SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE March 19, 1993 1:35 p.m. MEMBERS PRESENT Senator Steve Rieger, Chairman Senator Bert Sharp, Vice-Chairman Senator Loren Leman Senator Mike Miller Senator Jim Duncan Senator Johnny Ellis Senator Judy Salo MEMBERS ABSENT All Members Present COMMITTEE CALENDAR SPONSOR SUBSTITUTE FOR SENATE BILL NO. 91 "An Act providing for coverage of midwife services under Medicaid; reordering the priority of optional services provided by the state under Medicaid; and providing for an effective date." SENATE BILL NO. 45 "An Act relating to persons under 21 years of age; providing for designation of `safe homes' for runaway minors; and providing for an effective date." SB 61 (IMPLEMENT ALASKA 2000 RECOMMENDATIONS) WAS SCHEDULED BUT NOT HEARD THIS DATE. PREVIOUS SENATE COMMITTEE ACTION SB 91 - No previous action to record. SB 45 - See HESS minutes dated 3/5/93. SB 61 - See HESS minutes dated 2/8/93, 2/10/93, 2/17/93, 2/24/93, 3/3/93, 3/8/93 and 3/17/93. WITNESS REGISTER Annette Kreitzer, Legislative Staff to Senator Leman State Capitol Building, Room 113 Juneau, Alaska 99801 POSITION STATEMENT: Explained SSSB 91. Kaye Kanne, Certified Direct-Entry Midwife Chair, Certified Direct-Entry Midwifery Board P.O. Box 22624 Juneau, Alaska 99802 POSITION STATEMENT: Testified in support of SSSB 91. Stacie Mendez 710 Willow Street Kodiak, Alaska 99615 POSITION STATEMENT: Testified in support of SSSB 91. Karren Shine-Audett, Certified Direct-Entry Midwife and Regional Director, Midwive's Association P.O. Box 287 Girdwood, Alaska POSITION STATEMENT: Testified in support of SSSB 91. Grace Elliott-DeAngles 8124 Dogwood Lane Juneau, Alaska POSITION STATEMENT: Testified in support of SSSB 91. Sally Bryne, Midwife P.O. Box 2110 Kodiak, Alaska 99615 POSITION STATEMENT: Testified in support of SSSB 91. Charlotte O'Shirley-Davis 14870 Snowshoe Lane Anchorage, Alaska 99516 POSITION STATEMENT: Testified in support of SSSB 91. Sherrill Malone Certified Direct-Entry Midwife 2000 East 66th Avenue Anchorage, Alaska 99507 POSITION STATEMENT: Testified in support of SSSB 91. Sharon Evans, Certified Direct-Entry Midwife President, of Midwives Association of Alaska 1655 Sitka, Number 204 Anchorage, Alaska 99501 POSITION STATEMENT: Testified in support of SSSB 91. Sally Pessage Anchorage, Alaska POSITION STATEMENT: Testified in support of SSSB 91. Dave Williams, Planner Project CHOICE Division of Medical Assistance Department of Health and Social Services P.O. Box 110660 Juneau, Alaska 99811-0660 POSITION STATEMENT: Testified in support of SSSB 91. Jerry Burnett, Legislative Staff to Senator Randy Phillips State Capitol Building, Room 113 Juneau, Alaska 99801 POSITION STATEMENT: Answered questions on SB 45. Senator Randy Phillips State Capitol Building, Room 113 Juneau, Alaska 99801 POSITION STATEMENT: Sponsor of SB 45. Randall Hines, Acting Social Services Program Officer Division of Family and Youth Services Department of Health and Social Services Box 110630 Juneau, Alaska 99811 POSITION STATEMENT: Answered questions on SB 45. Pat O'Brien, Program Officer ALPS License and Regulations Division of Family and Youth Services Department of Health and Social Services Box 110630 Juneau, Alaska 99811 POSITION STATEMENT: Answered questions on SB 45. ACTION NARRATIVE TAPE 93-27, SIDE A Number 001 CHAIRMAN RIEGER called the Senate Health, Education and Social Services (HESS) Committee to order at 1:35 p.m. The first order of business was SSSB 91 (MEDICAID COVERAGE OF MIDWIFE SERVICES), sponsored by Senator Leman. ANNETTE KREITZER, legislative staff to Senator Leman, explained the bill would add midwives to the category of optional providers to be covered under Medicaid. It would also realign the priority of payments under Medicaid so that midwives are the lowest priority when the funds are distributed. KAYE KANNE, Certified Direct-Entry Midwife, Chair, Certified Direct-Entry Midwifery Board, said the improvement in the outcome of pregnancies resulting from the greater use of well trained midwives has become increasingly evident. She discussed the benefits and the use of midwifery in other countries. Ms. Kanne said it is obvious from the good outcomes of infants delivered by midwives that we could reduce the numbers of new born infants requiring intensive care by increasing the number of midwives and expanding the services offered by them. She noted a 1989 study by the Health Insurance Association of America (HIAA) sights a number of ways that the U.S. can save money in health care. A midwife's fee typically covers more time spent with a woman during pregnancy and after the birth, and the fee is much lower than that of a physician's fee. Ms. Kanne said midwives rely much less on technical procedures but can access them if necessary. She continued to discuss the