are persistent and
tend to accumulate in the bodies of animals and people.
Addressing fire safety, she said that phasing these fire
retardant chemicals out does not mean lowering safety standards.
Many electronic manufacturers have already adopted new materials
and designs that meet safety codes without relying on deca or
other bromanated flame retardants. These alternate products have
saved thousands of lives and their use has not been accompanied
by an increase in fires or fire casualties.
MS. MILLER said they know that people are exposed through
inhalation of indoor air and dust particles and through foods
that are contaminated with PBDEs. Exposure occurs in the uterus
and infants are exposed through the mother's breast milk. Over
time PBDEs have increased significantly in the bodies of people,
particularly in North America. Northern people are at greater
risk of exposure because these chemicals are transported through
wind and ocean currents and they tend to concentrate in the
flesh of animals that are used as traditional food sources.
Alaskans may also be at higher risk because their homes are
closed in more than homes in warmer climates.
PDBEs are known to harm neurodevelopment, reproduction, thyroid
function, and are implicated in immune system suppression. SB
295 is an important measure to protect the health of Alaskans,
particularly those fighting fires. It is especially important as
a measure to protect the health of children whose developing
brains are more vulnerable. SB 295 will not compromise fire
safety or harm Alaska businesses because of the prevalence of
safer alternatives. She urged passage.
2:37:22 PM
SENATOR PASKVAN asked if she has any information regarding
whether the ban of PBDEs would increase the frequency of hazards
or related injuries of fire.
MS. MILLER answered that in places where PBDEs have been banned
there has been no compromise in fire safety.
SENATOR PASKVAN referenced the testimony that cited the CDC
research and asked if the scientific community is divided on the
issue.
2:38:53 PM
MS. MILLER responded she believes that the consensus in the
scientific and health communities is quite clear and more
studies are coming out in peer review literature every day. The
EPA recognized the significant harm that deca and other
brominated flame retardants present and negotiated a voluntary
phase out with three major manufacturers. She reiterated that
there are effective, safe, and economical alternatives already
on the market. This bill is not about compromising fire safety.
That wouldn't be responsible, but it is responsible to phase out
this class of chemicals that are highly harmful to human health.
SENATOR PASKVAN summarized that she believes that fire safety
will be comparable and the health risks to Alaskans will be
reduced.
MS. MILLER agreed.
2:40:44 PM
SHARON WHYTAL, representing herself, said she is a registered
nurse who supports SB 295 and she would urge the committee to do
likewise. As a nurse, she is concerned about emerging science
linking PBDEs to adverse health effects including learning and
memory impairment, brain development, cancer, and thyroid
problems. Higher concentrations of these chemicals are found in
northern regions, but scientists are finding impacts at lower
concentrations.
SB 295 is an important measure to protect workers and the
general public. In fact, the American Public Health Association
has passed a resolution urging state and federal governments to
phase out the use of PDBEs in products manufactured in the U. S.
Safer alternatives are already available so fire safety wouldn't
be compromised by eliminating PDBEs. As a society we need to be
proactive about health issues; many other countries have already
taken this step, she concluded.
CHAIR DAVIS urged anyone who would like to submit written
testimony to do so before the meeting on Monday. She held SB 295
in committee.
2:45:50 PM
There being no further business to come before the committee,
Chair Davis adjourned the Senate Health and Social Services
Standing Committee hearing at 2:45 p.m.
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