HOUSE COMMUNITY AND REGIONAL AFFAIRS STANDING COMMITTEE January 16, 1996 1:07 p.m. MEMBERS PRESENT Representative Ivan Ivan, Co-Chair Representative Alan Austerman, Co-Chair Representative Kim Elton Representative Al Vezey Representative Pete Kott MEMBERS ABSENT Representative Jerry Mackie Representative Irene Nicholia COMMITTEE CALENDAR * HOUSE BILL NO. 392 "An Act relating to the affirmative vote necessary to amend the articles of incorporation of Native village corporations to authorize the classification of directors." - PASSED OUT OF COMMITTEE * HOUSE BILL NO. 383 "An Act relating to reimbursement by the state to municipalities and certain established villages for services provided to individuals incapacitated by alcohol; and providing for an effective date." - HEARD AND HELD (* First public hearing) PREVIOUS ACTION BILL: HB 392 SHORT TITLE: NATIVE CORP DIRECTOR CLASSIFICATION SPONSOR(S): REPRESENTATIVE(S) IVAN JRN-DATE JRN-DATE ACTION 01/05/96 2369 (H) PREFILE RELEASED 01/08/96 2369 (H) READ THE FIRST TIME - REFERRAL(S) 01/08/96 2369 (H) CRA, JUDICIARY, FINANCE 01/16/96 (H) CRA AT 01:00 PM CAPITOL 124 BILL: HB 383 SHORT TITLE: REIMBURSE FOR LOCAL SERVICE TO INEBRIATES SPONSOR(S): REPRESENTATIVE(S) IVAN JRN-DATE JRN-DATE ACTION 12/29/95 2366 (H) PREFILE RELEASED 01/08/96 2366 (H) READ THE FIRST TIME - REFERRAL(S) 01/08/96 2366 (H) CRA, STATE AFFAIRS, FINANCE 01/16/96 (H) CRA AT 01:00 PM CAPITOL 124 WITNESS REGISTER TOM WRIGHT, Legislative Assistant to Representative Ivan Ivan Alaska State Legislature State Capitol Building, Room 503 Juneau, Alaska 99801 Telephone: (907) 465-4942 POSITION STATEMENT: Presented sponsor statements for HB 392 and HB 383. GLEN PRICE, Representative Napaskiak Incorporated and Swan Lake Corporation Foster Pepper & Shefelman 601 West Fifth, Suite 500 Anchorage, Alaska 99501 Telephone: (907) 276-4411 POSITION STATEMENT: Provided information on HB 392. CRISTY TILDEN, Program Director Drug and Alcohol Services Bristol Bay Area Health Corporation; and Board Member, Advisory Board on Alcohol and Drug Abuse P.O. Box 130 Dillingham, Alaska 99576 Telephone: (907) 842-5266 POSITION STATEMENT: Supported HB 383, with additional suggestions. JAN McCARTNEY, Patient Accounts Manager Bristol Bay Area Health Corporation P.O. Box 130 Dillingham, Alaska 99576 Telephone: (907) 842-5201 POSITION STATEMENT: Supported HB 383. GEORGE YOUNG, Fire Chief City of Bethel P.O. Box 388 Bethel, Alaska 99559 Telephone: (907) 543-2131 POSITION STATEMENT: Supported HB 383. CHRIS LIU, Police Chief City of Bethel P.O. Box 500 Bethel, Alaska 99559 Telephone: (907) 543-3781 POSITION STATEMENT: Supported HB 383. DAVE TRANTHAM P.O. Box 759 Bethel, Alaska 99559 Telephone: (907) 543-2772 POSITION STATEMENT: Supported HB 383. ANASTASIA COOK Association of Village Council Presidents Receiving Home P.O. Box 219 Bethel, Alaska 99559 Telephone: (907) 543-2019 POSITION STATEMENT: Supported HB 383. BOB CHARLES, Vice President of Operations Association of Village Council Presidents P.O. Box 219 Bethel, Alaska 99559 Telephone: (907) 543-3521 POSITION STATEMENT: Supported HB 383, with suggested amendment. EDMON MYERS, Administrator Kodiak Island Hospital/Care Center 1915 East Rezanof Kodiak, Alaska 99615 Telephone: (907) 486-3218 POSITION STATEMENT: Supported HB 383. DENNIS OAKLAND, Chief of Police Police Department City of Homer 4060 Heath Street Homer, Alaska 99603 Telephone: (907) 235-3150 POSITION STATEMENT: Supported HB 383. WILLIAM WALTERS, Judicial Services Officer Police Department City of Homer 4060 Heath Street Homer, Alaska 99603 Telephone: (907) 235-3150 POSITION STATEMENT: Supported HB 383, with proposed amendments. GARY GRANDY, Administrator Petersburg Medical Center; and Council Member, Petersburg City Council P.O. Box 589 Petersburg, Alaska 99833 Telephone: (907) 772-3059 POSITION STATEMENT: Supported HB 383, with suggestions about funding. GREG PORTER, Administrator Cordova Medical Center P.O. Box 160 Cordova, Alaska 99574 Telephone: (907) 424-8000 POSITION STATEMENT: Supported HB 383. MIKE HOLSMAN, Planning Officer Department of Health and Human Services Municipality of Anchorage 825 L Street Anchorage, Alaska 99501 Telephone: (907) 343-4619 POSITION STATEMENT: Supported HB 383, with additional suggestions. CHRIS HLADICK, Manager City of Dillingham P.O. Box 869 Dillingham, Alaska 99576 Telephone: (907) 842-5211 POSITION STATEMENT: Supported HB 383, with additional suggestions. MARY PAVIL, Representative Orutsaramuit Native Council; and Council Member, City of Bethel P.O. Box 37 Bethel, Alaska 99559 Telephone: (907) 543-2608 POSITION