savings in dollars if midwives are used and urged passage of the legislation. Number 080 STACIE MENDEZ, mother of two, indicated her children were born under the Medicaid Program. She said she would have liked to have been able to choose the type of prenatal and infant care that would have better met her needs and those of her family. Care offered by midwives should be allowable to all low risk women and their families, Ms. Mendez concluded. KARREN SHINE-AUDETT, Certified Direct-Entry Midwife and Regional Director, Midwive's Association, said she feels there are many benefits, not only to the state but people on Medicaid, by passing SSSB 91. She said there are other states that have allowed midwives for Medicaid recipients and it has saved taxpayers millions of dollars. Midwives charge a fraction of the price that individuals on Medicaid are paying currently. Ms. Shine-Audett said there are women who were on Medicaid who wanted to have a home birth but didn't because midwives are not covered. There are also low income women who have gone into debt by paying out of their own pockets for midwives as they strongly believe that home births are the best care. Ms. Shine-Audett said she believes that statistics will improve immensely through the individual attention clients receive. We need to offer babies and their mothers the right to choose their care providers no matter where the compensation comes from. She said the key to preventing premature babies and unhealthy mothers is good nutrition and individual attention. She continued to give testimony in favor of the legislation and encouraged the members to support the bill. GRACE ELLIOTT-DEANGLES, testifying as a former Medicaid mother, said eight years ago when she was pregnant she chose midwife services. She paid for the services out of her pocket with money she made during the fishing season as a deck hand. Ms. Elliott-DeAngles said she moved to Juneau after the fishing season and became an AFDC recipient. A person receives very little money on AFDC, and it was very difficult for her to pay her bill. She explained that if you borrow money and you are on AFDC, you are penalized and the AFDC check is lowered. Ms. Elliott-DeAngles explained that a midwife will spend about an hour with a patient per visit. She said during her last pregnancy her doctor spent about six to eight minutes with her each visit. She urged the committee to pass the legislation. Number 171 SALLY BRYNE, Midwife, said women in Alaska who qualify for Medicaid need to be in a position to make their own decisions regarding their own health care. The medical establishment would like us to believe that the change from home to hospital is the reason for improved outcomes of pregnancies. Going into the hospital is not the cause of the improvements. Improved outcomes is a result of improved hygiene, economic status, nutrition, and access to prenatal care. She urged that Alaska become a state where quality prenatal care is available to all low income women and their families. Families will all benefit from the intensive individualized attention given to them by midwives. She thanked the committee for listening to her. CHARLOTTE O'SHIRLEY-DAVIS, testifying from Anchorage, said midwifery allows women to make choices for themselves. The essence of midwifery is flexibility. Medicaid reimbursement allows women more choices and flexibility in care. Ms. O'Shirley-Davis said midwives oversee women's choices and they assist them. There is also more whole family involvement. She urged that there be Medicaid reimbursement for midwifery. SHERRILL MALONE, Certified Direct-Entry Midwife, testified from Anchorage. She said she feels that any woman, in any walk of life, no matter what her financial status, should be able to choose where she would like to have her baby. Midwives give excellent care and are able to take more time with each women. They give the much needed nutritional counseling to alleviate a number of complications that could arise should the woman's nutrition be less than optimum, which in turn causes women to fall into a high risk category and necessitate more medical intervention, thus causing the cost of premium care to become greater. Ms. Malone said midwife fees usually cost less than half of what a doctor's hospital birth would cost. If midwives had the opportunity to bill Medicaid they would save the state many thousands of dollars. The transport records are low and any need for any other medical attention is very minimal. The passing of SSSB 91 would benefit all on both sides of the spectrum. Ms. Malone said she would appreciate the committee's support of SSSB 91. SENATOR SALO asked Ms. Malone what the training requirements are for direct-entry midwives in Alaska. Ms. Malone said for a person to become a midwife they must complete two