Legislature(2017 - 2018)CAPITOL 106
03/28/2017 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Presentation: the Economic Costs of Alcohol Abuse in Alaska | |
| HB54 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 151 | TELECONFERENCED | |
| *+ | HB 54 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 54-TERMINALLY ILL: ENDING LIFE OPTION
4:04:29 PM
CHAIR SPOHNHOLZ announced that the next order of business would
be SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 54, "An Act providing
an end-of-life option for terminally ill individuals; and
providing for an effective date."
4:04:56 PM
REPRESENTATIVE HARRIET DRUMMOND, Alaska State Legislature,
paraphrased from a prepared statement, which read [original
punctuation provided]:
Thank you chairwoman, Spohnholz. For the record, my
name is Harriet Drummond and I am the Representative
for House District 18. I would like to thank the
committee for hearing this bill today. I know this is
not an easy subject for most people. Death is a
difficult topic, because it is raw and emotional. No
one wants to lose a loved one or think about leaving
their family behind. And because no one likes to talk
about it, we often don't even start the conversation
until someone becomes ill. And by not starting these
conversations sooner, talking about something as
serious as aid-in-dying becomes personal and painful.
We need to change that.
House Bill 54 allows terminally ill patients to ease
their pain and suffering by allowing doctors to
prescribe medication to aid in dying. This bill allows
an Alaskan the right to live, and die, on their own
terms according to their own desires and beliefs.
Death is a natural part of life. This bill allows
people to be in control of their own care. Providing
dignity and peace of mind during a patient's final
days with family and loved ones places a much greater
focus on a person's life than on the often painful and
agonizing process of dying.
My aide will go over the specifics of the bill in just
a minute, but I wanted to talk to you about why I
introduced this legislation.
At the beginning of session, Claire Richardson came to
my office and asked when this bill was going to get a
hearing.
Her husband, Lisle (pronounced LYLE) was battling ALS,
an incurable, progressive nervous system disorder but
he wanted to come in and testify on this bill. Some of
you may know Lisle. He was born and raised in Juneau.
He founded the Gold Town Nickelodeon. He was a social
worker and an avid outdoorsman. Lisle isn't here
today. But his words are. He recorded this video when
he realized he wouldn't be able to make it to this
hearing.
4:07:27 PM
The committee took a brief at-ease.
4:08:03 PM
A short video of Lisle Hebert recorded prior to his death was
shown to the committee.
4:12:40 PM
REPRESENTATIVE DRUMMOND continued to read from the prepared
statement, which read [original punctuation provided]:
I introduced this bill because of people like Lisle.
The people who are no longer here to advocate for
themselves.
This is my second time introducing this legislation.
And I have heard from a lot of people who have very
strong opinions about this bill. During public
testimony you will hear from family members who have
had to deal with things I hope and pray none of you
will ever have to deal with.
I have also been told I am evil for introducing this
bill. I have been told I am going to hell, I have been
called a Nazi, and I have been told I am playing God.
We hook terminally ill patients up to countless
machines that prolong death for weeks. We have
machines that can breathe, eat, and urinate for
people. We administer CPR on sick patients and break
their ribs, burrow large IV lines into burned-out
veins and plunge tubes into swollen, bleeding airways.
God is looking down on us and asking "what are you
thinking?!"
Science is not God. Medicine is here to help sick
people. And when people are too sick to keep living,
medicine should still be able to help people.
We have stopped seeing the person and are only looking
at the patient.
I have been told that by introducing this legislation,
I am promoting suicide. I resent that. My son was a
sensitive, caring, athletic 17-year old the day he
took his own life. Stephen was my oldest child. He
loved biking and snowboarding. He biked to Denali when
he was just an eighth grader. I have spent years going
over every minute detail of the days leading up to his
death. I have agonized over every decision, every word
I said, wondering if there was anything I could have
done to prevent it. There isn't a day that goes by
when I don't think about how old he would be now or
what he might be doing if he was alive today. Suicide
is a tragedy. An irrational, self-destructive act that
should be prevented at all costs. We don't get to pick
and choose which deaths we want to be suicide. Does a
patient who decides to quit chemo, or stop undergoing
lifesaving dialysis after years of slowly
deteriorating count as suicide? Does a Marine who is
under attack and jumps on a bomb to save his fellow
soldiers count as suicide? Does a Jehovah's Witness
who refuses a blood transfusion because of her
religious beliefs count as suicide? Suicide is a
healthy person who could live but wants to die. Aid-
in-dying is about a sick person who wants to live but
is dying.