STATEMENT: Supported HB 383. KIMBERLY METCALFE-HELMAR, Special Assistant Office of the Commissioner Department of Community and Regional Affairs P.O. Box 112100 Juneau, Alaska 99811-2100 Telephone: (907) 465-4898 POSITION STATEMENT: Testified on HB 383. LOREN JONES, Director Division of Alcoholism and Drug Abuse Department of Health and Social Services P.O. Box 110607 Juneau, Alaska 99811-0607 Telephone: (907) 465-2071 POSITION STATEMENT: Testified on HB 383. HARLAN KNUDSON, President/CEO Alaska State Hospital & Nursing Home Association 319 Seward, #11 Juneau, Alaska 99801 Telephone: (907) 586-1790 POSITION STATEMENT: Supported HB 383. ACTION NARRATIVE TAPE 96-1, SIDE A Number 001 CO-CHAIR IVAN IVAN called the House Community and Regional Affairs Committee meeting to order at 1:07 p.m. Members present at the call to order were Representatives Ivan, Austerman, Elton and Kott. Members absent were Representatives Vezey, Mackie and Nicholia. Co-Chair Ivan noted that Representative Nicholia was en route to Juneau. He then introduced committee staff and reviewed the committee guidelines. HB 392 - NATIVE CORP DIRECTOR CLASSIFICATION Number 429 CO-CHAIR IVAN noted the bill packets contained a copy of HB 392; the sponsor statement; two zero fiscal notes, one from the Department of Community and Regional Affairs and one from the Department of Commerce and Economic Development; a letter from Glen Price of Foster Pepper & Shefelman explaining the intent of the bill; and resolutions in support from Napaskiak Incorporated and Swan Lake Corporation. As sponsor of the legislation, he asked Tom Wright to present the bill on his behalf. Number 477 TOM WRIGHT, Legislative Assistant to Representative Ivan, presented the sponsor statement for HB 392, explaining it amends the Alaska corporations code to authorize Alaska Native Claims Settlement Act (ANCSA) village corporations to provide for Board of Director classification in their bylaws. If enacted, HB 392 would allow ANCSA village corporations to amend their articles of incorporation to authorize a classified or staggered term board of directors by a majority vote of the shares represented at a meeting of shareholders. Under current law, for those villages which did not have classified boards in place by July 1, 1989, such an amendment requires a two-thirds vote of all outstanding shares entitled to vote, which is often difficult for village corporations to achieve. Number 564 REPRESENTATIVE PETE KOTT asked if there were only two village corporations to which HB 392 applied. MR. WRIGHT responded that they were aware of only two, Napaskiak and Swan Lake; however, there could be others. REPRESENTATIVE KOTT asked if they knew the reason why, prior to 1989, those corporations did not have a classified board in place. MR. WRIGHT suggested that Glen Price, representative for Napaskiak and Swan Lake, could better answer the question. CO-CHAIR IVAN added that the legislation was intended to assist village corporations that incur costs in executing annual shareholder meetings. Shareholders attended by proxy and in person, but the statutes required a two-thirds majority of all shareholders to amend the articles and bylaws. He deferred to Glen Price to answer technical questions. Number 686 GLEN PRICE, Foster Pepper & Shefelman, representing Napaskiak Incorporated and Swan Lake Corporation, testified via teleconference from Anchorage, saying he was unaware of why the corporations had no classified boards before 1989. He had represented Napaskiak and Swan Lake for two or three years. The corporations had attempted to address the issue at their last two annual meetings, but had only obtained a majority vote at each meeting, not the two-thirds vote required to amend articles. He added there were probably other corporations to which HB 392 would apply, but he did not know which corporations had classified boards. He thought polling Native corporation villages might be required to obtain that information, which was not on file with the Department of Commerce and Economic Development. Number 760 REPRESENTATIVE KOTT asked Mr. Price if the villages having classified boards in place prior to 1989 required a simple majority vote. MR. PRICE responded that he thought so; before July 1, 1989, it could be in the bylaws. Because a board could have amended the bylaws, he thought boards rather than shareholders of most corporations had enacted the change. Number 819 CO-CHAIR IVAN clarified that in no way did the legislation attempt to alter the checks and balances in place. However, the majority of small communities had