Legislature(2011 - 2012)BUTROVICH 205

03/30/2011 01:30 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SCR 7 FETAL ALCOHOL SPECTRUM DISORDERS DAY TELECONFERENCED
Moved SCR 7 Out of Committee
*+ SB 22 STUDENT ATHLETE TRAUMATIC BRAIN INJURIES TELECONFERENCED
Moved CSSB 22(HSS) Out of Committee
*+ SB 74 INS. COVERAGE: AUTISM SPECTRUM DISORDER TELECONFERENCED
Moved SB 74 Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         March 30, 2011                                                                                         
                           1:34 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Bettye Davis, Chair                                                                                                     
Senator Dennis Egan                                                                                                             
Senator Johnny Ellis                                                                                                            
Senator Kevin Meyer                                                                                                             
Senator Fred Dyson                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Representative Pete Petersen                                                                                                    
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE CONCURRENT RESOLUTION NO. 7                                                                                              
Proclaiming September 9, 2011, as Fetal Alcohol Spectrum                                                                        
Disorders Awareness Day.                                                                                                        
                                                                                                                                
     - MOVED SCR 7 OUT OF COMMITTEE                                                                                             
                                                                                                                                
SENATE BILL NO. 22                                                                                                              
"An Act relating to prevention and evaluation of and liability                                                                  
for traumatic brain injuries in student athletes."                                                                              
                                                                                                                                
     - MOVED CSSB 22(HSS) OUT OF COMMITTEE                                                                                      
                                                                                                                                
SENATE BILL NO. 74                                                                                                              
"An  Act   requiring  insurance  coverage  for   autism  spectrum                                                               
disorders,  describing  the  method for  establishing  a  covered                                                               
treatment  plan for  those disorders,  and  defining the  covered                                                               
treatment  for those  disorders; and  providing for  an effective                                                               
date."                                                                                                                          
                                                                                                                                
     - MOVED SB 74 OUT OF COMMITTEE                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SCR 7                                                                                                                   
SHORT TITLE: FETAL ALCOHOL SPECTRUM DISORDERS DAY                                                                               
SPONSOR(s): SENATOR(s) MEYER                                                                                                    
                                                                                                                                
03/22/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/22/11       (S)       HSS                                                                                                    
03/30/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  22                                                                                                                  
SHORT TITLE: STUDENT ATHLETE TRAUMATIC BRAIN INJURIES                                                                           
SPONSOR(s): SENATOR(s) MCGUIRE                                                                                                  
                                                                                                                                
01/19/11       (S)       PREFILE RELEASED 1/7/11                                                                                
01/19/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/11       (S)       HSS, FIN                                                                                               
03/30/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  74                                                                                                                  
SHORT TITLE: INS. COVERAGE: AUTISM SPECTRUM DISORDER                                                                            
SPONSOR(s): SENATOR(s) ELLIS                                                                                                    
                                                                                                                                
01/28/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/28/11       (S)       HSS, L&C                                                                                               
03/30/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
SENATOR KEVIN MEYER                                                                                                             
Alaska State Legislature                                                                                                        
Juneau, AK                                                                                                                      
POSITION STATEMENT: Sponsor of HCR 7.                                                                                         
                                                                                                                                
DEB EVENSEN, representing herself                                                                                               
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in support of SCR 7.                                                                            
                                                                                                                                
K.J. METCALFE, representing himself                                                                                             
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SCR 7.                                                                            
                                                                                                                                
ESTHER TEMPEL, Staff to Senator Lesil McGuire                                                                                   
Alaska State Legislature                                                                                                        
Juneau, AK                                                                                                                      
POSITION STATEMENT: Presented SB 22 for sponsor, Senator                                                                      
McGuire.                                                                                                                        
                                                                                                                                
GARY MATTHEWS, Executive Director                                                                                               
Alaska School Activities Association                                                                                            
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
JILL HODGES, Executive Director                                                                                                 
Alaska Brain Injury Network                                                                                                     
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
PETER HOEFFNER, School Board Member                                                                                             
Cordova School District                                                                                                         
Cordova, AK                                                                                                                     
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
CHRISTOPHER DEAN                                                                                                                
Alaska Athletic Trainers Association                                                                                            
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
BRENDA SHELTON, President                                                                                                       
Alaska Athletic Trainers Association                                                                                            
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
BRUCE JOHNSON, Executive Director                                                                                               
Alaska Council of School Administrators                                                                                         
POSITION STATEMENT: Testified in support of SB 22.                                                                            
                                                                                                                                
SENATOR JOHNNY ELLIS                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, AK                                                                                                                      
POSITION STATEMENT: Sponsor of SB 74.                                                                                         
                                                                                                                                
