Legislature(2023 - 2024)DAVIS 106
03/02/2023 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB52 | |
| HB6 | |
| HB56 | |
| HB17 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 56 | TELECONFERENCED | |
| *+ | HB 6 | TELECONFERENCED | |
| *+ | HB 52 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 17 | TELECONFERENCED | |
HB 52-NO PATIENT LEFT ALONE ACT
3:03:06 PM
CHAIR PRAX announced that the first order of business would be
HOUSE BILL NO. 52, "An Act relating to the right of patients and
residents to have a support person in person during treatment
and during stays at certain facilities; and relating to a
requirement that health care facilities make certain information
available to the public."
3:04:28 PM
REPRESENTATIVE SARAH VANCE, Alaska State Legislature, as prime
sponsor, introduced HB 52. She paraphrased from the sponsor
statement [copy included in the committee packet], which read as
follows [original punctuation provided]:
HB 52 seeks to safeguard a patient's right to a
support person receiving emergency medical services,
or staying at hospital, nursing facility, assisted
living home, or hospice care. This bill ensures no
patient is left alone when they feel most medically
vulnerable and may not be withheld a support person
based on a state or federal declaration of disaster,
allows for civil penalties and requires healthcare
facilities to make visitation policies available to
the public.
The pandemic has caused great uncertainty and anxiety
across Alaska and has significantly affected the
medical community. Many unintended consequences have
happened to patients because of visitation policies
that have prohibited them from having any visitors,
including a spouse, parent, close family member,
guardian, health care agent, chaplain, or caregiver;
and as a result, many have been forced to be alone
during their treatment for serious conditions,
traumas, illnesses, heart attacks, and routine and
emergency surgeries.
Some of these patients have been forced to be alone
for the entire course of their treatment and in some
cases have died alone; and many families have been
unable to be physically present with their loved ones
while in a hospital, nursing home, hospice care, adult
care home, special care unit, or residential treatment
setting for mental illness, developmental or
intellectual disability, or substance use disorder.
Alaskans have been limited to electronic video
communications, if any, with the patient; and the
patients who have been affected have included adults,
minors, and individuals with intellectual or
developmental disabilities; however it is my belief
that it is our moral obligation that these patients be
allowed at least one support person of their choice to
be physically present at reasonable times throughout
the period of hospitalization or residential
treatment.
3:07:19 PM
REPRESENTATIVE VANCE shared a recent story which related that a
father had resorted to camping on the lawn of a hospital in
order to be near his daughter who had been admitted to the
hospital with a severe asthma attack. She stated that the
father offered to test for COVID-19 and wear protective gear at
the hospital, as he believed his presence would improve his
daughter's health. She stated that the hospital had refused
access to the father. She related a story concerning a
constituent's experience after he was admitted to the hospital
with COVID-19. His wife was not allowed to be with him in the
hospital, and this had been mentally and physically challenging
for him. She said he had told her that he had not considered
the importance of having a loved one present during recovery.
She related that he had realized that this presence would
improve the patient as much as drugs and treatment. She
maintained that this is an issue of human dignity.
3:11:20 PM
REPRESENTATIVE VANCE presented a PowerPoint on HB 52, titled "No
Patient Left Alone Act." As listed on slide 2, she addressed
the main components of the bill: provide patients with a right
to a support person; allow for civil liability; not allow for
the rights of patients to be suspended; provide that facilities
have written policies; and allow for an investigation by the
Department of Health (DOH).
REPRESENTATIVE VANCE continued to slide 3, which addressed a
patient's right to a support person. She stated that the
proposed legislation would require health care facilities to
allow a support person to be present at all times during the
patient's stay. To eliminate the possibility of any loopholes,
she stated that the proposed legislation specifies "in person"
in reference to this. She continued that the support person's
privileges would not be limited to the visitation hours of the
facility, and the right to a support person could not be
withheld based on a declaration of disaster. She addressed
civil liability, as seen on slide 4. She explained this
provision would allow a patient or the support person to bring a
civil complaint against a health care facility or health care
professional.
3:13:36 PM
REPRESENTATIVE VANCE, continuing to slide 5, stated that the
proposed legislation would prohibit a state or federal
declaration of disaster to change a patient's rights. She
continued that the proposed legislation would also require
health care facilities to inform patients of the right to equal
treatment concerning a support person. Connected to this is the
requirement that the current version of a health care facility's
visitation policies and procedures be made widely available to
the public, as seen on slide 6. She moved to slide 7, stating
that this would include investigations by DOH, and individuals
would be able to file a complaint with DOH concerning any
violation. Moving to slide 8, she stated that, unless required
by federal law or regulation, a state agency may not take action
against a health care facility for prohibiting a visitor from
entering an operating room, isolation room, isolation unit,
behavioral health setting, or other typically restricted areas.
