03/21/2006 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB426 | |
| HB258 | |
| HB412 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 426 | TELECONFERENCED | |
| += | HB 258 | TELECONFERENCED | |
| += | HB 412 | TELECONFERENCED | |
| += | HB 356 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 21, 2006
3:04 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Paul Seaton, Vice Chair
Representative Tom Anderson
Representative Carl Gatto
Representative Vic Kohring
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 426
"An Act relating to medical assistance eligibility and coverage
for persons under 21 years of age."
- HEARD AND HELD
HOUSE BILL NO. 258
"An Act relating to aggravating factors at sentencing."
- MOVED CSHB 258(HES) OUT OF COMMITTEE
HOUSE BILL NO. 412
"An Act relating to the waiver of undergraduate expenses for a
spouse or dependent of a deceased resident peace officer or
member of the armed services or fire department."
- MOVED CSHB 412(HES) OUT OF COMMITTEE
HOUSE BILL NO. 356
"An Act relating to consent for medical and dental services,
including bone marrow donation, for a minor."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 426
SHORT TITLE: MEDICAL ASSISTANCE FOR PERSONS UNDER 21
SPONSOR(s): REPRESENTATIVE(s) COGHILL
02/06/06 (H) READ THE FIRST TIME - REFERRALS
02/06/06 (H) HES, FIN
02/23/06 (H) HES AT 3:00 PM CAPITOL 106
02/23/06 (H) <Bill Hearing Rescheduled to 2/28/06>
02/28/06 (H) HES AT 3:00 PM CAPITOL 106
02/28/06 (H) Scheduled But Not Heard
03/16/06 (H) HES AT 3:00 PM CAPITOL 106
03/16/06 (H) -- Meeting Canceled --
03/21/06 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 258
SHORT TITLE: SEXUAL ASSAULT BY PERSON WITH HIV/AIDS
SPONSOR(s): REPRESENTATIVE(s) LYNN
04/06/05 (H) READ THE FIRST TIME - REFERRALS
04/06/05 (H) HES, JUD
02/23/06 (H) HES AT 3:00 PM CAPITOL 106
02/23/06 (H) <Bill Hearing Rescheduled to 2/28/06>
02/28/06 (H) HES AT 3:00 PM CAPITOL 106
02/28/06 (H) Scheduled But Not Heard
03/21/06 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 412
SHORT TITLE: TUITION WAIVERS:MILITARY/POLICE/FIRE
SPONSOR(s): REPRESENTATIVE(s) RAMRAS
01/30/06 (H) READ THE FIRST TIME - REFERRALS
01/30/06 (H) EDU, HES, FIN
02/14/06 (H) EDU AT 11:00 AM CAPITOL 106
02/14/06 (H) Moved Out of Committee
02/14/06 (H) MINUTE(EDU)
02/15/06 (H) EDU RPT 6DP
02/15/06 (H) DP: GATTO, GARA, WILSON, THOMAS, LYNN,
NEUMAN
02/23/06 (H) HES AT 3:00 PM CAPITOL 106
02/23/06 (H) <Bill Hearing Rescheduled to 2/28/06>
02/28/06 (H) HES AT 3:00 PM CAPITOL 106
02/28/06 (H) Scheduled But Not Heard
03/16/06 (H) HES AT 3:00 PM CAPITOL 106
03/16/06 (H) -- Meeting Canceled --
03/21/06 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE JOHN COGHILL
Alaska Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as sponsor of HB 426.
RYNNIEVA MOSS, Staff
To Representative John Coghill
Alaska Legislature
Juneau, Alaska
POSITION STATEMENT: Testified on CSHB 426, Version I.
KEVIN HENDERSON, Medical Assistant
Administrative Manager
Division of Public Assistance
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified on CSHB 426, Version I.
DWAYNE PEEPLES, Director
Division of Health Care Services
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified on CSHB 426, Version I.
STACIE KRALY, Chief Assistant attorney General
Statewide Section Supervisor;
Human Services Section
Civil Division (Juneau)
Department of Law (DOL)
Juneau, Alaska
POSITION STATEMENT: Testified on CSHB 426, Version I.
JANET CLARKE, Assistant Commissioner
Finance and Management Services
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified on CSHB 426, Version I.
REPRESENTATIVE BOB LYNN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Spoke as prime sponsor of HB 258.
MIKE SICA, Staff
to Representative Bob Lynn
Alaska Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 258 on behalf of
Representative Lynn, sponsor.
TREVOR STORRS, Executive Director
Alaska Aids Assistance Association (Four A's)
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 258.
ROBERT BASSETT, Jr., Master Family Therapy (MFT)
Certified HIV/AIDS Counselor and Educator
State of Connecticut
Washington D.C.
POSITION STATEMENT: Testified in support of HB 258.
BARBARA BRINK, Vice President
Alaskan AIDS Assistance Association
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 258.
JON BENORDEN
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 258.
ELIZABETH SCHENK SALTONSTALL, MD
Medical Director
Ryan-White Title Three Program
Alaska Native Tribal Health Consortium (ANTHC)
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 258.
JOHN CYR, Business Manager
Public Safety Employees Association (PSEA)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 258.