This bill allows patients to have important end-of-
life discussions with the doctors they already know
and trust. Without this discussion, well-meaning
doctors are faced with prescribing painful procedures
even when the patient does not want them and there is
little hope for success. People in these conditions
have already lost their health and often much, much
more. This bill at least lets them control the last
and most important decision they have left.
I will turn it over to my aide to walk you through the
bill and then we will answer any questions the
committee may have.
4:16:33 PM
KRISTIN KRANENDONK, Staff, Representative Harriet Drummond,
Alaska State Legislature, spoke from a prepared statement, which
read:
For the record my name is Kristin Kranendonk, and I am
staff to Representative Drummond. We modeled this
legislation off what other states have done.
Oregon enacted the first "death with dignity" law in
the U.S in 1994 through a citizen-approved ballot
initiative. Washington followed in 2008. Vermont,
California, Washington DC, and Canada have all
legalized similar legislation as well. What we have
learned in the over 20 years since Oregon first passed
this legislation is that aid-in-dying has resulted in
significant improvements in the care of the terminally
ill.
I will now go over the sections of the bill and then
answer any questions you might have.
4:17:20 PM
MS. KRANENDONK referenced the Sectional Analysis of the proposed
bill [Included in members' packets], and paraphrased from a
prepared statement which read [original punctuation provided]:
Section 1 & 2:
Page 1: Lines 4-10
New subsections are added to AS 11.41.115 (defenses to
murder) and AS 11.41.120 (manslaughter) to allow a
defense for acting under this new chapter, 13.55.
Provides immunity from criminal liability. (Use of
"defense" places the burden on the state to disprove
the existence of the defense.)
Section 3:
Pages 1-11: Lines 11-21
Adds a new chapter AS 13.55, which provides the
process in which terminally ill individuals may
request medication to aid in their peaceful death.
Sec. 13.55.010:
This section lists the criteria an individual
must meet to qualify for medication. A person needs to
be a resident of Alaska, over 18, suffering from a
terminal disease, they must be mentally capable and
must voluntarily express a wish to die. It also
clearly states that age or disability alone is not
sufficient enough to qualify.
Sec. 13.55.020: Authorizes a qualified individual's
attending physician to dispense or write a
prescription for the necessary medication if the
physician complies with the chapter.
This section allows a doctor or pharmacist to
prescribe or fill out a prescription. This section is
not saying a doctor will ADMINISTER the medication. It
is just talking about dispensing medication.
Sec. 13.55.030: Requires a qualified individual to
make an oral request to their attending physician to
receive the necessary medication. Requires the
qualified individual to repeat the oral request at
least 15 days after the initial request. Provides
alternative request methods for qualified individuals
who are not able to speak or not able to sign the
request.
If an individual is unable to speak (as sometimes
happens with ALS/cancer patients for example,
Stephan Hawking) they can use other means to make
their request. (Like an electronic voice box)
Sec. 13.55.040: Directs the attending physician to
offer the opportunity to rescind the initial oral
request when the qualified individual makes the second
oral request. Allows a qualified individual to rescind
a request at any time. Prohibits an attending
physician from dispensing or prescribing medication
unless the physician offers the qualified individual
an opportunity to rescind the request.
When a qualified individual makes their second
oral request at least 15 days after the initial
request for medication, this section directs the
attending physician to offer the opportunity to
rescind their request. This section also explicitly
states an individual can change their mind and rescind
a request at any time. It also prohibits an attending
physician from dispensing or prescribing any
medication unless they offer a qualified individual a
chance to change their mind.
Sec. 13.55.050:
This section lays out the steps a physician needs
to take throughout the process. These include
determining whether the individual has a terminal
disease, is capable, and has made the medication
request voluntarily. Also includes providing
information to the individual about the medical
diagnosis and prognosis, the risks and probable result
of taking the medication, and feasible alternatives.