AMORY LELAKE, Staff to Senator Ellis                                                                                            
Alaska State Legislature                                                                                                        
Juneau AK                                                                                                                       
POSITION STATEMENT: Presented SB 74 for Senator Ellis, the                                                                    
sponsor.                                                                                                                        
                                                                                                                                
LAURIE EUNAM, Senior Litigation Council                                                                                         
Autism Speaks                                                                                                                   
POSITION STATEMENT: Testified in support of SB 74.                                                                            
                                                                                                                                
MARK LAMBRIGHT, Independent actuary                                                                                             
Anchorage, AK                                                                                                                   
POSITION STATEMENT: Testified in support of SB 74.                                                                            
                                                                                                                                
MARGARET COSSLER, representing herself                                                                                          
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 74.                                                                            
                                                                                                                                
JANICE GERTON, representing herself                                                                                             
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 74.                                                                            
                                                                                                                                
LAURIE KING, representing herself                                                                                               
Juneau, AK                                                                                                                      
POSITION STATEMENT: Testified in support of SB 74.                                                                            
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:34:28 PM                                                                                                                    
CHAIR BETTYE DAVIS  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:34 p.m.  Present at the                                                               
call to order were Senators  Ellis, Egan, Dyson, Meyer, and Chair                                                               
Davis.                                                                                                                          
                                                                                                                                
          SCR  7-FETAL ALCOHOL SPECTRUM DISORDERS DAY                                                                       
                                                                                                                                
1:34:35 PM                                                                                                                    
CHAIR DAVIS  announced the first  order of business would  be SCR                                                               
7, Fetal Alcohol Spectrum Disorders Awareness Day.                                                                              
                                                                                                                                
SENATOR KEVIN MEYER,  sponsor of SCR 7, said  this bill proclaims                                                               
September  9, 2011,  as Fetal  Alcohol Spectrum  Disorders (FASD)                                                               
Awareness Day.  The date is  a reminder on  the ninth day  of the                                                               
ninth  month that  during the  nine months  of pregnancy  a woman                                                               
should  abstain  from alcohol.  He  has  had the  opportunity  of                                                               
participating in FASD awareness events over the past few years.                                                                 
                                                                                                                                
Unfortunately, Alaska has  the highest known rate of  FASD in the                                                               
United States.  This is caused  by prenatal exposure  to alcohol;                                                               
FASD   can   result   in   permanent   brain   damage,   learning                                                               
difficulties, behavior  problems, birth defects, and  the loss of                                                               
individual  potential. Lifetime  costs of  services for  affected                                                               
individuals  are in  the  millions of  dollars.  FASD is  totally                                                               
preventable.  This   resolution  supports  an  effort   to  bring                                                               
attention to the  condition that has been  devastating our state.                                                               
If we  keep working  at it  long enough  and hard  enough, people                                                               
will get the message and we will see a change in behavior.                                                                      
                                                                                                                                
1:37:03 PM                                                                                                                    
SENATOR DYSON commended the sponsor  for introducing the bill. He                                                               
said  FASD is  totally preventable,  and some  progress has  been                                                               
made in the past twelve years  with laws requiring warnings to be                                                               
posted. Six years ago the state  was spending about $1 million on                                                               
each child with FASD by age 18.                                                                                                 
                                                                                                                                
1:38:04 PM                                                                                                                    
DEB EVENSEN, representing  herself, said SCR 7 was  a really good                                                               
idea.  This  is  an  inexpensive  way to  deal  with  a  gigantic                                                               
problem. Helping  mothers not drink  when they are  pregnant will                                                               
decrease suicide rates, crime rates,  school failures, and reduce                                                               
the prison population.  Over the last 25 years she  has worked in                                                               
almost  every village  and town  in  the state  and almost  every                                                               
school district. In some communities  there is a third generation                                                               
of children  being born with  FASD. Many people still  don't know                                                               
that a  glass of wine  during pregnancy destroys 10,000  cells in                                                               
the  developing  fetal  brain.  We can  help  turn  this  problem                                                               
around.                                                                                                                         
                                                                                                                                
1:40:32 PM                                                                                                                    
K.J. METCALFE, speaking  for himself, said he had  been the chair                                                               
for  the last  two FASD  regional conferences  here in  Southeast                                                               
Alaska. They  are having a  workshop this coming Tuesday  on FASD                                                               
and  sexuality. This  bill goes  to the  heart of  the issue.  He                                                               
would  like  to say  that  prevention  is  the key,  but  support                                                               
services are also needed.                                                                                                       
                                                                                                                                
For  example, he  knows  of two  women in  town  who are  chronic                                                               
alcoholics, probably  their mothers were also.  Between them they                                                               
had 20  children who  all became  wards of  the state.  Now those                                                               
children  are   becoming  sexually  active,  and   they  are  all                                                               
affected.  Twenty  children,  two  adults,  probably  more  being                                                               
created as we  speak; that is a  huge amount of money  that if we                                                               
had  taken care  of  those two  women they  could  have raised  a                                                               
healthy baby  and we could cut  down the FASD rate.  Education is                                                               
the key.                                                                                                                        
                                                                                                                                