years of apprenticeship and a midwifery course. She said the course is a written course that must be taken during the two years and covers the study of every area of the aspects of midwifery focusing on the prenatal period, nutrition, and any complications that may arise. The course ends in extensive testing by examination. Number 251 SHARON EVANS, Certified Direct-Entry Midwife and President of the Midwives Association of Alaska, said her association has kept statistics on the families that they have served over the last several years. The statistics have proved that pregnant women under a midwife's care have fewer low- weight babies, premature births, and neonatal mortality rates than the average for the State of Alaska and the nation. According to information received from the State of Alaska, Department of Vital Statistics, of the babies born at home under midwive's care, from 1989 to 1991, less than 1 percent of them were transferred to a hospital. Ms. Evans continued to give the committee members statistics relating to the information received from the state. Direct-Entry Midwives, licensed in the state, propose that if they are put on the list of Medicaid providers, the education and nutritional counseling that they give to low income women will help immensely to decrease the premature birth rate and the problems associated with low birth weight babies, thereby, dramatically reducing the cost of care to the State of Alaska. Ms. Evans urged the committee to please consider passing SSSB 91. DAVE WILLIAMS, Planner, Project CHOICE, Division of Medical Assistance, Department of Health and Social Services, said the committee has a position paper in support of the legislation. The department believes the bill is reasonable legislation and women should have this choice available to them. He said he would answer any questions the committee may have. Number 289 SALLY PESSAGE, testifying from Anchorage, said she has had two births and is currently pregnant. She explained that she saw a doctor while pregnant with her first child. Ms. Pessage said the care she received with a midwife was much better, far superior than a doctor's care, and there was more personal contact. Ms. Pessage informed the committee that she is currently on Medicaid. She indicated she will not be covered by Medicaid if the baby is born at home. Ms. Pessage said it is important to her, her unborn child, and her family that she goes through a home birth with her midwife. She asked that people on Medicaid be given the option of having a home birth. Number 308 CHAIRMAN RIEGER referred to the fiscal note and said a physician birth would cost $2,000 as opposed to a midwife birth at $1,480. He asked if those numbers seem right. SENATOR LEMAN said he has had three children and the $2,000 for the physician assisted birth seems to be a lot lower than what he paid. MR. WILLIAMS explained that the $2,000 is physician only and if a hospital were included it would be another $3,000. SENATOR LEMAN indicated he had a proposed amendment. He moved Amendment #1 which follows: Page 1, line 1, after "Act": Insert "prohibiting unfair discrimination against direct-entry midwives who perform services within the scope of their certification;" Page 1, after line 4: Insert a new bill section to read: "* Section 1. AS 21.36.090(d) is amended to read: (d) Except to the extent necessary to comply with AS 21.42.365, a person may not practice or permit unfair discrimination against a person who provides a service covered under a group disability policy that extends coverage on an expense incurred basis, or under a group service or indemnity type contract issued by a nonprofit corporation, if the service is within the scope of the provider's occupational license. In this subsection, "provider" means a state licensed physician, dentist, osteopath, optometrist, chiropractor, nurse midwife, advanced nurse practitioner, naturopath, physical therapist, occupational therapist, psychologist, psychological associate, [OR] licensed clinical social worker, or certified direct-entry midwife." CHAIRMAN RIEGER objected to Senator Leman's motion for the purpose of an explanation. SENATOR LEMAN said the amendment adds certified direct-entry midwives to the list of those protected from unfair discrimination. He said his understanding is that this was an oversight when legislation was passed during the Seventeenth Legislature. The insurance companies would have to provide payment for them to the same extent they do for others. Chairman Rieger asked if all the providers in the section are mandatory providers. He said if you are offering a health insurance policy you would have to cover all the things listed. MS. KREITZER said she doesn't believe that it is mandated that the insurance companies cover all the people listed, but means that