five directors, each up for election every year. In the case of Napaskiak and Swan Lake, they were trying to expand the number of directors and institute staggered terms to provide continuity. REPRESENTATIVE KOTT asked whether HB 392 would affect regional corporations. MR. PRICE confirmed that it would not. He said it specifically referenced village corporations only. Number 908 REPRESENTATIVE KIM ELTON noted that the language of July 1, 1989, was highly specific. He asked Mr. Price what the history of the 1989 language was and why it was included. MR. PRICE responded that July 1, 1989, was the effective date of the corporations code currently in place. Prior to that, corporations could provide for classified boards in their bylaws. Under the new code, there must be authority in the articles if there was no classified board before July 1, 1989. For pre- existing corporations, as of July 1, 1989, they needed a two-thirds vote to amend the articles. However, he said, those corporations cannot even get two-thirds attendance at a meeting. REPRESENTATIVE ELTON wanted to know if there had been discussion of the difference between treatment of village corporations existing before and after 1989. MR. PRICE responded he was unaware of such discussion. CO-CHAIR IVAN asked if there were any further comments or questions from the committee. Hearing none, he indicated he wanted to consider passing the bill from committee. Number 1109 CO-CHAIR ALAN AUSTERMAN moved that HB 392 move from committee with individual recommendations. There being no objection, it was so ordered. HB 383 - REIMBURSE FOR LOCAL SERVICE TO INEBRIATES Number 1122 CO-CHAIR IVAN introduced the next item of business, HB 383, indicating the committee packets contained the bill; the sponsor statement; a zero fiscal note from the Department of Health and Social Services; a fiscal note from the Department of Community and Regional Affairs; relevant statutes; support documents; and a legal opinion from Division of Legal and Research Services regarding use of the mental health trust income account. He invited Tom Wright to present the bill on his behalf. Number 1180 TOM WRIGHT, Legislative Assistant to Representative Ivan, presented the sponsor statement. Under AS 47.37.170, he said, a person who appears intoxicated and incapacitated in a public place will be taken into protective custody and placed in an approved public treatment facility or a state or municipal detention facility. This person must then be examined by a licensed physician or other qualified health practitioner as soon as possible. If the person is found to be incapacitated by alcohol, the person is detained for no more than 48 hours in a health facility or for no more than 12 hours in a detention facility. The costs of this program to the municipalities and the public health facilities are tremendous. He said Representative Ivan introduced HB 383 to offer a solution that will reduce or eliminate the fiscal responsibilities that municipalities and public health facilities bear each year undertaking what Representative Ivan feels is an unfunded mandate. MR. WRIGHT explained that the situation was exacerbated by what occurred in Dillingham over the last year. He referred to the fiscal note from the Department of Health and Social services, which he said contained a history of what took place there. In addition, he said, the problem was ongoing statewide. CO-CHAIR IVAN thanked Mr. Wright and asked if there were questions or comments from the committee. Hearing none, he proceeded to take testimony from teleconference participants. Number 1295 CRISTY TILDEN, Program Director for Drug and Alcohol Services, Bristol Bay Area Health Corporation, testified via teleconference from Dillingham in support of HB 383. She said the issue has been significant for both Dillingham and other communities statewide. As a health professional, she supports measures providing treatment and safety for persons incapacitated by drugs or alcohol. However, the statute as written compels good treatment without compensation. She commented that it has been a bitter pill for Dillingham and other communities. MS. TILDEN added that she is a member of the Advisory Board on Alcoholism and Drug Abuse. She said the board supports HB 383 but has further suggestions to improve the statute, including adding substances besides alcohol and redefining "incapacitated." Number 1438 JAN McCARTNEY, Patient Accounts Manager, Bristol Bay Area Health Corporation, testified via teleconference from Dillingham. She stated she supports HB 383, and stressed the hardship