1:43:31 PM                                                                                                                    
CHAIR  DAVIS thanked  Senator  Meyer  and asked  if  the day  was                                                               
always September 9.                                                                                                             
                                                                                                                                
SENATOR MEYER  answered yes, it  is always  the ninth day  of the                                                               
ninth month.                                                                                                                    
                                                                                                                                
CHAIR DAVIS noted there is a way  where this would not have to be                                                               
passed each year.                                                                                                               
                                                                                                                                
SENATOR  EGAN  moved   to  report  SCR  7   from  committee  with                                                               
individual  recommendations and  attached  fiscal note(s).  There                                                               
being  no objection,  SCR  7  moved from  the  Senate Health  and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
1:45:11 PM                                                                                                                    
At-ease.                                                                                                                        
                                                                                                                                
        SB  22-STUDENT ATHLETE TRAUMATIC BRAIN INJURIES                                                                     
                                                                                                                                
1:45:58 PM                                                                                                                    
CHAIR DAVIS announced the next order  of business would be SB 22,                                                               
relating to student athlete traumatic brain injuries.                                                                           
                                                                                                                                
ESTHER TEMPEL, staff to Senator  Lesil McGuire, sponsor of SB 22,                                                               
said  the  bill seeks  to  minimize  the complications  and  more                                                               
permanent  conditions that  can be  caused when  student athletes                                                               
continue to practice  or play after receiving  a concussion. More                                                               
than  60,000 high  school  student  athletes sustain  concussions                                                               
each  year. The  risk  can be  reduced with  a  helmet but  these                                                               
injuries cannot always be prevented.                                                                                            
                                                                                                                                
SB 22 is modeled after  legislation passed in Washington State. A                                                               
middle  school  football player  was  returned  to a  game  after                                                               
receiving a  concussion. When he  returned to play he  suffered a                                                               
second  injury from  which he  will  never fully  recover. SB  22                                                               
seeks to  require school districts  and Alaska  School Activities                                                               
Association  (ASAA)   to  develop  and  publish   guidelines  and                                                               
information  about the  nature and  risks. It  will also  require                                                               
athletes  suspected of  sustaining a  concussion be  removed from                                                               
play and cleared by a licensed  health care provider. There is no                                                               
way  to  completely prevent  concussions  but  we can  strive  to                                                               
prevent serious complications.                                                                                                  
                                                                                                                                
1:49:35 PM                                                                                                                    
SENATOR  EGAN moved  to adopt  the proposed  committee substitute                                                               
(CS) for SB 22, labeled 27-LS0250\B, as the working document.                                                                   
                                                                                                                                
CHAIR DAVIS objected for discussion purposes.                                                                                   
                                                                                                                                
MS. TEMPEL said  the CS was prepared after  consultation with the                                                               
Alaska Brain Injury  Network and the ASAA. It  replaces the words                                                               
"traumatic brain injuries" with  "concussions." A concussion is a                                                               
form  of traumatic  brain injury.  The change  occurs on  page 1,                                                               
line 6; page 2, line 13; and page 3, lines 18 and 21.                                                                           
                                                                                                                                
Section 2  adds a  new section,  AS 14.30.142(b),  which requires                                                               
that  schools provide  students  and their  parents with  written                                                               
information on the  nature and risks of  concussions. Parents are                                                               
also  required  to   sign  off  that  they   have  received  this                                                               
information.                                                                                                                    
                                                                                                                                
There  is  also a  language  change  with  reference to  who  can                                                               
evaluate a student suspected of  sustaining a concussion. This is                                                               
because in rural  Alaska a licensed health care  provider may not                                                               
always  be present.  A qualified  person could  be a  health care                                                               
provider  or a  person  acting  at the  direction  and under  the                                                               
supervision  of  a  licensed  physician.  This  would  include  a                                                               
village  health  aide.  Subsection 14.30.142(e)  adds  additional                                                               
language saying, " .  . . and who is not  paid for conducting the                                                               
evaluation."                                                                                                                    
                                                                                                                                
1:53:50 PM                                                                                                                    
GARY  MATTHEWS,  Executive  Director,  Alaska  School  Activities                                                               
Association (ASAA), said that their  responsibility is to provide                                                               
guidance  and regulation  and promote  interscholastic activities                                                               
in the high schools in Alaska.  This is an entity which will work                                                               
with member school  districts. They have worked  closely with the                                                               
Alaska   Association  of   School  Boards   (AASB),  the   Alaska                                                               
Association of  School Administrators  (AASA), and the  office of                                                               
Representative  Doogan,  who  sponsored  a similar  bill  in  the                                                               
House.                                                                                                                          
                                                                                                                                