they may not be discriminated against. Number 379 Chairman Rieger removed his objection to Amendment #1. There being no further objection to the motion, Amendment #1 was adopted. SENATOR SHARP asked how many other states allow midwives to be covered under Medicaid. SENATOR LEMAN said it is his understanding that there is one other state which does, New Mexico. Number 389 Senator Leman moved to pass SSSB 91, as amended, out of the HESS Committee with individual recommendations. Hearing no objection, the motion carried. Number 396 The next piece of legislation to come before the committee was SB 45 (MISC. LAWS RELATING TO MINORS), sponsored by Senator Randy Phillips. Chairman Rieger said there was a proposed committee substitute. JERRY BURNETT, legislative staff to Senator Randy Phillips, referred to the proposed committee substitute and said it makes a number of changes. The largest changes are in Sections 1, 13, and 17, as they incorporate an amendment offered by Senator Duncan at the last hearing on the bill. The amendment relates to the detention and incarceration of minors. He said it would put state law in conformity with federal law. Mr. Burnett said another change is in Section 2. The department asked that the term "protect" be changed to "reduce the risk to." That was for the purpose of reducing their liability as they don't believe that they are able to adopt regulations that can absolutely protect a juvenile in a safe home. Mr. Burnett referred to Section 14 and said a provision was added that if a runaway is known to be in the custody of the state and is evading the custody of the state, the safe home operator would have to notify state authorities. There is also a provision that a safe home operator must notify the parents within forty-eight hours of a runaway coming to a safe home. He referred to Section 19 and said the wording was changed in AS 47.35.085(b)(2), by request of the Department of Health and Social Services. Section 9 was removed which referred to the possession and purchase of a firearm by persons under the age of twenty-one. SENATOR ELLIS asked Mr. Burnett if there was a new name for "safe home" as there is confusion of existing safe homes. Mr. Burnett indicated they have not come up with a better name. Number 452 SENATOR DUNCAN moved to adopt the CSSB 45 (HES). Hearing no objection, the motion carried. Chairman Rieger referred to page 3, line 5, and said at the last meeting, a witness indicated that they had a problem with the wording "having control." The witness stated it was a problem for non-custodial parents. Mr. Burnett said he spoke briefly with the drafter and there was a question as to whether or not to open up the question of non- custodial parents. SENATOR ELLIS indicated concern about not addressing the concerns of custodial and non-custodial parents. He said he believes it should be clarified. Number 481 Chairman Rieger referred to page 4, lines 4 - 7, and said there was a question relating to liability. MR. BURNETT said the section makes it a crime of contributing to the delinquency of a minor for someone who aids, induces, causes, or encourages a child to be absent from their parents. A question came up as to whether or not this would mean that a person in a runaway shelter was then contributing to the delinquency of a minor. He said that is dealt with on page 7. Chairman Rieger referred to page 4, line 18, and said there is reference to "after 10:00 p.m. on the night before school is in session." He said he assumes that is the school the minor is attending. Chairman Rieger asked if there is a need for clarifying language. Mr. Burnett said that concern has not been brought to his attention. Chairman Rieger moved to insert "the minor's" before the word "school." There being no objection to the motion, the new language was adopted. Chairman Rieger referred to the committee substitute language offered by Senator Duncan on page 5, line 10, "however, detention in a correctional facility under this paragraph may not exceed the lesser of (A) six hours; or (B) the time necessary to arrange the minor's transportation..." He questioned whether it should say "lesser" or "greater." SENATOR DUNCAN said the language should limit the time a minor may be held in an adult facility to six hours except in certain cases. RANDALL HINES, Acting Social Services Program Officer, Division of Family and Youth Services, Department of Health and Social Services, said the reason there are two options is to try to limit the amount of time a child can be held under these circumstances recognizing that the ideal under federal law is that kids not be held there at all. He said they are trying motivate the process of getting them into an appropriate juvenile facility rather than holding them for extended periods of time. Chairman Rieger asked what