put on small communities by unfunded mandates. Number 1527 GEORGE YOUNG, Fire Chief, City of Bethel, spoke via teleconference in support of HB 383. He asked whether the bill was intended to apply only when a municipality placed people under protective custody, or if it would also allow medical services, including fire department services, to recover losses from people rendered unconscious or having impaired mobility. CO-CHAIR IVAN responded that HB 383 asks the state to provide funding to reimburse municipalities or established villages that have detention facilities. MR. YOUNG reiterated his support, and added he would seek information on how to make this applicable to ambulance services not involved with protective custody. Number 1631 CHRIS LIU, Police Chief, City of Bethel, testified via teleconference from Bethel, expressing gratitude that the needs of the people in the delta were being addressed. From 1985-1995, an average of 938 persons were detained for protective custody, with 1,124 people detained in 1995. The financial burden was significant, costing the police department hundreds of thousands. He and his fellow chiefs of police agreed the state of Alaska must address unfunded mandates, this being the most significant one. Number 1719 DAVE TRANTHAM spoke via teleconference from Bethel, testifying as a senior citizen in support of HB 383. He agreed with previous speakers that this unfunded mandate was costly, and added that the City of Bethel had attempted to collect a $300 fee from individuals picked up for their own protection. However, the City was often unable to collect, and the cost was passed on to Bethel's citizens through taxation and reduced services in other areas. He expressed appreciation to the committee and the Alaska State Legislature for joining with Bethel to help solve this problem. Number 1927 ANASTASIA COOK, Association of Village Council Presidents (AVCP) Receiving Home, Bethel, testified via teleconference in support of HB 383. Children of people in protective custody were often placed in emergency shelters and receiving homes. One-third to one-half of the AVCP Receiving Home's cases related to protective custody; often the children were in the shelters for three weeks to a month. She asked that these children be kept in mind. Number 1938 BOB CHARLES, Vice President of Operations, Association of Village Council Presidents (AVCP), Bethel, testified via teleconference in support of HB 383. As a follow-up to Ms. Cook's testimony, he asked the committee to consider amending the bill to reimburse both those who care for children impacted by protective custody cases and Village Public Safety Officers who provide services relating to such cases, as the two groups are often poorly compensated. CO-CHAIR IVAN thanked Mr. Charles and asked him to please forward any proposed amendments to Tom Wright for consideration. Number 2050 EDMON MYERS, Administrator, Kodiak Island Hospital/Care Center, testified via teleconference in support of HB 383, saying he concurred with the majority of testimony heard previously. At his hospital, there were $70,000 to $80,000 in unreimbursed costs that probably fell within the relevant categories. Patients in "gray areas" probably represented an additional $100,000 to $120,000. Unreimbursed costs were compensated for by other users and hurt the medical community a great deal. In addition, the hospital maintained a security force to protect staff from inebriated patients, adding to costs. MR. MYERS said Kodiak police officers often call an ambulance to transport inebriated persons to the hospital, resulting in a question as to when the person is in protective custody. Police may wait at the back door and arrest a person once they had been medically evaluated and released. HB 383 would eliminate problems of defining protective custody for purposes of reimbursement. Number 2239 DENNIS OAKLAND, Chief of Police, City of Homer, testified via teleconference in support of HB 383. Despite Homer having fewer inebriates than some other communities, he said, unreimbursed expenses ran into the hundreds of thousands of dollars for incarceration, medical and attached liability costs. In addition, because reimbursement was affected, many inebriated individuals who committed minor crimes were charged with those crimes in situations where they might not otherwise have been charged, adding to the criminal justice system load. He added that the 17 communities in Alaska with contract jails are not reimbursed for individuals brought in under Title 47. Number 2312 CO-CHAIR AUSTERMAN referred to