04/08/2014 03:00 PM House HEALTH & SOCIAL SERVICES

             HB  90-TESTING NEWBORNS FOR VITAMIN D                                                                          
                                                                                                                                
3:16:43 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS announced that the  next order of business would be                                                               
HOUSE BILL  NO. 90, "An  Act establishing a temporary  program in                                                               
the  Department  of  Health  and   Social  Services  for  testing                                                               
newborns  for baseline  vitamin  D  levels."   [In  front of  the                                                               
committee was the  proposed committee substitute (CS)  for HB 90,                                                               
labeled  28-LS0376\O, Mischel,  2/4/14,  adopted  as the  working                                                               
draft on February 6, 2014.]                                                                                                     
                                                                                                                                
REPRESENTATIVE  KELLER  moved  to adopt  the  proposed  committee                                                               
substitute  (CS)   for  HB  90,  labeled   28-LS0376\Y,  Mischel,                                                               
3/31/14, as the working draft.   There being no objection, it was                                                               
so ordered.                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON, as the sponsor  of the bill, explained the                                                               
changes to Version  Y, reporting that these changes  were made in                                                               
response  to  suggestions  from   the  House  Health  and  Social                                                               
Services  Standing  Committee.     He  noted  that  the  original                                                               
proposal had  been for statewide  universal testing for  one year                                                               
with an opt out option, and  that the research did not direct any                                                               
immediate benefit for the newborns  or the mothers.  He explained                                                               
that Version Y  would make this a two year  pilot project for 500                                                               
volunteer  pregnant women.   He  was discussing  involvement with                                                               
various providers to become the  coordinating local entity and to                                                               
provide program  analysis and data for  the participants benefit.                                                               
He  reported  that this  would  become  a  project based  on  the                                                               
application  of medical  science  to collect  the information  on                                                               
pregnancies  in  Alaska  and  to  provide  medical  benefits  for                                                               
mothers and newborns.   He pointed out that a  similar project in                                                               
South  Carolina had  reduced the  pre-term births  to 7  percent,                                                               
which  would equate  to  a  reduction of  25  pre-term births  in                                                               
Alaska and a  savings of $1.3 million.  He  shared that the state                                                               
would  have a  maximum match  with  the partners  of 20  percent,                                                               
about  $100,000.   He referred  to the  Protect Our  Children Now                                                               
program  description and  cost  schedule.  [Included in  members'                                                               
packets]  He  stated that this would move  the population forward                                                               
in prevention  of unintended pregnancy  outcomes.  He  asked that                                                               
the committee move the bill forward.                                                                                            
                                                                                                                                
3:23:08 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS asked  for clarification that the end  goal for the                                                               
program was  for documentation proving  that Vitamin D  does what                                                               
Representative Seaton had presented, and to encourage its use.                                                                  
                                                                                                                                
REPRESENTATIVE SEATON  expressed his agreement,  reiterating that                                                               
this was a  voluntary demonstration project and  that, should the                                                               
results  support it,  the medical  community would  encourage the                                                               
use of Vitamin D.                                                                                                               
                                                                                                                                
CHAIR HIGGINS asked about the study in Australia.                                                                               
                                                                                                                                
REPRESENTATIVE  SEATON  clarified   that  the  proposed  program,                                                               
Protect Our  Children Now, was  based on a South  Carolina study.                                                               
He  opined  that  the  program could  lower  pre-term  births  in                                                               
Alaska.                                                                                                                         
                                                                                                                                
3:25:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON,  in response  to Chair Higgins,  said that                                                               
the South Carolina  study had been conducted since  2004, and had                                                               
begun as a  research project.  He said that  the proposed program                                                               
for Alaska was an outgrowth of this project.                                                                                    
                                                                                                                                
CHAIR  HIGGINS reflected  on  a recent  seminar  he had  attended                                                               
which discussed  studies and  research.   He offered  an anecdote                                                               
claiming  that a  two year  study was  useless and  needed to  be                                                               
drawn out over a much longer  period, and that the performance of                                                               
the  studies often  made the  research useless.   He  pointed out                                                               
that the  proposed bill was for  a two-year study, yet  he opined                                                               
that  it was  necessary for  a longer  research project  to fully                                                               
understand the data.                                                                                                            
                                                                                                                                