would happen if a minor is arrested in a rural village and there isn't a plane until the next morning which is eight hours away. Mr. Hines said federal law recognizes that there are conditions, acts of God, where you wouldn't be able to move a child. He said it has been under discussion in the federal regulatory process to try and get federal regulations amended to allow those kinds of situations to be exempt under law. Mr. Hines said the section in the bill that speaks to this was accepted by the federal government. It would have to be documented as to why the time had to exceed six hours. Number 533 Chairman Rieger referred to page 6, line 23, "A safe home may not shelter a runaway minor for more than seven days unless the department determines that..." He said there had been testimony requesting longer periods of time. Chairman Rieger asked what the issue is. PAT O'BRIEN, Program Officer, ALPS License and Regulations, Division of Family and Youth Services, Department of Health and Social Services, said in the current licensing statute there is a ninety day exemption for a twenty-four hour care facilities. She said if a person is offering their home as a safe home, then they would have to fall under regulation. Ms. O'Brien said last year the department had asked that the 90 day clause be removed. Chairman Rieger said if a runaway shows up at a safe home and is there for seven days, what would happen on the eighth day. Ms. O'Brien said if the department hears about it, the people would be informed of the law, they would be given an application and told that they need to become a licensed safe home. Chairman Rieger asked what is involved with the time limitation. MR. HINES said the intent is to bring the child and family back together and not allow a long period of time without some kind of intervention. The department's intent is, under existing runaway laws, to get families and children back together as soon as possible and not leave them in an alternate placement without some kind of case plan. SENATOR DUNCAN asked if the department has the capabilities to respond in seven days. MR. HINES said the department has the capability to respond in seven days, but what those alternatives are may be limited, depending on the community where this is occurring. In larger communities where there are more foster homes and services available, there would be more alternatives. MS. O'BRIEN said the other alternative is that the home could convert to an emergency foster home license and keep the child for a longer period of time. She noted that would mean a more extensive review. TAPE 93-27, SIDE B Number 001 Senator Duncan said he thinks there should be a period of time where the department would be required to evaluate the child and get involved at a case level. He said 90 days seems like a long period of time. Mr. Hines said if a child is placed in a home and reaches the seven day time period, and it is determined that is the best alternative for the child, the department can take alternative action, such as an emergency license, to be sure that child stays in that home if that is the best place for the child to be. SENATOR ELLIS indicated concern on line 26, "A safe home may not shelter a runaway minor for more than seven days unless the department determines that... (2) another appropriate setting is not available for the minor." He said it seems like that is a tremendous disincentive to ever getting more permanent foster homes on line. It is a disincentive to having adequate runaway shelters that have some sort of therapeutic counseling component services. MR. HINES said the initiative that the division has undertaken to go to family preservation/family centered services and to train a staff in shifting their thinking about removal and the rescue based model, etc. is something that the division is moving forward in with some success. He said he believes that the shift in philosophy would be another safeguard. Senator Ellis asked if kids would go through some kind of review process other than the department's internal foster care review process. Mr. Hines said kids in court ordered custody will go through the review process. If a youth was in a safe home and under the state's custody, then the same kind of review process would occur. If they were not in court ordered custody, it would be his understanding that the internal review process would not occur. Senator Ellis indicated concern with including "(2)." If the safe home can be used beyond seven days, the home should be part of a review process. He said there needs to be some kind of a review and we need to work with the department to figure out a review that is reasonable and within the department's given resources so that kids that aren't in foster care aren't lost in the system. Number 105 CHAIRMAN RIEGER