3:17:33 PM
CHAIR PRAX announced the committee would hear invited testimony
on HB 52.
3:18:09 PM
JANET OGAN, representing self, began her invited testimony in
support for HB 52. She shared the story that in July 2022 her
sister-in-law had been admitted to the Mat-Su Regional Medical
Center for pneumonia and tested positive for COVID-19. She
stated this became a nightmare for her family because the
sister-in-law was terrified at being alone and put on a
ventilator. Family members were unable to visit her, including
her husband, until she died nine days later. She expressed the
understanding that the hospital did not welcome the husband.
She stressed that sickness can be frightening, and the process
can be made easier by having a loved one present for comfort and
as an advocate. She described the distressed situation as
"helpless." The family had been notified that the sister-in-law
was dying but were not allowed in the room until after she had
passed away. She questioned, "What logic justified this
deprivation of human dignity?" She added that her family had
traditions around the death of family members, and that
tradition was robbed when they were unable to comfort her
sister-in-law or grieve her death. She stated that others have
suffered similar actions by health care institutions,
emphasizing that a society is judged by its treatment toward the
elderly, unborn, and sick. She stated that the COVID-19
pandemic had ushered in a "dark time" for the country, as
patients were denied the right to have loved ones make decisions
concerning care, and treatment protocols had been forced without
allowing alternatives. She stated that HB 52 would be a step in
the right direction.
3:25:08 PM
NATALIE BEYELER, DO, Internal Medicine Specialist, Dr. Natalie
Beyeler and Associates, provided invited testimony in support of
HB 52. She shared that she currently runs her own clinic, but
for 16 years she had been the director of critical care and
intensive care at Mat-Su Regional Medical Center, and for 25
years she had been the director of pulmonary care. She said
that after the hospital began employing its own physicians,
privately employed physicians, like herself, were relegated to
"backseat drivers." She explained that this is why her
testimony is important. She expressed the opinion that not
recognizing the importance of family members for a patient's
recovery process is "absolutely insane." She referenced a
recovery-unit study which indicated patients recuperated 80
percent better when they had a view of a tree; however, she
argued that a study is not needed to know that the presence of a
familiar face or squeeze of a hand improves medical outcomes for
patients. She stated that many times patients can be confused,
over medicated, sedated, or experiencing intensive-care
psychosis. She continued that, whether it is a tooth extraction
or a brain surgery, there is no substitute for having a support
person present. She voiced the opinion that this could improve
medical outcomes for the patient.
3:29:26 PM
DR. BEYELER continued that not being able to take care of a
family member in the hospital leaves those remaining with
regret, remorse, long-lasting grief, anxiety, depression, and
guilt. She stated that this is a terrible testimony on health
care facilities and expressed shame over being a doctor. She
pointed out that hospitals are currently overrun, and the nurse-
to-patient ratio is "high," so having the presence of a loved
one to rely on is important. She referenced the medical
condition of "cryptic shock," which has no outward signs for
nurses or other providers to notice, especially with
understaffing. She expressed the opinion that a loved one at
the bedside would more readily notice this condition, and this
could save the patient's life.
3:32:41 PM
DR. BEYELER stated there are many stories of patients who had
improved outcomes because they were surrounded by loved ones.
She shared a recent account of a husband who had contracted a
very serious illness and was taken to the hospital. The wife
had learned that his outcome would worsen if he were intubated.
The wife was not allowed into the hospital room, but she could
hear talk through the door concerning intubation. She described
the wife as "banging on the intensive care doors" and
"screaming" to stop her husband's intubation. She stated that
the husband had relied on his wife to be his spokesperson, and
when he heard her screaming, whether it was the adrenaline pump
or her voice, he was shocked into survivor mode and his oxygen
levels went up.
3:35:14 PM
DR. BEYELER stated she has researched hospital admissions,
discharges, readmissions, and post-hospitalization mortality;
however, she has not found one study addressing the presence of
a support person. She expressed the opinion that depriving a
parent from being present with a minor patient defies civility
and should be "punishable by incarceration." She argued that
individuals in the hospital would not have the capacity to
answer for themselves, so someone must be present to stand in
for them. She offered to follow up with any needed materials in
support of the proposed legislation.