recommendations forwarded to the committee by Mr. Oakland and asked if he wanted to address those in his testimony. MR. OAKLAND deferred to the author of that information, William Walters, who had been in charge of the Homer jail for several years. CO-CHAIR IVAN noted that Representative Al Vezey had joined the meeting and called on William Walters to testify. Number 2357 WILLIAM WALTERS, Judicial Services Officer, Police Department, City of Homer, spoke via teleconference and said the problem in Homer was getting individuals out of a jail environment and under medical supervision. Because many intoxicated persons had severe medical crises as they withdrew from alcohol, the jail was not the appropriate place for them. Hospitals were concerned with liability, unreimbursed costs and the lack of statutory detention authority at the medical facility. He referred to his written suggestions to add a liability waiver absent gross negligence or intentional misconduct on the part of the facility, and to provide authority in section 170(a) whereby medical staff "may" detain these people. MR. WALTERS stated support for HB 383 in concept, but added he would like a provision in the bill for direct reimbursement by the state to medical facilities, rather than having a facility petition the municipality; this would save significantly on administrative costs. However, he could live with the bill as is, if necessary. Tape 96-1, Side B Number 001 GARY GRANDY, Administrator, Petersburg Medical Center (PMC), and Council Member, Petersburg City Council, testified via teleconference in support of HB 383. He said PMC includes a hospital, nursing home and physicians' offices; their bad debts amount to about $100,000 per year. He gave an example of an inebriated person who attempted suicide, resulting in a medical bill of $5,000. The medical center sought reimbursement from the Indian Health Services and SEARHC programs, but those programs, which do not pay costs related to alcohol, reimbursed only a few hundred dollars for treatment of the patient's wrists. Mr. Grandy said the hospital has $10,000 to $20,000 per year written off the books, which they can no longer absorb. MR. GRANDY expressed concern about numerous demands on the mental health trust. He wondered if the committee would look at using general funds, which are fed in part by alcohol and tobacco taxes. Number 126 GREG PORTER, Administrator, Cordova Medical Center, testified via teleconference, stating he supported HB 383 and concurred with previous testimony. A small facility owned by the City of Cordova, the center's costs for these cases ranged from $60,000 up per year. Mr. Porter said he understood the need for medical treatment of inebriates, as he knew of patients who had nearly died in the jail. However, the city had no funds to support the hospital and operated hand-to-mouth. Number 134 MIKE HOLSMAN, Planning Officer, Department of Health and Human Services, Municipality of Anchorage, testified via teleconference in support of HB 383, agreeing with previous speakers. A burden on local hospitals and police, the problem costs the Municipality of Anchorage several hundred thousand dollars per year of local taxpayer money. He asked the committee to look at statewide actions to prevent or reduce public drinking. He noted that many inebriates have incomes of $750-850. He suggested inebriates pay for their treatment; for example, their checks could be reduced or their permanent fund dividends garnished. Number 328 CHRIS HLADICK, Manager, City of Dillingham, testified via teleconference. He agreed with previous testimony and supported HB 383. He added he also supported an amendment to the bill providing direct reimbursement to medical facilities. Number 387 MARY PAVIL, Representative, Orutsaramuit Native Council, and Council Member, City of Bethel, testified via teleconference in support of HB 383. She asserted that as long as it was not a crime to be drunk in public, communities would be mandated to put people in protective custody. She commended the police department for saving a large number of lives and suggested hidden costs be covered as well as more obvious ones. Number 445 CO-CHAIR IVAN noted that the teleconference testimony was concluded and called on Kimberly Metcalfe-Helmar to testify. Number 471 KIMBERLY METCALFE-HELMAR, Special Assistant, Office of the Commissioner, Department of Community and Regional Affairs (DCRA), said the department's concern with HB 383 was the reimbursement program envisioned in the bill. The grants administrator in the Division of Administrative Services