About 12 states  have adopted similar legislation.  The intent is                                                               
to protect  students. It  is also to  educate and  train parents,                                                               
coaches,  school   nurses,  and  others  in   the  management  of                                                               
concussions  and  return  to  play. They  work  with  a  national                                                               
affiliate  to   reduce  injuries  in  sports.   Their  sphere  of                                                               
influence is  high school  interscholastic activities.  The rules                                                               
should  include proper  safety  equipment,  training of  coaches,                                                               
etc.                                                                                                                            
                                                                                                                                
ASAA is pleased  with the CS but they do  have one small concern.                                                               
On page 2, section (d), starting  on line 27, the state of Alaska                                                               
has  no  registry which  lists  health  care providers  who  have                                                               
received training in the management  of concussions. The provider                                                               
is the  only one who  knows if he or  she is a  qualified person.                                                               
The  last  step  should  be   to  place  a  slight  amendment  to                                                               
subsection (d), as follows: "A  student who has been removed from                                                               
participation in a  practice or game for  suspicion of concussion                                                               
may not return  to play until the student has  been evaluated and                                                               
cleared for participation by a  qualified person who has received                                                               
training  and  is  currently  certified  in  the  evaluation  and                                                               
management of  concussions."   At the end  of that  sentence they                                                               
would like  to add, ",  as verified  in writing by  the qualified                                                               
person."                                                                                                                        
                                                                                                                                
1:59:01 PM                                                                                                                    
There is no way for the school  to know if a person is qualified.                                                               
So  the person  needs to  self-certify they  are qualified.  That                                                               
way, any liability  falls onto the health care  provider, not the                                                               
school district.                                                                                                                
                                                                                                                                
2:00:03 PM                                                                                                                    
CHAIR DAVIS  said that everything was  in the new CS,  except "as                                                               
verified  in writing  by the  qualified person."  She noted  that                                                               
language could be added today by the committee.                                                                                 
                                                                                                                                
2:00:53 PM                                                                                                                    
JILL  HODGES, Executive  Director, Alaska  Brain Injury  Network,                                                               
said  she was  calling  in  support of  SB  22.  The network  has                                                               
testified in support of many  bills and resolutions. SB 22 brings                                                               
attention to concussions among student  athletes. She said it was                                                               
exciting to  be testifying in support  of a bill that  would help                                                               
to  keep student  athletes safe  and  prevent serious,  traumatic                                                               
brain injury.                                                                                                                   
                                                                                                                                
2:03:52 PM                                                                                                                    
There  is  no fiscal  note,  so  this  is  an affordable  way  to                                                               
increase  awareness.  SB  22  will  help  keep  brains  safe  and                                                               
increase  awareness of  traumatic  brain injuries.  It will  help                                                               
schools and  coaches better understand  how to reduce  the number                                                               
of injuries  and the risk  of injuries. The Brain  Injury Network                                                               
believes SB 22 will help  student athletes to continue to succeed                                                               
in sports and school.                                                                                                           
                                                                                                                                
2:06:17 PM                                                                                                                    
PETER HOEFFNER,  Board Member, Cordova  School District,  said he                                                               
supports SB  22. It focuses  on concussions  and is good  for the                                                               
health and well being of students.                                                                                              
                                                                                                                                
2:07:33 PM                                                                                                                    
CHRISTOPHER DEAN,  Alaska Athletic  Trainers Association  said SB                                                               
22 creates  a right and a  duty for all people  involved in youth                                                               
athletics to  protect the child.  The Center for  Disease Control                                                               
(CDC) has  defined concussions as  being at epidemic level.  As a                                                               
trainer  he sees  this first  hand. Post  season reporting  shows                                                               
that close to 50 percent of  athletes in contact sports receive a                                                               
concussion during  the season, yet  only 15 percent of  these are                                                               
reported to  the athletic trainer during  the season. Concussions                                                               
are  severely underreported.  Many  schools do  not have  trained                                                               
personnel on site, which makes  it important to train and educate                                                               
our coaches, administrators, and parents.                                                                                       
                                                                                                                                
2:09:58 PM                                                                                                                    
BRENDA SHELTON,  President, Alaska Athletic  Trainers Association                                                               
(AATA), said  the organization  is committed  to the  support and                                                               
implementation  of this  legislation.  An athletic  trainer is  a                                                               
health  care  professional  who specializes  in  the  prevention,                                                               
diagnosis,   treatment,  and   rehabilitation  of   sport-related                                                               
injuries.  SB   22  is  revenue   neutral;  free   and  reputable                                                               
educational  tools are  available.  An athlete  who exhibits  the                                                               
signs,  symptoms,  or  behaviors  consistent  with  a  concussion                                                               
should be  removed immediately from  practice or  competition and                                                               
should not be returned to play  until cleared by a trained health                                                               
care professional. AATA stands in support of SB 22.                                                                             
                                                                                                                                