Requires the physician to refer the individual to a
consulting physician to confirm the diagnosis and to
determine that the individual is capable and acting
voluntarily. Requires the physician to refer the
individual for counseling if appropriate under Sec.
13.55.090. This section requires the attending
physician to counsel an individual about where this
medication can be consumed (not in public, etc) and
talks about the importance of having someone present
(nurse, family, etc) at the time medication is to be
consumed. Allows the attending physician to sign the
death certificate.
Sec. 13.55.060: Before an individual can qualify under
the chapter, it requires a consulting physician to
examine the individual and confirm the attending
physician's diagnosis of a terminal disease, and to
verify that the individual is capable, acting
voluntarily, and has made an informed decision.
Sec. 13.55.070: Requires the attending or consulting
physician to refer the individual for counseling and
prohibits the dispensing or prescribing of the
necessary medicine until the counselor determines that
the individual is not suffering from depression
causing impaired judgment.
Sec. 13.55.80: Prohibits the attending physician from
dispensing or prescribing medication unless the
qualified individual has made an informed decision.
Sec. 13.55.90: Prohibits the attending physician from
denying the medication request because the individual
declines or cannot notify next of kin.
Sec. 13.55.100: Requires certain waiting periods
before medication can be dispensed or prescribed.
Sec. 13.55.110: Requires that the medical record of
the qualified individual contains the items listed in
the section before the individual receives the
medication.
Sec. 13.55.120: Invalidates will or contractual terms
that require, prohibit, impose conditions on, or
otherwise addresses whether an individual may make or
rescind a request under this chapter.
Does not invalidate a will. This simply means you
cannot condition a will/contract. (You get this $$ on
the condition that you agree not to end your life or
to end your life.)
Sec. 13.55.130: Provides a person with immunity from
civil and criminal liability or professional
disciplinary action for participating in good faith
compliance with the chapter. States that a medication
request by an individual or an attending physician
providing medication in good faith compliance with
this chapter may not provide the sole basis for the
appointment of a guardian or conservator.
Sec. 13.55.140: States that a health care provider has
no duty to participate.
Sec. 13.55.150: Under certain conditions allows a
health care provider to prohibit another health care
provider from participating on the premises in this
chapter.
For example, Providence could prohibit a
physician from prescribing medication at the hospital
and can prohibit qualified individuals from
administering medication at the hospital, but they
cannot prohibit a doctor from doing these things
outside of the hospital (if they have their own
private practice for example).
Sec. 13.55.160: Requires a health care provider to
notify a physician in writing if they prohibit the
administration of medication on the premises.
Sec. 13.55.170 If a health care provider violates the
prohibition (for example, if the physician at
Providence ignores their policy on this issue) the
health care provider can terminate a contract or
impose a loss of privileges.
Sec. 13.55.180: Establishes the crime of abuse for
coercion, or action without authorization from the
qualified individual. Makes the crime a class A
felony.
Sec. 13.55.190: States that the chapter does not limit
liability for civil damages resulting from a person's
negligent conduct or intentional misconduct.
Sec. 13.55.200: Allows a governmental entity to file a
claim against an individual's estate to recover
expenses incurred if an individual consumes medication
to end their life in a public place.
Sec. 13.55.210: Directs the Department of Health and
Social Services to review a sample of the records
maintained under the chapter every year. Requires a
health care provider to file a record of dispensing
medication under this chapter with the department.
Directs the department to adopt regulations to
facilitate the collection of information about
compliance with the chapter. Makes the information
confidential but requires the department to provide
the public an annual statistical report about the
information collected.
Sec. 13.55.220: Outlines the qualifications a
physician must meet
Sec. 13.55.230: Prohibits construing the chapter to
authorize or require health care contrary to
applicable generally accepted health care standards.
Prohibits construing the chapter as authorizing the
ending of life by certain methods, including lethal
injection. Establishes that an action allowed by this
chapter is an affirmative defense to certain crimes,
including murder, manslaughter, and euthanasia.
Sec. 13.55.240: Prohibits a person from conditioning
the sale, procurement, issuance, rate, delivery, or
another aspect of a life, health, or accident
insurance or annuity policy, on the making or
rescission of a request for medication under the
chapter.