BARBARA MASON, Executive Director
Council on Domestic Violence and Sexual Assault
Department of Public Safety (DPS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 258.
BRENDA STENFILL, Executive Director
Interior Alaska Center for Non-Violent Living;
Chair, Alaska Network on Domestic Violence and Sexual Assault
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 258.
REPRESENTATIVE JAY RAMRAS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 412 as prime sponsor.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:04:11 PM
Cissna, Seaton, Gardner, and Wilson were present at the call to
order. Representatives Gatto, Kohring, and Anderson arrived as
the meeting was in progress.
HB 426-MEDICAL ASSISTANCE FOR PERSONS UNDER 21
3:05:16 PM
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 426, "An Act relating to medical assistance
eligibility and coverage for persons under 21 years of age."
REPRESENTATIVE SEATON moved to adopt CSHB 426, Version 224-
LS1602\I, Mischel, 3/14/06. There being no objection, Version I
was before the committee.
3:05:55 PM
REPRESENTATIVE JOHN COGHILL, Alaska Legislature, testified as
sponsor of HB 426, and paraphrased from the following written
statement [original punctuation provided]:
In times when federal dollars are diminishing, the
legislature will have to review policies for providing
for the public health. To better provide medical
assistance to the truly needy, some eligibility
requirements need to be changed.
As the department has put it, we are trying to address
the "low hanging apples" that drain millions of
dollars a year from a program that is growing in
astounding increments.
HB 426 puts best practices to use by increasing third-
party reimbursement, reducing Medicaid abuse and
fraud, setting home equity limits, and implementing
new federal requirements on the State for asset
transfers and treating annuities like a Miller's
Trust.
This bill also requires a person applying for medical
assistance for a minor to be that person's parent or
legal guardian, unless the parent or legal guardian is
a minor. If a child is in state custody, an employee
of the department can apply for coverage.
Currently, the unmarried father's income and resources
are not considered in determining the eligibility of a
pregnant woman for Medicaid. In this bill, we would
count the income and resources of the unmarried father
of an unborn child when determining the eligibility of
the pregnant woman. Neither the resources nor the
income of the unmarried father can exceed $50,000 a
year.
Lastly, this bill directs the department to report
back to the legislature no later than the first day of
the Twenty-Fifth Legislature on ways to reduce medical
assistance expenditures for services received in
residential psychiatric treatment centers by enhancing
parental financial responsibilities and maximizing
third-party resources available. Under current law a
child could be placed in residential treatment and
qualify for medical assistance after being out of the
family home for thirty days, even though one or both
parents have medical insurance.
3:09:03 PM
RYNNIEVA MOSS, Staff to Representative John Coghill, Alaska
Legislature, explained that current law allows other public
assistance can garnish the permanent fund dividend (PFD) for
reimbursement. This bill provides language allowing the
[Department of Health and Social Services (DHSS)] to garnish a
PFD to reimburse for medical assistance. Ms. Moss, in response
to a question, indicated that the PFD garnishment language is
located in Section 5.
3:11:23 PM
CHAIR WILSON inquired as to when the PFD garnishment would be
applied.
3:11:27 PM
KEVIN HENDERSON, Medical Assistant, Administrative Manager,
Division of Public Assistance, Department of Health and Social
Services (DHSS), explained that the current law allows the
department to garnish the PFD of individuals who, as recipients
of public assistance programs, owe money to the state for
reasons provided in statute. This bill adds medical assistance
to that statute.
3:12:40 PM
CHAIR WILSON posed a scenario:
I've had people come to me where ... maybe the ex-
husband is making [support] payments and then
something came up ... [and he] didn't make the payment
... so social services made the payment; ...[thus] he
got behind on his payments [but] now he's making
payments. I just want to make sure that this isn't
added on to what he owes.
3:13:16 PM
MR. HENDERSON responded that this is limited in scope for two
reasons. Current regulations state that when a recipient of
medical assistance abuses the program or is found guilty of
fraud, they have an obligation to repay the state for those
services. Also, a recipient awaiting a fair hearing for the
previously indicated reason may request continued benefits while
awaiting that hearing. However, if the recipient is not
successful in his/her hearing, he/she is subject to repay the
state for the cost of medical assistance paid during the
extended benefits period. He said:
Sometimes it's like getting blood out of a turnip.
... The PFD is really the most efficient way for the
state to get reimbursement in those cases. We just
want to add Medicaid to that list.
3:14:57 PM
REPRESENTATIVE CISSNA asked whether a garnishment would apply to
a parent's or a child's PFD.
MR. HENDERSON responded that if a parent filed for a fair
hearing on behalf of his/her child's case and lost the case, the
department could seek from the parents any medical assistance
paid to the child.
3:15:44 PM
REPRESENTATIVE SEATON stated that [Version I] appears to
encompass more than fair hearing situations. He asked whether
it would provide for retroactive collection of funds when
someone is reassessed and determined to no longer be waiver
eligible.
MR. HENDERSON said that the fair hearing situation is one
example when the department could seek reimbursement. Program
abuse or fraud would be other examples, he offered.