2:11:43 PM                                                                                                                    
BRUCE  JOHNSON,  Executive  Director, Alaska  Council  of  School                                                               
Administrators  (ACSA), said  they  have  worked collectively  to                                                               
bring this legislation to the  committee. They feel strongly that                                                               
the  time is  right to  pass this  bill. Education  is available,                                                               
particularly  for those  involved  in contact  sports. They  have                                                               
worked  hard  to  get  the  protocols  in  place  for  evaluating                                                               
possible concussions.                                                                                                           
                                                                                                                                
2:13:05 PM                                                                                                                    
CHAIR DAVIS  closed public  testimony on SB  22. She  noted there                                                               
was one recommendation for a small change.                                                                                      
                                                                                                                                
SENATOR MEYER asked  Ms. Lelake if she thought  the sponsor would                                                               
agree to the suggested change.                                                                                                  
                                                                                                                                
MS. LELAKE said she thought he would.                                                                                           
                                                                                                                                
SENATOR DYSON said we can pass  the bill out with the change, and                                                               
the sponsor can undo it if he wants to.                                                                                         
                                                                                                                                
SENATOR EGAN asked where the new words would be inserted.                                                                       
                                                                                                                                
MS. LELAKE answered on page 2, line 30.                                                                                         
                                                                                                                                
2:15:41 PM                                                                                                                    
CHAIR DAVIS  said it  was just  a matter  of adding  "as verified                                                               
by."                                                                                                                            
                                                                                                                                
SENATOR MEYER  said it was  a good bill  and would work  in urban                                                               
areas, but what  about in rural areas if no  health care provider                                                               
was available.                                                                                                                  
                                                                                                                                
MS. LELAKE responded  she believes the CS  addresses the problem,                                                               
because village health aids would qualify.                                                                                      
                                                                                                                                
SENATOR MEYER said that should work.                                                                                            
                                                                                                                                
CHAIR DAVIS asked for a motion to move the bill.                                                                                
                                                                                                                                
SENATOR EGAN moved to report CS  for SB 22, version B as amended,                                                               
and  adding  on  line  30, after  concussions,  "as  verified  in                                                               
writing by the qualified person,"  from committee with individual                                                               
recommendations   and   accompanying    fiscal   notes.   Without                                                               
objection, CSSB 22(HSS)  moved from the Senate  Health and Social                                                               
Services Standing Committee.                                                                                                    
                                                                                                                                
2:19:19 PM                                                                                                                    
At-ease from 2:19 p.m. to 2:20 p.m.                                                                                             
                                                                                                                                
         SB  74-INS. COVERAGE: AUTISM SPECTRUM DISORDER                                                                     
                                                                                                                                
CHAIR DAVIS announced the next order  of business would be SB 74,                                                               
relating to insurance coverage for autism spectrum disorders.                                                                   
                                                                                                                                
2:20:22 PM                                                                                                                    
SENATOR JOHNNY  ELLIS, sponsor  of SB  74, thanked  the committee                                                               
for hearing  the bill. He  said autism is a  devastating disorder                                                               
affecting one in 110 American  children. Despite being treatable,                                                               
most children  with autism spectrum  disorders never  receive the                                                               
treatment they need.  SB 24 would require  insurance companies to                                                               
cover treatment  for autism spectrum disorders  (ASDs), including                                                               
medically  necessary   applied  behavior  analysis   (ABA).  Most                                                               
insurance  policies specifically  exclude  coverage for  treating                                                               
autism. A  total of 35 states  and the District of  Columbia have                                                               
laws related to this issue,  and at least 23 specifically require                                                               
insurance  companies to  provide  coverage for  the treatment  of                                                               
autism.                                                                                                                         
                                                                                                                                
According to  the governor's council on  disabilities and special                                                               
education,  insurance coverage  of treatment  of ASDs  would save                                                               
the  state  $280,500  per capita  in  avoided  special  education                                                               
costs, with a lifetime savings of $1.8 million per child.                                                                       
                                                                                                                                
2:22:37 PM                                                                                                                    
The  majority of  children with  autism  who receive  appropriate                                                               
intervention  and  treatment experience  remarkable  improvement.                                                               
Early  intervention and  treatment work.  Forty-seven percent  of                                                               
those  treated  recover  typical  function;  forty  percent  make                                                               
significant  improvement, while  the  remaining thirteen  percent                                                               
make little progress.  Treatment can save the  state millions and                                                               
significantly improve the lives  of thousands. Families feel like                                                               
they are drowning without assistance.                                                                                           
                                                                                                                                