3:38:33 PM
REPRESENTATIVE SUMNER, concerning health care facility
liability, pointed out language that would be added to statute
as Section 18.20.630 [under Section 1 of HB 52, on page 4,
beginning on line 24], which would preclude any state agency
from taking any action against a facility. He expressed the
understanding that most of the testimony concerned
hospitalizations in COVID-19 isolation wards. He questioned
whether the legislation would actually address this situation.
3:39:31 PM
REPRESENTATIVE VANCE expressed the understanding that not all
patients during the pandemic were in isolation wards. She
expressed appreciation for the comment; however, many
constituents have informed her of situations in regular hospital
rooms where they were not allowed a support person. She
referred to seniors in assisted living homes who were not
allowed to see loved ones. She referenced an example where a
doctor prescribed anti-depressants to an individual who was
quickly failing in a senior care facility because of the
inability to see family. She commented that a variety of
facilities limited the rights of patients.
3:41:18 PM
REPRESENTATIVE SUMNER expressed the understanding that isolation
rooms would be needed in the case of extremely contagious
outbreaks. He expressed agreement that in the case of COVID-19,
[family support] should not have been restricted; however, he
advised that there could be a potential need for isolating
patients.
3:42:42 PM
REPRESENTATIVE SADDLER questioned Dr. Beyeler on the Mat-Su
Medical Center's policies prior to the COVID-19 pandemic.
DR. BEYELER responded that there have always been visiting
hours, and at least one family member could be with the patient
in the critical care unit. She stated that every single room in
the hospital has a bed available for a family member, and rarely
does a patient explicitly ask to not have a support person. She
stated that having a support person present makes providers'
jobs easier in regard to bathing, feeding, monitoring
medication, and more.
3:44:49 PM
REPRESENTATIVE SADDLER, with a follow-up question for
clarification, asked whether hospitals currently have no limits
on the presence of a support person, even in the emergency room,
recovery room, or operating room.
DR. BEYELER responded that operating rooms are restricted
because of distractions and the need for a sterile environment.
In situations with the critically ill, she said, there may be
limited space in the room for a support person. She stated that
patients in the recovery room would always have at least one
support person, but not more than two in a post-operation area.
She expressed the importance of having a support person present
when a patient is given instructions or a diagnosis.
3:47:10 PM
REPRESENTATIVE MINA thanked the bill sponsor. She pointed out
that the examples presented had been during the COVID-19
pandemic. She directed attention to the language on page 2,
lines 2-3, which concerns a provider's ability to restrict
access to patients during emergency-medical services. She
continued that the language is repeated within the bill in
relation to hospitals, mental health facilities, long-term care
facilities, and hospice. She questioned whether the provider's
ability to restrict access would apply to COVID-19 concerns.
REPRESENTATIVE VANCE, in regard to the intent of the
legislation, responded that health care facilities would not
restrict access to the patient, regardless of a pandemic or
declared disaster, and medical center policies should reflect
this intent. She stated that the term "reasonable" would apply,
and this would mean detriment to the care of the patient. She
expressed the opinion that it had been learned during the COVID-
19 pandemic that withholding a support person is not
"reasonable." She stated that health care facilities would need
some flexibility to care for patients in a medically appropriate
way, while clarifying the right of an individual to have a
support person.
3:50:36 PM
REPRESENTATIVE MINA provided the example of a highly infectious
pneumonic plague and questioned whether the proposed legislation
would allow hospitals to apply restrictions, or whether the
hospital would be sued based on the civil liability section.
REPRESENTATIVE VANCE expressed the belief that she would not be
the best person to answer the question. She stated that, in
regard to the intent of the legislation, the health care
facility would have the ability to make the decision, as long as
it is "reasonable" and every individual is treated equally. She
suggested that this was not the case during the pandemic.
3:52:40 PM
REPRESENTATIVE RUFFRIDGE voiced the opinion that few people
would dispute the necessity of having a loved one present in a
critical care situation; however, he concurred with
Representative Mina. He expressed the concern that the current
version of the proposed legislation may not accomplish its
intent. He surmised that it does not clearly define a
"reasonable restriction". He expressed the opinion that
throughout the COVID-19 pandemic most of these issues came to
light, and most health care facilities would have "driven pretty
hard" on the "clinically necessary" component of the bill. He
suggested that the language be clarified. He stated that the
provisions in Section 18.20.610 and Section 18.26.620 already
exist through DOH. He said that if HB 52 were to become law,
then both of these would be redundant.
