ALASKA STATE LEGISLATURE   HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  March 3, 2009 2:58 p.m. MEMBERS PRESENT Representative Bob Herron, Co-Chair Representative Wes Keller, Co-Chair Representative John Coghill Representative Bob Lynn Representative Paul Seaton Representative Sharon Cissna MEMBERS ABSENT  Representative Lindsey Holmes COMMITTEE CALENDAR  HOUSE BILL NO. 26 "An Act repealing the repeal of preventative and restorative adult dental services reimbursement under Medicaid; providing for an effective date by repealing the effective date of sec. 3, ch. 52, SLA 2006; and providing for an effective date." - MOVED HB 26 OUT OF COMMITTEE SENATE CONCURRENT RESOLUTION NO. 1 Relating to establishing March 2009 as Brain Injury Awareness Month. - MOVED SCR 1 OUT OF COMMITTEE PREVIOUS COMMITTEE ACTION  BILL: HB 26 SHORT TITLE: MEDICAID FOR ADULT DENTAL SERVICES SPONSOR(s): REPRESENTATIVE(s) HAWKER 01/20/09 (H) PREFILE RELEASED 1/9/09 01/20/09 (H) READ THE FIRST TIME - REFERRALS 01/20/09 (H) HSS, FIN 02/26/09 (H) HSS AT 3:00 PM CAPITOL 106 02/26/09 (H) Heard & Held 02/26/09 (H) MINUTE(HSS) 03/03/09 (H) HSS AT 3:00 PM CAPITOL 106 BILL: SCR 1 SHORT TITLE: BRAIN INJURY AWARENESS MONTH: MARCH 2009 SPONSOR(s): SENATOR(s) MCGUIRE 01/21/09 (S) READ THE FIRST TIME - REFERRALS 01/21/09 (S) HSS 02/11/09 (S) HSS AT 1:30 PM BUTROVICH 205 02/11/09 (S) Moved SCR 1 Out of Committee 02/11/09 (S) MINUTE(HSS) 02/13/09 (S) HSS RPT 3DP 02/13/09 (S) DP: DAVIS, ELLIS, PASKVAN 02/25/09 (S) BEFORE SENATE ON FINAL PASSAGE 02/25/09 (S) TRANSMITTED TO (H) 02/25/09 (S) VERSION: SCR 1 02/27/09 (H) READ THE FIRST TIME - REFERRALS 02/27/09 (H) HSS 03/03/09 (H) HSS AT 3:00 PM CAPITOL 106 WITNESS REGISTER TREVOR FULTON, Staff to Senator Lesil McGuire Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced SCR 1 on behalf of the sponsor, Senator McGuire. DANI CARLSON, Staff to Senator Lesil McGuire Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Presented SCR 1 on behalf of the sponsor, Senator McGuire, and responded to questions. JILL HODGES, Executive Director Alaska Brain Injury Network, Inc. (ABIN) Anchorage, Alaska POSITION STATEMENT: During discussion of SCR 1, answered questions and provided comments. NANCY MICHAELSON Palmer, Alaska POSITION STATEMENT: Testified in support of SCR 1. ACTION NARRATIVE 2:58:45 PM CO-CHAIR WES KELLER called the House Health and Social Services Standing Committee meeting to order at 2:58 p.m. Representatives Keller, Herron, Seaton, and Coghill were present at the call to order. Representatives Cissna and Lynn arrived as the meeting was in progress. Representative Holmes was excused. HB 26-MEDICAID FOR ADULT DENTAL SERVICES 2:59:10 PM CO-CHAIR KELLER announced that the first order of business would be HOUSE BILL NO. 26, "An Act repealing the repeal of preventative and restorative adult dental services reimbursement under Medicaid; providing for an effective date by repealing the effective date of sec. 3, ch. 52, SLA 2006; and providing for an effective date." [Before the committee was HB 26, Version 26-LS0142\E, which had been adopted as the working document on February 26, 2009.] CO-CHAIR KELLER noted that public testimony had been closed. 2:59:36 PM REPRESENTATIVE COGHILL moved to adopt the original HB 26, Version 26-LS0142\R, as the working document. There being no objection, the original HB 26 was adopted. 2:59:57 PM REPRESENTATIVE COGHILL opined that it would be a long term program. 3:00:41 PM CO-CHAIR HERRON said that he supported the original version, and that he had introduced Version E to encourage a debate. 3:01:07 PM CO-CHAIR KELLER said that he supported the original version of HB 26. 3:01:26 PM REPRESENTATIVE COGHILL moved to report the original HB 26, Version 26-LS0142\R, out of committee with individual recommendations and the accompanying fiscal notes. 3:01:38 PM REPRESENTATIVE SEATON objected, and asked to clarify that HB 26, Version R, had been adopted as the working draft. 3:01:54 PM CO-CHAIR KELLER clarified that it was. 3:02:18 PM It was noted that Representative Seaton removed his objection. There being no objection, the original HB 26, Version R, was reported from the House Health and Social Services Standing Committee. SCR 1-BRAIN INJURY AWARENESS MONTH: MARCH 2009 3:03:09 PM CO-CHAIR KELLER announced that the next order of business would be SENATE CONCURRENT RESOLUTION NO. 1, Relating to establishing March 2009 as Brain Injury Awareness Month. 3:03:26 PM TREVOR FULTON, Staff, to Senator Lesil McGuire, Alaska State Legislature, introduced Dani Carlson as the presenter of the bill for the sponsor. 3:03:48 PM DANI CARLSON, Staff, to Senator Lesil McGuire, Alaska State Legislature, said that SCR 1 aimed to recognize March, 2009, as traumatic brain injury (TBI) month in Alaska. She cited the fragility of our brains, and stated that TBI is often called an invisible disease. She estimated that more than 12,000 Alaskans had suffered a TBI, and that there were 800 TBIs reported annually. She recounted that these statistics had increased with the return of military combat veterans, 20 percent of whom showed signs of TBI. She reported that screenings at the National Naval Medical Center showed that 83 percent of the wounded treated at that facility had some sort of brain injury. She confirmed that TBI was a leading cause of death for young people in Alaska. 