3:16:52 PM
REPRESENTATIVE SEATON reiterated his concern that this bill
language appears to cover any benefit considered an overpayment,
including a recipient of medical assistance, who upon review, is
found to be ineligible and determined to have been ineligible
for some time prior to the reassessment, and has his/her PFD
subject to garnishment.
MR. HENDERSON offered the specific departmental regulations, 7
AAC 43.1800 and 7 AAC 43.1810, to clarify the criteria applied
to seek reimbursement. He explained that the department does
not seek reimbursement for services provided in good faith, only
when the applicant has sought services inappropriately.
3:19:08 PM
REPRESENTATIVE SEATON cautioned that in creating statute for
reimbursement of benefit overpayment, the committee's obligation
is to be clear regarding the scope of the bill versus relying on
regulatory language for specifications.
3:19:39 PM
MS. MOSS offered to present the bill sections individually and
in numerical order.
3:20:45 PM
DWAYNE PEEPLES, Director, Division of Health Care Services,
Department of Health and Social Services (DHSS), explained that
Sections 1-4 focus on support activities, which the Division of
Health Care Services and DHSS are conducting to "tighten up and
control and coordinate ... other third-party benefits, and
reduce Medicaid expenditures." Under the Reimbursable Services
Agreement, the Department of Law assigns attorney generals to
DHSS to pursue subrogation and estate recoveries. Section 1
addresses eligibility and coordination of benefits, such that
during the process of applying for Medicaid other potential
third-party payers would be identified. Approximately 22
percent of people [receiving] Medicaid have other resources for
health insurance. He noted that part of this is mandating 36
months during which the department can coordinate claims
payments with other third-party payers, which meets federal
statutes. Section 2 strengthens the department's ability to
recover funds when there are legal actions on a subrogation.
For instance, in an accident in which an insurance party will
pay against a claim for settlement, the department has sometimes
lost out on full recovery on its Medicaid payments for
hospitalization physician services.
3:23:07 PM
CHAIR WILSON surmised then that Section 2 makes it such that the
department is one of the entities in line [to receive funds].
3:23:14 PM
STACIE KRALY, Chief Assistant Attorney General, Statewide
Section Supervisor, Human Services Section, Civil Division
(Juneau), Department of Law (DOL), confirmed that Sections 2-4
all enhance the department's ability to participate in third-
party recoveries with Medicaid recipients when litigating
through civil litigation or negotiating with insurance companies
for payment for services that the state Medicaid program has
paid. Therefore, Ms. Kraly specified that the language enhances
the department's ability to gather information, coordinate
services, and ensure that the department receives its third-
party recovery to the fullest extent possible.
CHAIR WILSON emphasized that such allows for more money to help
someone else.
3:23:54 PM
REPRESENTATIVE GARDNER turned attention to page 3, lines 26-27,
and inquired as to how an attorney would know that he/she has a
duty to notify the attorney general's office in such a case.
MS. KRALY answered that the duty is a statutory duty requiring
plaintiff and defense attorneys to understand the third-party
recovery process. With regard to the general practice, Ms.
Kraly said that if an individual seeks representation, there
would be a duty to gather all of the information on the part of
the attorney in order to determine whether the individual was a
Medicaid recipient. The aforementioned duty exists now in a
certain sense because the state has an ongoing subrogation and
lien interest in these recoveries. Therefore, the
aforementioned language further clarifies the attorney's
responsibility so that as the attorney takes on representation
of Medicaid clients, the department is aware of it and not left
out during the negotiation process.
3:25:49 PM
REPRESENTATIVE CISSNA inquired as to how many cases of this kind
are performed every year.
MS. KRALY answered that the attorney currently doing the
subrogation cases has an open case load of almost 500 cases.
Those are cases that have, through a review process, been
determined to be meritorious to pursue in relation to the
resources that are available, one attorney and one paralegal.
Ms. Kraly opined that the department believes that with more
resources more cases could be sought for recovery. Furthermore,
[more resources] would address the state recovery issues
mandated by federal law as well as the audit process required
under AS 47.05.200.
3:27:14 PM
MR. PEEPLES pointed out that Sections 4 and 5 are tied together
and would allow the Division of Health Care Services to pursue
PFD recoveries in those cases of fraud, waste, et cetera.
Section 4 specifies the order in which a PFD would be garnished
following tax liens and settlement costs for attorneys.
MS. KRALY interjected that [Section 4] further clarifies the
statutory lien for subrogation rights in regard to the Medicaid
lien. The language specifies the order of priority of the
Medicaid lien, which allows [the state] to recovery before other
entities.
3:29:12 PM
REPRESENTATIVE SEATON, referring to Section 5, asked if
statutory language to the effect that the benefit overpayment is
collected where fraud, waste, and abuse were present is included
or is that "our" interpretation.
MR. PEEPLES specified that [the language] refers to a benefit
overpayment that has been determined to have been used
fraudulently.
REPRESENTATIVE SEATON asked if the language, "where fraud,
waste, or abuse has occurred" could be inserted without
"troubling the statute." He mentioned that the question could
be answered later.