REPRESENTATIVE VANCE responded that she was not aware of the
redundancy. She expressed the willingness to work with the
committee on clarifying the language.
3:55:33 PM
REPRESENTATIVE MINA stated that emergency room physicians have
brought forward situations where providers have had to separate
the patient, who is a victim, from an abuser. She pointed out
that the provision on page 4, line 3 of the proposed legislation
would prohibit a health care facility from separating a minor
from a support person, except in a case of suspected abuse. She
questioned the reasoning for not including this language in
other sections related to facilities and providers of emergency
medical services.
REPRESENTATIVE VANCE responded that the section on page 5, line
7 addresses this, with the intent to make sure patients are
safeguarded.
3:57:41 PM
REPRESENTATIVE MINA pointed out the provision on page 5, line 7,
wherein restricted access could be requested by a patient, law
enforcement agency, or court order. In other words, in the case
of a dangerous situation, restricted access would have to be
requested by the patient, agency, or court before the facility
could restrict access. Referring back to page 4, line 3, she
pointed out that this provision would not require a court order
or a request from the patient before access could be restricted.
She expressed the opinion that the language on page 4 should be
mirrored fully in the other sections.
REPRESENTATIVE VANCE stated that this could be easily
accommodated.
3:59:19 PM
CHAIR PRAX announced that HB 52 was held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 6 Sectional Analysis .pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 6 |
| HB 6 Sponsor Statement.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 6 |
| HB0006A.PDF |
HHSS 3/2/2023 3:00:00 PM |
HB 6 |
| HB 52 - v.A.PDF |
HHSS 3/2/2023 3:00:00 PM HHSS 3/16/2023 3:00:00 PM |
HB 52 |
| HB 52 - Sponsor Statement.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/16/2023 3:00:00 PM |
HB 52 |
| HB 52 - Sectional Analysis.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/16/2023 3:00:00 PM |
HB 52 |
| HB0056A.PDF |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB56 Sectional Analysis.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB56 Support Letter.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| House Bill 56 Sponsor Statement.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB 56 Fiscal Note.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 56 |
| HB56 Rep.Ruffridge Presentation.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB 56 Hearing Slides 2023 (002).pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| Geiger HB56 Support Ltr - Feb 26 2023 - 7-15 PM.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB56 Delker Support.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| HB56 letter removing opposition vets PDMP.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/11/2023 3:00:00 PM |
HB 56 |
| PDMPFlyer.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 56 |
| HB 56 2023AVKMA-PDMPWhitePaper.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 56 |
| HB56 VerSteeg Support Letter.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 56 |
| HB 6 Kellsie's Lesson Example.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 6 |
| HB 17 Support Document - Public Costs From Unintended Pregnancies February 2015.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Document - Unintended Pregnancies Study March 2011.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Document - UCSF Study Newspaper Article 2.22.2011.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Document - HRSA Women's Preventive Services Guidelines.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Document - Insurance Coverage of Contraceptives 4.01.2021.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Document - Guttmacher Alaska Statistics 2016.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 v. A Sponsor Statement.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB17 Version A.PDF |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 v. A Sectional Analysis.pdf |
HHSS 2/7/2023 3:00:00 PM HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Support Letter.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| Opposition Letter for HB 17 Redacted.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| ACOGFactsAreImportantEC.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| FDA Decisional Memorandum 12.23.2022.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Opposition Letter Redacted 3.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 opposition letters 4 Redacted.pdf |
HHSS 2/18/2023 3:00:00 PM HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| ALPHA Policy Comm Letter of Support HB17 2-10-23.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB17.SB27 LOS 2.23 ANDVSA.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 17 SB 27 |
| A.1--amendment to HB 17 Contraceptives.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 17 Opposition Letters Redacted 2.pdf |
HHSS 3/2/2023 3:00:00 PM |
HB 17 |
| HB 52 - Slideshow Presentation (03-01-23).pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/16/2023 3:00:00 PM |
HB 52 |
| HB 17 Fiscal Note DCCED.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/7/2023 3:00:00 PM |
HB 17 |
| HB 17 Fiscal Note DOA-DRB.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/7/2023 3:00:00 PM |
HB 17 |
| HB 17 Fiscal Note DOH.pdf |
HHSS 3/2/2023 3:00:00 PM HHSS 3/7/2023 3:00:00 PM |
HB 17 |