referred to page 6, line 23, and asked if "seven days" means seven consecutive days. He asked what if a runaway goes to a safe home, is placed back with their family, and then three months later they go back to the safe home. SENATOR RANDY PHILLIPS said he wouldn't have a problem with saying "seven consecutive twenty-four hour periods." Chairman Rieger said two different time periods couldn't be added together for the total of seven days. MR. HINES said the question hasn't been discussed with the drafter of the legislation. Chairman Rieger referred to page 6, line 27, "(b) The provider of a safe home shall promptly inform the department of a runaway minor in the home..." He asked if the verbiage "promptly inform" when talking about child abuse is the same type of verbiage that applies to other people who are under duty to report. SENATOR SALO referred to page 7, line 7, and said it defines it by saying "but within 48 hours." She said she was reading that as the definition of "promptly inform." CHAIRMAN RIEGER referred to page 9, lines 11 - 13, "The department shall also offer counseling services to the person having legal custody of the minor and to the members of the minor's household if it determines that counseling services would be appropriate in the situation," and questioned what is being mandated. MS. O'BRIEN said if the department is involved, it could be anything from short term intervention to allow a cooling off period to very serious issues that might require outside counseling. She said if the issues become more serious, then the department may become involved in a legal way. SENATOR ELLIS referred to page 6 and page 7, relating to "promptly inform" and the "48 hours," and said his staff has informed him that the suggestion was putting "48 hours in both places - "(b)" and "(c)." MR. HINES said the department wouldn't have an objection. Number 170 Senator Ellis moved that on page 6, line 27, after "shall promptly" insert "but within 48 hours." Chairman Rieger asked if there was an objection to the motion. SENATOR LEMAN objected. He said if a minor is taken into custody on a Friday night, the 48 hours would expire on a Sunday night. Senator Ellis asked if it is the Division of Family and Youth Services' testimony that they never work on weekends and that there is no way to respond to a child in crises over the weekend. He said he didn't think that was the case. Mr. Hines said that is not the case. There is a way to get in touch with on call staff. MS. O'BRIEN said within communities where the department isn't able to have a person on call, there is always the ability to work through the local police to make sure there is some kind of contact. Where there are on call workers, they are used to being called on the weekends. Senator Leman removed his objection. Hearing no further objection to Senator Ellis' motion, the amendment passed. CHAIRMAN RIEGER said there was a question regarding the designation of "safe home" and finding a different name. He moved that every place where "safe home" appears in the bill, change the word to "shelter" or "shelters." Hearing no objection, it was so ordered. He asked the department if any changes in the bill would require new fiscal notes. MS. O'BRIEN said "no." Number 218 SENATOR ELLIS said a witness raised concern about the term "runaway" and whether it covers those children who are known as "throwaways." The suggestion was made to use the term "homeless youth." Senator Ellis asked if "runaway" is inclusive of kids who runaway and kids who are thrown out. Ms. O'Brien said the way the department sees it is the idea covers all of the various files. In the committee member's files there is a memorandum dated March 13, which discusses federal definitions. Senator Ellis asked if kids of any classifications would have a right to the protections. Ms. O'Brien said they would. Senator Ellis said there was a point raised about a current court challenge to the immunity from liability statute relating to page 7, line 24, and asked if that has been addressed. He said he assumes that the court challenge hasn't been resolved, and so there isn't a way to anticipate anything with the legislation. Mr. Burnett indicated that is correct. Number 263 Senator Ellis said he had some proposed amendments. Amendment #1 would delete the section of the bill that allows parents to petition the court to sever their legal responsibilities for a minor which is called "Removal of Disabilities of a Minor." Amendment #1 follows: Page 1, line 12: Delete "16 - 19" Insert "10 - 13" Page 2, line 4, through page 3, line 7: Delete all material Renumber the following bill sections accordingly. Senator Ellis said his amendments were drafted to the original bill. It was indicated that the amendment would remove sections 3 - 8 of the committee substitute. CHAIRMAN