3:30:31 PM
MR. HENDERSON, referring to Sections 6-8, related that DHSS is
supportive of the general effort, although it has concerns with
regard to Section 6.
3:31:07 PM
MS. MOSS, in response to Representative Gatto, explained that
originally the intent [of Section 6] was to include the income
of the stepfather in the household income. She related a case
in Anchorage in which a physician at Providence Hospital is the
stepfather of children who received Denali KidCare benefits.
However, the language to make it work hasn't been developed and
thus the compromise was to seek the unmarried father and make
him personally responsible for some of the medical bills. Ms.
Moss opined that part of the concern of the department is that
the woman could lie about who the father is, which would result
in paternity tests. She related that the sponsor feels strongly
that if [the desire] is to preserve family units, they should be
made personally responsible for the upbringing of their
children. The aforementioned is the background of Section 6,
which she characterized as a starting point.
3:33:17 PM
REPRESENTATIVE GATTO then referred to page 7, lines 9-12, which
refers to [the father's] household income and resources that
don't exceed $50,000 annually. He asked if it would be possible
for an individual to have an annual income of less than $50,000,
but have $1 million worth of resources in a house.
MS. MOSS said that's covered on page 8, line 9, which specifies
that the equity in the house can't exceed $500,000.
3:34:22 PM
REPRESENTATIVE GATTO posed a scenario in which the individual
has an annual income of less than $50,000, but $1 million worth
of resources in stocks and negotiable securities.
MR. HENDERSON commented that Medicaid eligibility rules "get
dicey." He related his understanding that the intent of the
$50,000 was that it refers to income or resources. If that's
not specified in the bill, then the department would consider [a
change to remedy that]. In further response to Representative
Gatto, he related his belief that the intent was to refer to
either the income or resources in the amount that exceed
$50,000.
MS. MOSS agreed with Mr. Henderson that the intent was to refer
to situations in which either the resources or the income of the
individual exceed $50,000.
3:36:10 PM
REPRESENTATIVE GATTO moved Conceptual Amendment 1, as follows:
Page 7, line 10:
Delete "each do"
Insert "either does"
3:36:33 PM
MS. MOSS opined that if the word "and" isn't replaced, then the
individuals resources and income would be limited to $50,000.
REPRESENTATIVE GATTO agreed, that on page 7, line 9, the word
"and" should be replaced with "or". He characterized it as a
friendly addition to Conceptual Amendment 1. Therefore,
Conceptual Amendment 1, as amended, would read as follows:
Page 7, line 9:
Delete "and"
Insert "or"
Page 7, line 10:
Delete "each do"
Insert "either does"
3:37:43 PM
CHAIR WILSON objected for discussion purposes.
REPRESENTATIVE GARDNER asked if the intention is that the
household income can't exceed $50,000 and the resources can't
exceed $50,000 or rather that the household income and resources
combined can't exceed $50,000.
MS. MOSS clarified that the intent is that either the household
income or the resources can't exceed $50,000. In further
response to Representative Gardner, if the individual has
household income of $25,000 and resources of $25,000, this
provision wouldn't be triggered.
3:38:33 PM
MR. HENDERSON, in response to Representative Cissna, specified
that except for a provision later in the bill, a person's home
is almost always an exempt resource and thus isn't included in
this discussion. He specified that the term "resources" refers
to additional property such as a [second property] or a mutual
fund.
3:39:31 PM
REPRESENTATIVE ANDERSON inquired as to what will ultimately be
denied of the putative father.
MR. HENDERSON answered that the pregnant women's Medicaid
eligibility would be denied. The department has a reservation
about [Section 6], he related. The intent has always been to
have a liberal eligibility group to encourage pregnant women to
obtain prenatal care such that healthy children are born, which
in the long-term results in less expenditures for Medicaid or
any health insurance.
3:41:06 PM
CHAIR WILSON related her understanding that 50 percent of all
children born in the state are paid for by the state.
3:41:17 PM
MR. HENDERSON opined that [Section 6] adds a layer of
bureaucracy. Furthermore, the legislation refers to the
"putative father", although there is no proviso for a paternity
test to uphold this aspect. However, he suggested that federal
law would result in the state's inability to enforce the
provision unless the individual was the documented and tested
father of the child. For some of the special Medicaid only
groups such as Denali KidCare and this pregnant woman
eligibility group, the income and resources of someone can't be
counted when determining eligibility unless he/she is the spouse
or the child. He related that the state will have to obtain a
state plan amendment to implement this provision. He further
related that the department is fairly certain that the federal
government wouldn't approve it in its current state.
3:43:00 PM
REPRESENTATIVE ANDERSON expressed concern with the lack of a
paternity test in determining the father and the amalgamation of
the father's resources to determine the mother's eligibility for
Medicaid. He inquired as to when the mother would receive
coverage.
MR. HENDERSON posed a situation in which a putative father,
after being identified as the father, refuses to cooperate with
verifying his income and resources. In such a situation, the
department can't do anything to the uncooperative father. Mr.
Henderson specified that the only action available to the
department is to deny eligibility for the pregnant woman.
REPRESENTATIVE ANDERSON opined that the aforementioned is the
case 50 percent of the time and thus the woman pays the penalty.