Sec. 13.55.250: States that a request for medication
under this chapter is not an advance health care
directive under AS 13.52 and that AS 13.52 (Health
Care Decision Act) does not apply to an activity
allowed by the chapter.
Sec. 13.55.900: Defines the terms used in the new
chapter.
4:27:56 PM
MS. KRANENDONK paraphrased from a prepared statement to describe
Section 4, Section 5, Section 6, and Section 7 of the proposed
bill, which read [original punctuation provided]:
Section 4:
Page 11: Lines 22-26
Indicates that the chapter applies to contracts,
wills, and life, health, or accident insurance or
annuity policies delivered or issued for delivery on
or after the effective date.
Section 5:
Pages 11: Lines 27-31
Allows the Department of Health and Social Services to
adopt regulations for the new chapter.
Section 6:
Page 12: Line 1
Makes the regulation authority given under Bill
Section 5 take effect immediately.
Section 7:
Page 12: Line 2
Makes the Act (except Bill Section 5) effective
January 1. 2019.
4:28:38 PM
REPRESENTATIVE TARR asked for clarification about "acting in
good faith compliance" in the immunity section on page 6. She
questioned whether this was referring to an incident if the
medication was used inappropriately by the wrong person.
MS. KRANENDONK replied that the section protected a physician
who had been acting in good faith, although the stealing of
medication was a prosecutable crime.
4:30:08 PM
REPRESENTATIVE KITO asked how this could be equitably
administered in Rural Alaska communities, if the law only
applied to people who lived close to a hospital or attending
physician. He asked how a request for a prescription by mail
was tracked to ensure that it reached the individual. He asked
about the obligation if a person had received the medication and
decided to rescind, even if this was after the second
consultation opportunity to rescind. He asked how this
medication would be returned if it was not used.
MS. KRANENDONK, in response, said that the telemedicine
component of the section was added to accommodate rural members.
Regarding drugs already in the hands of those who had requested,
there were current federal regulations to deal with unused
medications. She expressed an expectation for the Department of
Health and Social Services to cover this in its regulations as
described in Section 13.55.201. She pointed out that other
states had already addressed this.
REPRESENTATIVE KITO corrected the reference to be for Section
13.55.210.
4:32:38 PM
KAT WEST, National Director of Policy & Programs, Compassion &
Choices, explained that in most homes of terminally ill, dying
people, there were large quantities of pain medications, and
that Hospice would dispose of these unused medications. She
reported that Alaska had a drop off disposal program for safe
disposal of medications, as well. She stated that medical aid
in dying medications were normally taken one hour in advance to
be effective, and that two other medications needed to be
administered simultaneously. These two medications allowed for
absorption and prevention of regurgitation. She declared that
it would be very hard to accidentally overdose on medical aid in
dying medications, as they took about two minutes to drink and
were quite bitter. She stated that there had not been any
accidental overdoses and no mis-applications of the medication
in 30 years.
4:35:17 PM
REPRESENTATIVE KITO asked if this would not apply to communities
without access to regular medical facilities.
MS. WEST offered her belief that it would depend on the
telemedicine laws for rural communities. Currently, under
proposed SSHB 54, the person choosing medical aid in dying would
need to be seen either in person or through telemedicine for an
attending physician to make the original eligibility
determination for a terminally ill adult, diagnosed with six
months or less, and mentally capable of making their own health
care decisions. She added that this eligibility had to be
confirmed by a second consulting physician, and availability of
these physicians could be in person or through telemedicine,
dependent upon state law.
REPRESENTATIVE KITO offered a scenario whereby a person in a
rural community without an attending physician either dies prior
to receiving the medication or is too "far gone" to self-
administer. He expressed concern that the medication would not
be clearly tracked, accounted for, or identified for
disposition. He pointed out that there were not any trooper or
police offices in many communities.
MS. WEST pointed out that most dying people had multiple
prescriptions which were "just as lethal as a medical aid in
dying medication and actually much easier to inject." She added
that most often the health care provider disposed of any unused
medication.
4:39:23 PM
MS. KRANENDONK added that hospice in Juneau provided care to
communities outside Juneau, and that there were regulations in
place to collect the medications. She offered to add an
amendment to clarify.