RIEGER objected to the adoption of Senator Ellis' Amendment #1. A roll call vote was taken. Senators Rieger, Sharp, Leman, and Miller voted against the adoption of Amendment #1. Senators Duncan, Ellis, and Salo voted in favor of the adoption of Amendment #1. So the motion failed. SENATOR ELLIS moved Amendment #2. He said it would set some standards. Since Amendment #1 wasn't adopted and if we are going to allow people to divorce their difficult children at the age of 16, the amendment sets out some standards to be used by the courts and others to determine if the divorce should be allowed to proceed. Amendment #2 follows: Page 3, lines 15-19: Delete all material and insert: "*Sec. 8. AS 09.55.590(f) is repealed and reenacted to read: (f) If the petition under this section is filed by a minor, the court may remove the disabilities of minority as requested in the petition if the court finds on the record after a hearing that the minor is a resident of the state, at least 16 years of age, living separate and apart from the parent or guardian of the minor, and capable of self-support and managing the minor's own financial affairs. If the petition under this section is filed by the legal custodian of a minor, the court may remove the disabilities of minority as requested in the petition only if the court, in addition to making the other findings required under this subsection for a petition filed by a minor, makes a finding on the record that there is interpersonal conflict involving the legal custodian and the minor that the custodian and the minor have been unable to resolve satisfactorily through other means; the finding must include an estimate based on evidence in the record of when the interpersonal conflict began and a description of the efforts that were made by the legal custodian to resolve the interpersonal conflict before the custodian filed the petition under this section." SENATOR LEMAN said he agrees that it shouldn't be easy for a parent to divorce their child. He said he doesn't know what the current court standards are, but indicated he hopes they are not easy standards. SENATOR ELLIS asked if any other states allow parent instituted emancipation from a difficult kid. MS. O'BRIEN indicated she doesn't know the answer but would try and find out. Senator Ellis referred to "tough love" parents and said they are extraordinary people who are going through enormous pain. He continued to discuss the tough love parents. SENATOR RANDY PHILLIPS said his concern is the length of time it will take to go through the court system. He said if a parent is seeking relief, would there be a time limit. Senator Ellis said the court will take the time they want to take. He said he doesn't think that the amendment is asking for any certifications that could be used as justification for a long extended period of time. Number 446 CHAIRMAN RIEGER referred to the two references of "on the record" in Senator Ellis' amendment and asked what the meaning is. SENATOR ELLIS said he doesn't know exactly what the meaning is. Chairman Rieger said he would feel better if those references were deleted. He said he is worried that there might be a conflict with some confidentiality provisions. Senator Ellis said he doesn't think that "on the record" betrays any kind of private information because things that the court does all the time, in terms of minors, is confidential. SENATOR RANDY PHILLIPS indicated the next committee of referral is Judiciary and said legal could address the concern there. Chairman Rieger asked what the meaning is of "the finding must include an estimate based on evidence in the record of when the interpersonal conflict began and a description of the efforts that were made by the legal custodian to resolve the interpersonal conflict before the custodian filed the petition under this section." Senator Ellis said by including that wording in the amendment, he wants to make sure that the judge knows what the nature of the conflict is. SENATOR MILLER said they will have to show that they have tried to do something in the process whether it is counseling, etc. Senator Miller moved to change the wording to say "the finding must include a description of the efforts that were made by the legal custodian to resolve the interpersonal conflict before the custodian filed the petition under this section." TAPE 93-28, SIDE A Number 001 CHAIRMAN RIEGER asked if there was an objection to amend Amendment #2. Hearing no objection, the motion carried. Chairman Rieger asked if there was an objection to adopting Amendment #2 as amended. Hearing no objection, Amendment #2 was adopted. Number 029 SENATOR ELLIS moved for the adoption of Amendment #3. He explained that the amendment would add new subsections for the department to provide appropriate preemancipation services