would most likely oversee the program. DCRA feels additional staff would be required to operate the new program effectively. They have asked for a Range 13 administrative assistant under the supervision of the existing grants administrator. Number 531 REPRESENTATIVE ELTON asked whether, in the DCRA review, they had looked at how much money would be disbursed through the program. MS. METCALFE HELMAR said they had not; the amounts were uncertain at this point. REPRESENTATIVE ELTON stated one of his concerns was that collections might not be a big priority if all that was required for reimbursement was filling out a form. MS. METCALFE HELMAR responded that DCRA's concern was whether they could handle the workload and what the staffing would be. Number 768 LOREN JONES, Director, Division of Alcoholism and Drug Abuse, Department of Health and Social Services, said their concern was to protect people and engage them in treatment, with an eye to avoiding repeat occurrences. If a treatment facility was available, police officers, community service patrols or medical personnel would take a person there. However, he explained, many communities heard from via teleconference either lacked residential or detoxification facilities, or had needs exceeding available resources. In those cases, individuals sometimes ended up in jail instead of getting appropriate treatment. Number 725 REPRESENTATIVE ELTON asked Mr. Jones for an estimate of the amount of money the state would need to fund reimbursements under HB 383. MR. JONES replied that the advisory board and others had identified approximately $1 million that could be used to provide increased and better detoxification services. However, he could not estimate the needs of police departments, medical facilities or other providers. CO-CHAIR IVAN said the Bristol Bay area is doing their best to solve the problems. He stated he believed if there is a mandate, the state has the responsibility to address the issue. Alcoholism prevention programs statewide need to be reassessed. Number 887 MR. JONES said his department had worked hard with many of the communities that testified. He agreed that some of the proposed amendments would be ideas the department would like to work on. Number 931 HARLAN KNUDSON, President/CEO, Alaska State Hospital and Nursing Home Association, said several members of the association had testified previously. He stated that they strongly support HB 383. He admitted that because of the $500 million fiscal gap, it seemed a bad time to ask for funding; however, the issue was vitally important. He suggested the committee look at reports like "Healthy People 2000," and offered to be a resource on the issue. Number 1006 CO-CHAIR IVAN asked if there were questions from the committee. Hearing none, he concluded the testimony on HB 383, adding that he would invite further testimony from people across the state at a future meeting. He proposed appointing a subcommittee and asked for direction from the committee. REPRESENTATIVE ELTON commented that Mr. Knudson was right; the committee must look at not only what was being spent but also the cost to communities if the money was not spent. He indicated concern about the substantial amount of new money required. He referred to a memo from Bartlett Memorial Hospital in Juneau addressing the need for reimbursement, and stated he thought this was perhaps one of the most important issues facing many communities, including his own. Representative Elton commended Co- Chair Ivan for addressing the issue, and volunteered to serve on the subcommittee. Number 1159 CO-CHAIR IVAN appointed Co-Chair Austerman to head a subcommittee to consider HB 383; Co-Chair Austerman indicated he would contact committee members and form the subcommittee. Number 1242 REPRESENTATIVE VEZEY said he understood the communities to be saying that providing the services in question was not a high priority in their budgets and communities were therefore turning to the state for funding. He wondered if they were getting a vote at the local level telling the committee this was their top priority. Number 1281 CO-CHAIR IVAN said he appreciated Representative Vezey's comments, and that he also understood the dire situation in some of the municipalities. Dillingham, especially, was trying to address other priorities as well. He suggested the subcommittee look for ways and means to fund the program by everyone involved. Number 1364 ADJOURNMENT There being no further business to conduct, CO-CHAIR IVAN adjourned the House Community and Regional Affairs Committee meeting at 2:25 p.m.