4:40:23 PM
REPRESENTATIVE DRUMMOND pointed out that it was a very small
number of people who requested and obtained the medication. She
reported that in the more than 20 years since passage of the aid
in dying bill, only 700 - 800 people in Oregon had used this.
She pointed out that these drugs would be dealt with in the same
way as drugs to deal with the opioid crisis. She reminded that
hospice care was a service, not a building.
4:41:47 PM
REPRESENTATIVE JOHNSTON asked if there were any issues which
could compromise federal funds for health care.
MS. WEST, in response, explained that a 1997 federal law, passed
immediately following passage of the Oregon law, prohibited the
use of federal funds for medical aid in dying. She pointed out
that many states, including California and Oregon, had
segregated their state Medicaid funding from the federal
Medicaid funding, to make those funds available to people who
are eligible and qualified for medical aid in dying. She shared
that Oregon offered 23 prescriptions and 15 injections each
year.
4:44:38 PM
CHAIR SPOHNHOLZ opened public testimony. She asked to limit
each testimony to two minutes and to maintain respect.
4:45:52 PM
DAVID COMPTON, MD, stated that he was in full support of the
proposed bill both as a physician, a son, and as a human being.
He reported that the system had not allowed many of his patients
to have their end of life choices accepted. He allowed that
although the Hippocratic Oath said that physicians should not
participate, he offered his belief that a 5,000-year-old
document did not pertain today, as there were many more ethical
and moral decision-making tools. He rejected the slippery slope
argument, noting that there was 20 years of experience. He
opined that the objection was religious in nature, that no one
was being forced, and that a physician can choose to
participate.
4:48:33 PM
REPRESENTATIVE SULLIVAN-LEONARD asked about the Hippocratic
Oath.
DR. COMPTON replied that the statement most pertinent in this
situation was "first do no harm."
4:49:00 PM
MARGARET DORE, Attorney, reported that assisted suicide was
legal in the State of Washington. She added that she was also
the President of "Choice is an Illusion," a non-profit
corporation opposed to assisted suicide. She stated that it was
misleading to discuss aid-in-dying, as a terminal disease was
defined as "without treatment." She stated that the bill was
"stacked against the patient," noting that she was an
inheritance and probate lawyer. She said there was a complete
lack of oversight at the death. She opined that there was a
slippery slope in Oregon, and she noted that the proposed bill
allowed for euthanasia, as a patient may self-terminate with the
medication.
4:51:30 PM
REPRESENTATIVE SULLIVAN-LEONARD asked whether there was anything
in the proposed bill for signing prior to follow through with
the assisted process.
MS. DORE stated that this was not in the current version of the
proposed bill.
4:52:24 PM
DIANA KRISTELLER, Midwife, APRN, Voluntary Ending of Life,
stated her support for the proposed bill and asked for inclusion
of advanced practice registered nurses who were licensed
independent providers in Alaska with full prescriptive authority
in the proposed program.
4:53:15 PM
ROL EGNER offered a personal story of the suffering by her
husband after a severe stroke. She declared her support for the
legal availability for medically assisted death for those in
dire medical circumstances if they choose. She stated her
support for the proposed bill.
4:55:48 PM
MICHAEL HAUKEDALEN offered a personal story of the death of his
wife. He said that the legal system did not allow his wife to
terminate her own life. He encouraged passage of the proposed
bill.
5:00:26 PM
MARY MCDOWELL shared that she had spent a lot of time with
people during the end stages of their lives. She offered her
belief that although Alaska valued individual rights and self-
determination, the state denied "mentally competent adults who
are in the midst of a dying process the right to avail
themselves, only if they want to, of a liberty that they have if
they reside within a number of other states," the right to some
control over the timing and the way of death. She noted that
although many people who obtain the prescription have opted not
to use it, they have had peace of mind throughout the dying
process, knowing they had a way to shorten it if things got that
bad, and were not fretting about the loss of dignity or the loss
of bodily function. She pointed out that the proposed bill
required that an individual have a sound mind to make their own
choice. She offered her belief that this was the Alaskan thing
to do.
5:03:01 PM
NANCIANNA CLONAN offered a personal story about her husband's
death. She asked for passage of the proposed bill.
5:06:16 PM
JOHN FORBES, MD, stated that he was a psychiatrist and had spent
six years working for suicide prevention at a national level.