3:07:59 PM REPRESENTATIVE COGHILL asked what public information, other than awareness, would happen in association with SCR 1. JILL HODGES, Executive Director, Alaska Brain Injury Network (ABIN), said, in response to Representative Coghill, that ABIN advocated for the importance of this public health issue to the large health providers. She said that it was necessary to work with the military, Alaska Native Tribal Health Consortium (ANTHC), and the state of Alaska to raise awareness of brain injuries. 3:12:31 PM REPRESENTATIVE CISSNA noted that this critical issue had "lagged behind" for public recognition. She asked about the cost to the health system for these injuries, and what services were available for those soldiers returning with brain injuries. MS. HODGES replied, in response to Representative Cissna, that the annual national cost was about $60 billion. She reported that early intervention, including screening, lead to better outcomes. She encouraged the state for a cost analysis. 3:15:06 PM REPRESENTATIVE SEATON referred to the Governor's Proclamation, "Traumatic Brain Injury Awareness Month" and the sponsor statement for SCR 1 [both included in the members' packets]. He pointed out that one referred to brain injury awareness month and the other referred to traumatic brain injury month, and he asked about the difference. MR. FULTON noted that the difference was just within the wording of the title. REPRESENTATIVE SEATON asked if there was a difference between brain injury and traumatic brain injury. MR. FULTON, in response to Representative Seaton, explained that there was a difference, as all traumatic brain injuries were brain injuries, but that not all brain injuries were traumatic. He pointed out that stroke and fetal alcohol syndrome were examples of non-traumatic brain injuries. 3:18:26 PM REPRESENTATIVE COGHILL referred to SCR 1, page 1, line 14, "WHEREAS, most cases of traumatic brain injury are preventable:" and he asked about plans for prevention. MS. HODGES, in response to Representative Coghill, said that there were past policy decisions, for example the seat belt law, which had lowered the injury rate. She said that helmets for ATV and snow machine users, seat belts, and child booster seats were all programs that reduced TBI. She said that ABIN had abrogated to ANTHC and the state for injury prevention programs. 3:20:47 PM REPRESENTATIVE COGHILL asked what inducements would make people use safety equipment. MS. HODGES, in response to Representative Coghill, said that it started with education in the school system. She suggested that industries, specifically fishing and carpentry, focus on prevention. She mentioned that kids needed a performance based model to encourage wearing helmets. She said that this required a culture change, and with the variety of cultures in Alaska, the message would need to be community specific. 3:22:34 PM CO-CHAIR KELLER asked if there were specialists for TBI. 3:23:19 PM MS. HODGES explained that there was very standard care for a brain injury which began at the accident site, and was designed to prevent any further damage. She reported that Alaska had few post-acute therapy programs, so it required out of state access for rehabilitation. She said that rehabilitation improved the outcome, and she shared a personal family story. She summarized that Alaska needed a post acute rehabilitation center, and a residential recovery center with a supportive environment. 3:26:36 PM NANCY MICHAELSON shared the story of her brain injured son. She explained that, initially, her family went out of Alaska for treatment at a rehabilitation center. She said that, when they returned to Alaska, it took a long time to establish a team of care givers. She stressed that most TBIs could be prevented. She spoke about protection for sports related injuries. She supported a declaration for March as the brain injury awareness month. 3:29:54 PM CO-CHAIR KELLER asked if there was any more testimony, and seeing none, he closed public testimony. 3:30:20 PM REPRESENTATIVE SEATON reflected that he had not heard anything about prevention proposals, and he suggested that this resolution should include targeting for all aspects of brain injury. 3:32:12 PM CO-CHAIR KELLER agreed. 3:32:52 PM REPRESENTATIVE LYNN said that he fully supported SCR 1, but he asked what would happen after this resolution was passed. 3:34:32 PM REPRESENTATIVE COGHILL noted that the ABIN would take this proclamation as an additional authority for education. He added that it would also be used as a "legislators' voice" for any additional legislation. 3:36:04 PM REPRESENTATIVE COGHILL moved to report SCR 1 out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, SCR 1 was reported from the House Health and Social Services Standing Committee. 3:36:44 PM ADJOURNMENT  There being no further business before the committee, the House Health and Social Services Standing Committee meeting was adjourned at 3:36 p.m.