2:23:50 PM                                                                                                                    
AMORY LELAKE,  staff to  Senator Ellis, said  she would  walk the                                                               
committee  through  the bill.  Section  one  amends AS  21.42  by                                                               
creating  a  new  section, AS  21.42.397  relating  to  insurance                                                               
coverage for  autism spectrum disorders.  Subsection (a),  page 1                                                               
line  1 through  page 2,  line  12, requires  insurance plans  to                                                               
cover  medically   necessary  treatment  for   autism  disorders.                                                               
Subsection (b), page 2 lines  13-23, further defines the coverage                                                               
that must be provided.                                                                                                          
                                                                                                                                
Subsection (c),  page 2  lines 24 and  25, establishes  that this                                                               
section  does not  limit  coverage  already provided.  Subsection                                                               
(d),  page 2  lines 26-28,  prohibits an  insurance company  from                                                               
denying coverage to someone because  they have an autism spectrum                                                               
disorder. Subsection (e), page 2, line  29 through page 3 line 21                                                               
defines "autism  service provider," "autism  spectrum disorders,"                                                               
"health  care  insurance  plan,"  "health  care  insurance,"  and                                                               
"medically necessary."                                                                                                          
                                                                                                                                
Section 2 page  3 lines 22-26 establishes that  the provisions of                                                               
section 1 only  apply to insurance policies  issued after January                                                               
1,  2012. Section  3, page  3 lines  27 establishes  an immediate                                                               
effective date for this act.                                                                                                    
                                                                                                                                
2:25:58 PM                                                                                                                    
MS. LELAKE stated  there were numerous experts on  line who could                                                               
speak to the legislation.                                                                                                       
                                                                                                                                
LAURIE  EUNAM, attorney  and  parent of  a  10-year-old son  with                                                               
autism, said she was testifying in  support of SB 74. She is also                                                               
senior litigation  council with  Autism Speaks, a  New York-based                                                               
non-profit.  Her   full-time  job  is  to   advocate  for  autism                                                               
insurance reform in all 50  states. Autism is a medical condition                                                               
brought on  by no  fault of  the family. In  slide #2,  the graph                                                               
shows distinct diagnoses within  the disorder; Autistic Disorder,                                                               
Asperberger's  Syndrome,  and Pervasive  Developmental  Disorder.                                                               
The  most  severe  diagnosis   is  Autistic  Disorder.  Pervasive                                                               
Developmental  Disorder Not  Otherwise  Specified  (PDDNOS) is  a                                                               
mild form of  autism spectrum disorder. It  accounts for one-half                                                               
of all diagnoses.                                                                                                               
                                                                                                                                
There is no known  cure for autism but it can  be treated so that                                                               
symptoms  are   not  disabling.  The  most   commonly  prescribed                                                               
treatment protocol  is Applied Behavior Analysis  (ABA) which has                                                               
been  used for  many years  to  treat autism,  but the  insurance                                                               
industry  continues  to deny  coverage  for  this treatment.  The                                                               
Surgeon General,  the National Research Council  and the American                                                               
Academy of  Pediatrics all have  endorsed the use of  ABA therapy                                                               
for children with autism.                                                                                                       
                                                                                                                                
2:30:32 PM                                                                                                                    
Studies show that if ABA  is administered intensively by properly                                                               
trained  therapists,  about half  of  the  treated children  will                                                               
overcome their autistic characteristics  such that they can enter                                                               
first grade indistinguishable from  their peers. The therapy must                                                               
be administered intensively,  often 20, 30, or even  40 hours per                                                               
week. Her  son's autism is  severe and  his therapy costs  out of                                                               
pocket  $75,000  per   year.  She  and  her   husband  have  made                                                               
sacrifices, such  as selling their  home and moving to  a cheaper                                                               
one, to afford therapy for their  son. But how many families have                                                               
that kind of  money to sacrifice? Most don't, and  so children go                                                               
untreated.                                                                                                                      
                                                                                                                                
We know  there is a treatment  that works but children  can't get                                                               
the treatment  they need.  These are families  who are  doing the                                                               
right thing  by buying  insurance, and still  can't get  the help                                                               
their children need.  Only the wealthy few  get treatment. Autism                                                               
prevalence is  on the rise.  Over the past  25 years it  has gone                                                               
from  one in  2,500  to one  in  110. A  huge  autism tsunami  is                                                               
coming. Without private insurance,  the needed treatment will not                                                               
happen.                                                                                                                         
                                                                                                                                