He stated his personal opposition to the proposed bill. He
declared that the proposed bill was a public health problem and
would have unintended effects. He pointed out that there was a
"serious problem with suicide" in Alaska, and that this proposed
bill would affect suicide rates. He suggested that national
studies showed that locales which approved of assisted suicide
had higher rates of suicide, as well as higher rates of approval
and acceptance of suicide. He said that the acceptability of
suicide varied with different groups, and that the World Health
Organization (WHO) had included messaging guidelines "to avoid
language which sensationalizes or normalizes suicide or presents
it as a solution to problems." He declared that physician
assisted suicide was "invariably presented as a solution to the
problem." He opined that passage of the proposed bill would
send a message of the acceptability of suicide as a solution.
5:08:47 PM
WILLIAM HARRINGTON declared that it was a person's right to have
access to a self-determined self-termination, and that this
should be protected by law. He lauded the bill sponsor for
offering the bill in the face of powerful opposition from two
groups, the organized cartel of religions and medical
professionals. He opined that the chemicals designed to stop
the heart and induce death were not medication. He lauded the
fifteen day "cooling off period."
5:11:21 PM
SARAH VANCE asked for clarification regarding how the legality
by other states had greatly improved the care for the terminally
ill. She asked who paid for the medication, and how much was
the medication. She asked to address the cost and the
possibility for pharmaceutical companies to take advantage. She
declared that it was necessary to respect the sanctity of life,
as the end of life was an unsure time. She asked how many
doctors had been wrong in the determination of remaining time to
live. She declared her opposition to the proposed bill.
5:13:44 PM
DIANA BARNARD, MD, Hospice Care, University of Vermont Medical
Center, pointed out that dying was different than it had been in
past generations, as medical advances had allowed for illness
prevention and management of diseases and accidents. She
acknowledged that there was no cure for dying, and that patients
held deeply diverse beliefs about life and death, with very
different priorities and needs when facing a terminal condition.
She shared her experience that priorities during the final days
and weeks became very simple: time with family and a peaceful
death at home. She noted that the modern medical health system
often made these simple desires go unanswered. She offered her
belief that the nearness of death brought patients clarity to
regain control of how they live and how they die. She
emphasized that medical aid-in-dying was an important option,
one tool to meet the needs of some people. She said that her
experience indicated it was possible to offer this as a
voluntary option.
5:16:58 PM
CHRISTOPHER KURKA, Executive Director, Alaska Right to Life,
stated that this was a dangerous bill, and he urged to vote
against it. He said that this was a game of words. He said
that Alaska had the second highest suicide rate in the U.S. He
questioned the accuracy of diagnosis for a terminal patient,
opining that patients would feel pressure to end their lives.
5:19:55 PM
MICHAEL PAULEY, Alaska Family Council, stated opposition to the
proposed bill for three primary reasons: (1) legalizing
physician assisted suicide places the vulnerable in jeopardy, as
it contained no mandatory requirement for individuals to seek
psychiatric consultation for clinical depression or other
treatable mental health issues in order to protect the dignity
of terminally ill people; (2) physician assisted suicide
corrupts the practice of medicine, and he quoted from the
Hippocratic Oath, "I will keep the sick from harm and injustice.
I will neither give a deadly drug to anybody who asks for it,
nor will I make a suggestion to this effect"; and (3) physician
assisted suicide will lead to worse violations of human dignity.
He concluded that SSHB 54 was dangerous public policy for
Alaska, and he urged opposition to the proposed bill.
5:22:47 PM
CHAIR SPOHNHOLZ announced that public testimony would be left
open, and SSHB 54 would be held over.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Alcohol and Drug Impacts Presentation to the Legislature.3.24.....pdf |
HHSS 3/28/2017 3:00:00 PM |
Economic Costs of Alcohol Abuse in AK |
| SSHB 54.PDF |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Sponsor Statement 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Sectional Analysis ver O 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Supporting Document--Letters 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Supporting Document--Archbishop Tutu Opinion 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |
| SSHB 54 Opposing Document--Letters 3.27.17.pdf |
HHSS 3/28/2017 3:00:00 PM HHSS 4/6/2017 3:00:00 PM |
HB 54 |