to a minor. Currently, we allow 16 year olds to petition and justify why they ought to be emancipated from their parents through the court system. He said we don't provide any services to make sure those young people become self sufficient and not welfare cases. Senator Ellis said both parties will be able to petition the court so he believes there will be an increase in the number of people being emancipated at the age of 16 unless there are preemancipation services for the kids. Amendment #3 follows: Page 1, line 12: Delete "16 - 19" Insert "17 - 20" Page 5, after line 14: Insert a new bill section to read: *Sec. 13. AS 47.10.230 is amended by adding new subsections to read: (h) The department shall provide appropriate preemancipation services to a minor who is 16 years of age or older and who wishes to petition the court for emancipation under AS 09.55.590, or to a child 16 years of age or older who has been committed to the custody of the department and for whom the department finds that preemancipation services are appropriate or needed. The services may include (1) assistance in completing academic or vocational training designed to make the child employable; (2) assistance in acquiring and managing suitable housing; assistance under this paragraph may include financial assistance to the child; (3) training and supervision in skills needed for independent living; (4) assistance in petitioning for removal of the disabilities of minority; and (5) social support and services coordination. (i) The department may award a grant to or contract with a municipality or with an entity incorporated under AS 10.20 or licensed under AS 47.35.085 to provide preemancipation services under (h) of this section. The commissioner shall adopt regulations establishing criteria for the award of grants under this subsection. (j) If the child is committed to the custody of the department, the department may recruit and train foster parents to provide preemancipation services under (h) of this section." Renumber the following bill sections accordingly. SENATOR MILLER objected to Senator Ellis' motion to adopt Amendment #3. He said in some ways it is contrary to Amendment #2, as it says that in order for the parents to file for emancipation, the minor has to be separate and apart from the parent or guardian and capable of self- support and managing their own financial affairs. SENATOR ELLIS said he wouldn't have an objection rewording the amendment to say, "The department may provide preemancipation services..." Senator Miller indicated concern with the fiscal note. Senator Ellis said "you pay here or you pay in the welfare rolls that everybody is so concerned about." SENATOR SALO said by changing "shall" to "may," it answers a lot of the concerns regarding the fiscal note. There basically isn't a fiscal note unless the department can afford it. The department may choose to look at trying to afford it based on the "pay now or pay more later" theory. SENATOR DUNCAN said he thinks it is a good amendment. By changing "shall" to "may" means it will never happen. He suggested using the wording, "The department shall provide appropriate preemancipation services to a minor who is 16 years of age or older when requested..." SENATOR MILLER said he doesn't have an objection to changing the wording from "shall" to "may." He said he will still probably oppose the amendment because when an individual files for emancipation, they have to show that they are already living separately and apart. Senator Ellis pointed out the wording is "preemancipation services." It would cover the time from when the minor is in state custody leading up to when they are going to be on their own. Number 174 SENATOR ELLIS said his motion to amend Amendment #3 is in "(h)" on the first line delete "shall" and insert "may," and on the second line after the word "minor" insert "upon request." CHAIRMAN RIEGER asked if there was an objection to amend Amendment #3. Hearing no objection, the motion carried. Chairman Rieger said amended Amendment #3 is before the committee. A roll call vote was taken. Senators Rieger, Sharp, Miller and Leman voted against the adoption of Amendment #3. Senators Duncan, Ellis and Salo voted in favor of the adoption of Amendment #3. So the motion failed. Number 201 SENATOR MILLER moved to pass CSSB 45 (HES), out of the Senate HESS Committee with individual recommendations and with the accompanying fiscal notes. SENATOR ELLIS objected to the motion. A roll call vote was taken. Senators Rieger, Sharp, Duncan, Leman and Miller voted in favor of the motion. Senators Ellis and Salo were against the motion. So CSSB 45 (HES), moved out of committee with individual recommendations and accompanying fiscal notes. Number 218 CHAIRMAN RIEGER adjourned the Senate HESS Committee meeting at 3:25 p.m.