REPRESENTATIVE SEATON  expressed his  agreement.  He  pointed out                                                               
that the  aforementioned had  been a  research study,  while this                                                               
was a  project based on that  research.  He noted  that pregnancy                                                               
outcomes were recognized in 9  months, and it would require about                                                               
500  pregnancies for  enough data  to review  the pre-term  birth                                                               
rate.   He  declared that  the proposed  bill was  for a  project                                                               
based on  scientific research, and  although it would  offer more                                                               
data, was not a research project.                                                                                               
                                                                                                                                
3:30:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  pointed out  that  the  fiscal note  from                                                               
Department  of  Health  and  Social   Services  was  higher  than                                                               
permitted by the  proposed bill, and he relayed that  there was a                                                               
search for a different partner to  do this more economically.  He                                                               
mentioned partners  in other states  performing this  program for                                                               
much  less than  the attached  fiscal note  proposed.   He shared                                                               
that the proposed  bill would show a willingness by  the State of                                                               
Alaska  to  participate  in  the improvement  of  the  health  of                                                               
pregnant women and infants.  He  reiterated that this was a pilot                                                               
project,  implementing  earlier   research  findings  from  other                                                               
studies.                                                                                                                        
                                                                                                                                
3:31:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  referred to  other screenings, and  asked if                                                               
any  of them  would  be willing  to  incorporate questions  about                                                               
Vitamin D use.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  SEATON replied  that this  would be  part of  the                                                               
nutritional  and screening  information compiled  from those  who                                                               
volunteered to be in the program.   He clarified that the project                                                               
was not designed  for a questionnaire, but would  focus on better                                                               
outcomes and healthier  mothers and newborns.   The proposed bill                                                               
would show  that the state would  be willing to participate  as a                                                               
minor partner.                                                                                                                  
                                                                                                                                
3:33:37 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS stated that public testimony was still open.                                                                      
                                                                                                                                
3:33:55 PM                                                                                                                    
                                                                                                                                
STEPHANIE  WRIGHTSMAN-BIRCH,  Chief,  Women,  Children  &  Family                                                               
Health,  Division  of Public  Health,  Department  of Health  and                                                               
Social Services,  stated appreciation for the  changes to Version                                                               
Y,  especially as  it included  treatment and  public information                                                               
after the data  had been collected.  She  expressed concerns with                                                               
the  content of  the  bill  as it  pointed  toward conducting  an                                                               
experimentally  designed  research  study   which  would  be  the                                                               
responsibility  of  the  Division   of  Public  Health  to  carry                                                               
forward.   She  stated  that  this was  not  a  core function  of                                                               
Division of  Public Health.  She  acknowledged that participation                                                               
was  voluntary,  although  she   opined  that  all  research  was                                                               
voluntary.   She  stated  that  a longer  time  was necessary  to                                                               
collect the data.   She declared that DHSS was  very sensitive to                                                               
requiring Institutional Review Board  (IRB) approvals.  She noted                                                               
that  there  were rigorous  study  design  elements and  national                                                               
standards  that  needed  to  be  adhered.   She  noted  that  the                                                               
proposed   fiscal  note   included  state   personnel  time   for                                                               
administration, and even  if the intent was for  a contractor and                                                               
a grantee,  it was the  responsibility of the Division  of Public                                                               
Health to oversee  the study design and protocol,  and to conduct                                                               
a secondary  review of the  data.   She declared that  there were                                                               
costs  included  for this.    Once  the  data was  collected  and                                                               
analyzed,  it  had  to  be   compared  with  prior  research  and                                                               
recommendations.   She  declared a  challenge to  be the  lack of                                                               
acceptable standard  recommendations or guidelines for  Vitamin D                                                               
levels  on  newborns  or  pregnant women.    She  acknowledged  a                                                               
difference of  opinion between the  Vitamin D literature  and the                                                               
recommendations  for its  use by  organizations  to which  public                                                               
health officials were bound to follow.                                                                                          
                                                                                                                                
3:39:09 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS closed public testimony and took a brief at-ease.                                                                 
                                                                                                                                
3:39:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER moved  to  report  the proposed  committee                                                               
substitute  (CS)   for  HB  90,  labeled   28-LS0376\Y,  Mischel,                                                               
3/31/14,  out of  committee with  individual recommendations  and                                                               
the  attached  fiscal notes.    There  being no  objection,  CSHB
(HSS)  was moved  from  the House  Health  and Social  Services                                                               
Standing Committee.                                                                                                             
                                                                                                                                
3:39:58 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:42:11 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 3:42 p.m.