CHAIR WILSON said she, too, is concerned with the
aforementioned. She related that one of her constituents took a
paternity test and was found not to be the father. However, he
was still asked to pay. Chair Wilson opined that there needs to
be a way to be sure that the right person is held responsible.
3:46:05 PM
MS. MOSS interjected that she didn't want this provision to slow
the progress of this legislation because the sponsor
acknowledges that the legislation isn't exactly where it should
be. Therefore, if the committee chooses to delete [Section 6],
the sponsor can continue to work on this aspect. In response to
Chair Wilson, Ms. Moss said that the next committee of referral
for HB 426 is the House Finance Committee.
3:46:36 PM
CHAIR WILSON said that she liked [Section 6] if there was a
determination as to the identity of the father.
MS. MOSS suggested that Chair Wilson could request a referral to
the House Judiciary Standing Committee in order that it address
[Section 6].
REPRESENTATIVE ANDERSON agreed with the need to determine who is
the father. He then expressed the need to address a situation
in which the father refuses to pay and the mother is left
ineligible during the years it takes to garnish the father.
CHAIR WILSON said that she would like to have a House Judiciary
Standing Committee referral added before the House Finance
Committee referral.
MS. MOSS said that the sponsor wouldn't have a problem with that
because he wants the legislation to be correct when it makes it
to the floor.
3:47:22 PM
REPRESENTATIVE SEATON related his preference to delete [Section
6] and have it reinserted in the House Judiciary Standing
Committee if determined [to be appropriate]. From this
committee's standpoint, the child is not going to receive
prenatal care because there's an identified person who might
have resources that may not pay the bills.
3:48:13 PM
CHAIR WILSON reminded the committee that it has a motion before
it. She then removed her objection to Conceptual Amendment 1,
as amended. There being no further objection, Conceptual
Amendment 1, as amended, was adopted.
3:48:46 PM
REPRESENTATIVE SEATON moved Amendment 2, as follows:
Page 7, lines 7-12:
Delete all material.
REPRESENTATIVE GARDNER objected for discussion purposes. She
then inquired from where these income figures come.
MS. MOSS responded that the income figures already exist in
statute.
3:49:30 PM
REPRESENTATIVE SEATON said that he doesn't object to the concept
[of the language being deleted by Amendment 2]. However, he
opined that this provision needs more work and he preferred
having the work done in the House Judiciary Standing Committee.
3:50:03 PM
REPRESENTATIVE GARDNER agreed with Representative Seaton, and
opined that one of the large problems in society is that fathers
are undervalued. She said that valuing fathers includes holding
them responsible for their paternity, although not to the extent
of denying or limiting medical care to a pregnant woman.
3:50:56 PM
CHAIR WILSON announced that she will request that HB 426 be
referred to the House Judiciary Standing Committee in order to
address this provision.
3:51:34 PM
REPRESENTATIVE GARDNER removed her objection to Amendment 2.
There being no further objection, Amendment 2 was adopted.
3:52:27 PM
REPRESENTATIVE ANDERSON turned the committee's attention to
Section 8 on page 7, lines 24-26. He posed a situation in which
a 17-year-old woman has a one-year-old, and related his
understanding that the woman would be able to apply per this
language.
MS. MOSS related her understanding that once a child is born,
the parent is considered the legal guardian of that child.
3:53:19 PM
REPRESENTATIVE SEATON agreed with Ms. Moss, but pointed out that
the language in Section 8 specifies that the individual must be
an adult and the legal guardian or parent.
MS. MOSS said that could be changed.
REPRESENTATIVE ANDERSON said that [on page 7, line 26, the
"and"] should be replaced with "or".
3:53:38 PM
CHAIR WILSON announced that the aforementioned is Amendment 3.
MS. MOSS interjected that the committee may want a different
amendment because Amendment 3 may give any adult permission to
apply for the child.
3:54:02 PM
CHAIR WILSON asked if the language could merely refer to "the
parent or legal guardian of the child". Therefore, New
Amendment 3 would read as follows:
Page 7, line 26:
Delete "an adult and"
3:54:52 PM
REPRESENTATIVE GARDNER said that she's trying to determine what
problem is being addressed with this section. She surmised that
under this legislation, if a 15-year-old runaway lives with a
friend's family, the friend's family can't obtain Medicaid for
the runaway 15-year-old.
MS. MOSS said that is correct. She related that the sponsor
believes that the parents of an unemancipated child that's under
18 years of age should have a voice in that child's life,
regardless of whether the child has runaway or not. If the
child is in the state's custody, the department would have the
authority to apply for Medicaid. Further, if the child is
living with a relative, the adult caretaker who is the relative
would be able to apply for Medicaid.
3:56:15 PM
REPRESENTATIVE GARDNER asked if, under current law, adults
housing a runaway child can obtain [medical] care.
MS. MOSS answered that under current law, anyone 18 years of age
or older can apply for a child under 18 years of age to have
Medicaid.
REPRESENTATIVE GARDNER posed a situation in which a child is a
runaway living at Covenant House with his/her parents living out
of state and uninvolved, and asked how such a child would obtain
medical care.