2:34:02 PM                                                                                                                    
Twenty-four states  have mandated autism insurance  coverage. One                                                               
state has  passed a  bill in  2011, and  West Virginia's  bill is                                                               
about  to become  law. Actual  claims data  from Blue  Cross Blue                                                               
Shield  (BCBS) of  Minnesota, where  the law  has been  in effect                                                               
since 2001, shows  that the financial impact  for covering autism                                                               
is  .83  per  member  per  month. In  South  Carolina  the  state                                                               
employee health  plan has  released this  cost data:  the statute                                                               
passed in 2007 and took effect  in 2009. It caps coverage for ABA                                                               
therapy at $50,000  per year at age 16. In  2010 the increase was                                                               
.44 per member per month. The  law has minimal impact on premiums                                                               
and its overall  impact on the economy has  been positive. People                                                               
have been  trained and  are working  full-time as  therapists for                                                               
children with autism.                                                                                                           
                                                                                                                                
2:38:55 PM                                                                                                                    
SENATOR DYSON asked is it logical  to assume that in a state like                                                               
Alaska with  a very small  population, the cost per  policy would                                                               
be higher.                                                                                                                      
                                                                                                                                
MS. EUNAM answered if that  was typically the case, then probably                                                               
yes.                                                                                                                            
                                                                                                                                
SENATOR DYSON  said it would  seem that  if South Carolina  has a                                                               
cost  of .44  cents per  month with  around five  million people,                                                               
compared to Alaska with only  700,000 people, the cost per policy                                                               
holder would be higher.                                                                                                         
                                                                                                                                
MS. EUNAM  said she would  let the  actuary speak in  more detail                                                               
about that. Cost projections from  state to state have not varied                                                               
dramatically, and  she was not  aware of any factors  specific to                                                               
Alaska.                                                                                                                         
                                                                                                                                
2:41:31 PM                                                                                                                    
MARK LAMBRIGHT, Independent Actuary,  Oliver Wyman, said he would                                                               
address the  previous question. In  doing the  actuarial studies,                                                               
they  did  consider that  medical  costs  are higher  in  Alaska.                                                               
However, due  to fewer  people being  covered, the  overall costs                                                               
would be lower.  The costs per member would be  roughly the same.                                                               
Analysis  indicates  that  premiums   would  increase  .3  to  .7                                                               
percent. The  net result is  an estimate of cost  increase. Other                                                               
independent actuaries have provided similar analyses.                                                                           
                                                                                                                                
2:45:04 PM                                                                                                                    
MARGARET COSSLER, Anchorage,  said she was speaking  on behalf of                                                               
her five year old son with  autism. She and her husband wanted to                                                               
find  the best  possible treatment  for their  child. Not  having                                                               
insurance to  cover this is  extremely stressful for  the family;                                                               
knowing that  there is something  you can  do to help  your child                                                               
but  you  cannot  provide  it is  extremely  painful  and  nearly                                                               
unbearable.                                                                                                                     
                                                                                                                                
2:47:05 PM                                                                                                                    
SENATOR ELLIS  noted that Representative Petersen  had joined the                                                               
meeting.                                                                                                                        
                                                                                                                                
2:47:37 PM                                                                                                                    
JANICE  GERTON,  mother of  Chad  Gerton,  testified on  her  own                                                               
behalf.  He  was diagnosed  as  Autistic  at  age  5. At  12  his                                                               
diagnosis changed  from Autism to  Asperberger's Syndrome.  At 18                                                               
months they  knew he was  not the  same as their  other children.                                                               
Each  doctor   they  saw  said   he  did  need   speech  therapy,                                                               
occupational  therapy,  sensory   integration.  When  he  started                                                               
school they  gave him  an IEP  and they did  what they  could. He                                                               
never  lost  language  but  had   many  issues  with  peers.  His                                                               
experiences were  hard for the family  and hard for him.  Her job                                                               
became  24 hours  trying to  find services.  The family  had good                                                               
insurance but it did not cover what he needed.                                                                                  
                                                                                                                                
Early  intervention has  been proven  the best  way. There  would                                                               
have been  less impact  in his  life and life  of his  family. He                                                               
needed this in  school, home, and community. One out  of 110 kids                                                               
is affected. Four out of  five are boys. Intervention should have                                                               
come  early, but  it  was very  slow.  Early intervention  works.                                                               
Fewer  services are  needed over  a lifetime.  Her son  became an                                                               
Eagle  Scout,  his senior  class  treasurer,  and has  become  an                                                               
accountant. At  age 25,  he was recently  married. He  is working                                                               
full  time and  taking 12  credits at  UAS. Children  with autism                                                               
need a good health plan.                                                                                                        
                                                                                                                                
2:52:13 PM                                                                                                                    
This  should be  in place  for the  next generation  so they  can                                                               
receive early intervention and have  the best possible quality of                                                               
life. Her son  still has issues because he lacked  the right type                                                               
of  services early  on. The  month of  April is  Autism Awareness                                                               
Month; they  are trying  to get people  to understand  and accept                                                               
the differences.                                                                                                                
                                                                                                                                