MS. MOSS related her assumption that the child would have to
apply for a legal guardian with the assistance of the Office of
Children's Services.
MR. HENDERSON highlighted that under current law there isn't
anything that prevents a person from applying for themselves.
He related his understanding that [Section 8] attempts to
address the situation when someone applies on behalf of someone
else.
3:58:03 PM
REPRESENTATIVE GARDNER asked whether the state would seek
reimbursement from the parent of the 17-year-old in the
aforementioned situation.
MS. MOSS replied, yes. She then related an example of a
teenager in Utah receiving residential treatment. Although both
parents worked for the state and had state insurance, because
the child hadn't lived in the home for 30 days the child
qualified for Medicaid. Section 11 addresses this issue, which
is a complicated matter. She informed the committee that the
[department] has been asked to prepare a report with possible
legislation that would clarify parental financial responsibility
and maximize any third-party payers.
4:00:09 PM
REPRESENTATIVE SEATON asked if the addition of the new
subsection would mean that a 17-year-old could not apply for
him/herself.
MR. HENDERSON related his understanding that it's not intended
to do so.
MS. MOSS said she didn't believe that the sponsor has a problem
with an individual filing for Medicaid. However, the sponsor
does have a problem with a runaway who gets an adult to sign up
him/her for Medicaid without the parent's knowledge. Again, the
sponsor believes that the parents of a runaway should be
involved with decisions for their child under 18 years of age.
4:01:23 PM
REPRESENTATIVE SEATON expressed his desire to word subsection
(j) on page 7, lines 24-25, such that it captures the sponsor's
intent.
MS. MOSS said that the opportune language is "for a child",
which means that a person is applying for Medicaid for a child.
4:02:29 PM
MS. KRALY stated that Ms. Moss is correct, but stated that
[subsection (j)] would be less ambiguous if language "on behalf
of a child" was included. She then pointed out the statutory
provision in AS 18.25 that deals with the ability of an
unemancipated minor who is estranged from his/her family that
allows him/her to obtain medical care on his/her own behalf.
She said that the aforementioned needs to play into this
determination also. Again, it's important not to penalize a
child for an estranged relationship with his/her family.
REPRESENTATIVE GARDNER said that at the same time if the parent
is expected to pay for something, the parent should have some
input. Therefore, if a minor child can obtain his/her own
medical care and that child wants to do something that the
parent disapproves of, the parent shouldn't be held responsible,
she opined.
MS. KRALY clarified that she highlighted the conflicting
statutory authority in order to be sure that there is no
inherent conflict between the ability to apply for Medicaid and
the services for minors as opposed to the ability of a minor,
under that express statutory grant, to obtain medical care on
his/her behalf in certain circumstances. Ms. Kraly said that
she didn't disagree with Representative Gardner's point, but the
language needs to be reviewed and cleaned up.
4:05:03 PM
REPRESENTATIVE CISSNA opined that often a large problem is
obtaining medical help for teenagers who are not at home and
whose parents cannot be found. She then stressed the importance
of getting teenagers medical help.
4:05:55 PM
CHAIR WILSON inquired as to the language that would be utilized
in a paragraph (4) relating that there had been attempts to
contact the parents.
MS. KRALY indicated that such language would probably specify
that the department has exhausted all attempts to contact the
parents. She referred to such a provision as a notice
provision.
CHAIR WILSON opined that she would feel better knowing that is
part of the process.
4:07:29 PM
REPRESENTATIVE SEATON related his understanding that [Section 8]
restricts who can apply for medical assistance on behalf of
someone else.
CHAIR WILSON opined that one wouldn't want the child to apply
for such unless the parents had been contacted.
4:08:00 PM
MS. MOSS asked if a child under age 18 who is estranged from
his/her parents and the location of the parents isn't known
would be considered a child in need of aid (CINA).
MS. KRALY said that she wasn't sure she could answer that as an
absolute, but it would be a question that would require review.
4:08:33 PM
REPRESENTATIVE GARDNER related her practical experience in which
the division is hesitant to take children into custody against
their will when of an age to be noncompliant or resistant to a
placement. Once the child is in state custody, then the state
is responsible for where the child lives. However, if a 16-
year-old says that she is going to live with her older
boyfriend, there isn't much point in resources being spent on
the state. Still, one would want that 16-year-old to have
access to health care.
4:09:13 PM
CHAIR WILSON suggested that the committee bring up all the
questions during this hearing and the legislation could be heard
again in this committee or referred on to the House Judiciary
Standing Committee.
4:09:55 PM
REPRESENTATIVE SEATON moved an amendment to New Amendment 3, as
follows:
Page 7, line 24, following "coverage":
Delete "for"
Insert "on behalf of"
4:10:25 PM
There being no objection, the amendment to New Amendment 3 was
adopted.
CHAIR WILSON, upon determining there was no objection to New
Amendment 3, as amended, announced that New Amendment 3, as
amended, was adopted.
4:11:09 PM
MS. MOSS, addressing Chair Wilson's concern with regard to
contacting parents, related her understanding that under CINA
the department has to make reasonable efforts to locate
relatives. Therefore, Ms. Moss suggested inserting a paragraph
(4) specifying that the department has made a reasonable effort
to contact the parent or legal guardian.
4:12:16 PM
REPRESENTATIVE CISSNA related that in her work with teenage
females, it was common for sexual abuse to be the reason they
ran away from home. In cases such as that, she opined that it
may not be appropriate for the parent to know exactly what is
occurring.
MS. MOSS relayed that the sponsor believes that in such a case,
the state should pursue sexual abuse charges. However, under
CINA a civil court controls a criminal act and thus the sponsor
is attempting to find ways in which to ensure that more criminal
acts are treated as such.
REPRESENTATIVE GARDNER noted that a child who left home due to
sexual abuse may have vulnerable siblings at home and not taking
action gives the perpetrator free license.
REPRESENTATIVE CISSNA highlighted that the court system as well
as other systems are really backed up such that services are not
getting to children in time.
MS. MOSS reminded the committee that a child under 18 years of
age who has been sexually abused and left home, could apply for
Denali KidCare him/herself.
4:15:01 PM
REPRESENTATIVE SEATON said that rather than inserting the
language specifying that the department has made a reasonable
effort to contact the parent or legal guardian in a new
paragraph in Section 8, it should be inserted as part of
paragraph (3) because it's not to be in place of the caregiver,
relative, or parent or legal guardian.
4:15:37 PM
REPRESENTATIVE SEATON moved Conceptual Amendment 4, as follows:
Page 7, line 30, following "department":
Insert "and has made reasonable efforts to
contact the parents"
CHAIR WILSON objected for discussion, and pointed out that
Section 8(3) refers to a child in the custody of the department.
MS. MOSS explained that paragraph (3) would need to be
renumbered as paragraph (4) and the aforementioned language
would be the new paragraph (3).
MS. KRALY opined that placing this language in Section 8 is
confusing, and therefore she suggested tabling that issue and
allowing the House Judiciary Standing Committee address it. She
further opined that placing the language in Section 8 mandates a
duty on the department to make reasonable efforts to locate
parents for individuals who are applying for Medicaid, which is
a completely different concept than the CINA provisions. She
mentioned that the language may need to be inserted elsewhere
within the Medicaid eligibility provisions.
4:18:11 PM
CHAIR WILSON announced that she would take questions on HB 426,
but would ultimately hold it for further work.
4:18:34 PM
REPRESENTATIVE SEATON withdrew Conceptual Amendment 4.
REPRESENTATIVE ANDERSON recommended that committee members
thoroughly review HB 426, have questions answered in advance,
and not have lengthy dialogue [at the next meeting].
4:19:01 PM
REPRESENTATIVE CISSNA expressed her desire to contact those in
the field with regard to the ramifications of these substantial
changes encompassed in HB 426.
CHAIR WILSON stated that she had already made the decision to
"go ahead" because the committee has other legislation to
address.
4:19:34 PM
REPRESENTATIVE GATTO, referring to a February 22, 2006,
memorandum from Kevin Henderson, DHSS, pointed out that there is
the belief that an individual with $500,000 in equity should be
counted in that individual's assets. However, the legislation
allows for the individual to reduce the equity value in the home
by selling it or by taking out a loan that affects the equity.
He inquired as to why the aforementioned is the case.
MR. HENDERSON explained that the origin of this $500,000
provision came from the federal Deficit Reduction Act, which
applied only to those [seeking] long-term care. This
legislation would apply it to everyone else, except family
recipients. The federal law also includes the provisions
allowing a reverse mortgage or [selling of the house]. Mr.
Henderson emphasized that generally a house was totally exempt
and thus this language merely places a threshold for
eligibility. In further response to Representative Gatto, Mr.
Henderson clarified that whatever money was available as a
result of taking out a reverse mortgage would be factored in as
part of the eligibility calculation as income or resources.
4:21:57 PM
REPRESENTATIVE GARDNER related her understanding, as per the
sectional analysis, that Section 9 is a repealor. She inquired
as to what is being repealed.
MR. PEEPLES explained that currently the department has the
authority to provide a settlement waiver for medical costs on a
subrogation settlement. He then posed a situation of a personal
injury settlement in which a Medicaid beneficiary is injured and
the state has been paying for medical care. If the attorneys
settle between the insurance company and the recipient, the
department wants to pick up the cost of that medical claim to
reimburse the expenditure out of an insurance settlement.
Therefore, the client or whomever else is in the legal action
wouldn't reimburse the department for medical services. Section
9 repeals that authority.
4:23:44 PM
REPRESENTATIVE GARDNER inquired as to why anyone would support
the department's ability to waiver efforts to collect.
MR. PEEPLES said he wasn't too sure with regard to the history
on that. He informed the committee that during the last two-
and-a-half years the department did one waiver [on a
subrogation] settlement. By removing it from the authority of
the department, it places the onus on the personal injury
attorney not to discount the cost of medical services paid for
by state and federal funds in that settlement.
4:24:31 PM
MS. MOSS, in response to Representative Seaton, stated that the
department doesn't prepare fiscal notes until committee
substitutes (CS) are adopted. However, the department wanted to
provide the committee with an idea, without knowing whether the
CS would be adopted, of its fiscal impacts.