2:53:33 PM                                                                                                                    
CHAIR DAVIS thanked the witness for coming forward.                                                                             
                                                                                                                                
LAURIE KING, mother  of a 20 year old daughter  with autism, said                                                               
her family didn't  have the insurance they needed to  take her to                                                               
the  specialists at  an  early  age. They  had  insurance but  it                                                               
didn't cover what they needed.  Her husband was diagnosed with MS                                                               
and unable to work, so she had  to work instead of taking care of                                                               
her daughter. She  said her daughter would have  done much better                                                               
with earlier  intervention. They could  not get services  for her                                                               
until age eight;  as a result, her potential to  be a functioning                                                               
member of society was severely degraded.                                                                                        
                                                                                                                                
2:59:59 PM                                                                                                                    
CHAIR DAVIS  said the committee  had heard good testimony  on the                                                               
bill today. She  also had several letters and  emails of support.                                                               
BCBS of Alaska is in opposition.                                                                                                
                                                                                                                                
3:00:57 PM                                                                                                                    
CHAIR DAVIS invited Representative Petersen to testify.                                                                         
                                                                                                                                
REPRESENTATIVE PETE  PETERSEN said when  you hear the  stories it                                                               
is  hard  to  believe  the  lack  of  coverage  still  continues.                                                               
Children  are  missing their  window  of  opportunity to  have  a                                                               
normal life.                                                                                                                    
                                                                                                                                
CHAIR DAVIS asked for a motion to move the bill.                                                                                
                                                                                                                                
SENATOR  DYSON  said he  had  some  remarks  but given  the  time                                                               
constraints he would not speak.                                                                                                 
                                                                                                                                
CHAIR DAVIS asked why not a short version.                                                                                      
                                                                                                                                
3:03:02 PM                                                                                                                    
SENATOR  DYSON said  he applauds  the purpose  of the  bill. What                                                               
troubles him is  the funding source. The  insurance companies are                                                               
not the problem. When we get down  to figuring out how we serve a                                                               
good  purpose,  he  worries  that we  choose  pragmatism  at  the                                                               
expense of  freedom. He  agrees that  services for  children with                                                               
autism need  to be available. The  righteous way would be  to pay                                                               
for it  out of  the general  fund so that  everyone has  the same                                                               
chance. There  is a fairer way  to get services to  children, and                                                               
that is  to do  it through  the tax base.  Putting the  burden on                                                               
insurance  companies   is  easier,  but  he   worries  about  the                                                               
direction we are going.                                                                                                         
                                                                                                                                
3:06:42 PM                                                                                                                    
He also  questioned having a  zero fiscal note. Maybe  it doesn't                                                               
come out  of the state's  pocket, but it  will come out  of state                                                               
employees' pockets.  He does applaud  the intentions of  the bill                                                               
and his heart goes out to the kids.                                                                                             
                                                                                                                                
3:07:37 PM                                                                                                                    
CHAIR DAVIS said this bill  has another committee of referral and                                                               
some of those issues will be heard there.                                                                                       
                                                                                                                                
SENATOR  EGAN  moved   to  report  SB  74   from  committee  with                                                               
individual  recommendations and  attached  fiscal note(s).  There                                                               
being  no objection,  SB  74  moved from  the  Senate Health  and                                                               
Social Services Standing Committee.                                                                                             
                                                                                                                                
3:08:14 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Davis adjourned the meeting at 3:08 p.m.                                                                                  

Document Name Date/Time Subjects
SCR 7 Sponsor Statement.pdf SHSS 3/30/2011 1:30:00 PM
SCR 7 Bill Text.pdf SHSS 3/30/2011 1:30:00 PM
SCR7 10 Things You Should Know About FAS.pdf SHSS 3/30/2011 1:30:00 PM
SCR7 FASD Economic Cost pgs 34-37.pdf SHSS 3/30/2011 1:30:00 PM
SB 22_Version A.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 Sectional Analysis Version A.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB22 CS Version B.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 Summary of Changes Version B.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 Youth Concussion Ed Pack.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 State Legislatures Article.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 NPR Story.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 LetterOfSupport ABIN.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 Brain Injury Association of WA.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 Boston Univ Article.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 22 AATA Letter of Support.pdf SHSS 3/30/2011 1:30:00 PM
SB 22
SB 74 Bill.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
SB 74 Sectional Analysis.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
AK HB 79- SB 74 Actuarial Cost Analysis 3 4 2011 FINAL.pdf SHSS 3/30/2011 1:30:00 PM
HB 79
SB 74
SB 74 Autism Plan Progress.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
SB74 Breaking Through.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
SB74 Ganz Article on Societal Costs.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
SB74 Stone Soup Group.pdf SHSS 3/30/2011 1:30:00 PM
SB 74
SB74 Trust Letter.pdf SHSS 3/30/2011 1:30:00 PM
SB 74