4:25:17 PM
JANET CLARKE, Assistant Commissioner, Finance and Management
Services, Department of Health and Social Services (DHSS),
confirmed that the department hasn't done the fiscal notes.
Since the legislation is complicated and fluid, the department
has attempted to set out the construct based on assumptions so
that the department can try to calculate the fiscal impact by
trying to isolate the population that would be impacted. She
said that the department knows that it will have to establish
some regulations to implement this, and therefore the report
specifies full-year costs although for fiscal year 2007 only
half-year costs may occur. Ms. Clarke offered to, at the next
committee hearing on HB 426, go through each section of the
legislation and identify the assumptions.
4:26:28 PM
REPRESENTATIVE SEATON noted his interest in information
regarding Section 11 and the reports required for the
psychiatric treatment facilities and parental financial
responsibilities.
MS. CLARKE said that the department could provide that
information, but she pointed out that HB 426 wouldn't provide
any savings or change but would merely allow the department to
report what that might be in the future. Therefore, the
department hasn't attempted to cost-out any savings related to a
change in that provision. She related that the area in which
the most savings are seen has to do with requiring enrollment in
dual eligibles in Medicare.
4:27:35 PM
MS. MOSS, in response to Representative Seaton, related that the
sponsor doesn't have a problem waiting until the next meeting to
address and adopt the amendment he provided to the committee.
CHAIR WILSON announced that HB 426 would be held over.
HB 258-SEXUAL ASSAULT BY PERSON WITH HIV/AIDS
4:28:03 PM
CHAIR WILSON announced that the next order of business would be
HOUSE BILL NO. 258, "An Act relating to aggravating factors at
sentencing."
REPRESENTATIVE BOB LYNN, Alaska State Legislature, testified as
prime sponsor of HB 258, paraphrasing from the following
prepared statement [original punctuation provided]:
The key words here are rape and sexual assault, and
the question is whether the court should consider it
an aggravating factor if the perpetrator convicted of
a rape or sexual assault was previously diagnosed with
HIV or AIDS. That's what this bill is all about, and
nothing more.
How or why a perpetrator of rape or sexual assault
acquired HIV/AIDS is not the issue. The sexual
orientation of the perpetuator is not the issue. Any
perceived stigma someone associates with this life-
threatening disease -by a person guilty or innocent -
is not the issue. Those topics are not the issue and
have nothing whatsoever to do with this bill.
This bill is only - I repeat only - about whether a
convicted rapist or sexual predator previously
diagnosed with HIV/AIDS should be subject to an
aggravating factor at sentencing for their horrific
and life-changing crime. I think it should, and I hope
you agree.
Some might ask why include only HIV/AIDS in this bill?
What about ... Hepatitis C and other sexually
transmitted diseases? Why not include those diseases
in this bill as well? The answer is simple. HIV/AIDS
is an incurable and potentially fatal disease that is
primarily transmitted through sexual behavior - and
that sexual behavior sometimes includes rape and
sexual assault.
Not only does the victim suffer the horrific
consequences of rape or sexual assault, the victim
must also suffer the effects of a life-threatening
disease that is essentially a delayed death sentence.
It's a sobering fact that some HIV/AIDS patients have
shorter life spans than some criminals condemned to
death row.
We have received tremendous support for this bill from
law enforcement officials, agencies for victims of
sexual assault and others. Some of the witnesses you
should be hearing from include:
Brenda Stanfill in Fairbanks, the executive director
of the Interior Alaska Center for Non-Violent Living …
Juneau resident Bob Bassett, who is certified in
Connecticut as an HIV/AIDS counselor and family
therapist and is currently in Washington, D.C. …
Barbara Mason, who is here, and is the Executive
Director of the Alaska Council on Domestic Violence
and Sexual Assault …
Susan Sullivan, the Executive Director of Victims for
Justice, planned to testify today but is home sick. So
I would like to quote a sentence from her letter:
"We agree that adding months of terror, and possibly
years of illness and a shortened life, to the horror
of rape, makes an attack by an HIV/AIDS-positive
rapist a horrendous assault."
We have received many letters of strong support for HB
258.
Anchorage Police Chief Walt Monegan described a rapist
or sexual offender with HIV/AIDS to an assailant with
an insidious weapon that can be used to further strike
out against victims and the victims' loved ones.
Peggy Brown, the Executive Director for the Alaska
Network on Domestic Assault, says a sexual offender
with HIV/AIDS puts a victim at even greater risk and
emotional distress. "In order to hold the perpetrator
fully accountable, the sentences of these sexual
predators should be enhanced," she added.
Gerad Godfrey, chairman of the Violent Crimes
Compensation Board, urges passage of this bill … "as a
sign of respect, compassion, and understanding of the
trauma experienced by victims of serious sexual
offenses."
There are other letters you can read in your committee
packet, basically stating the same thing - please pass
this bill.
My staff has done considerable research on issues
relating to this bill. You can see some of the results
in your bill package - especially the question and
answer paper. Mike Sica, a staffer in my office, has
done lion's share of the work, and has become very
knowledgeable of the issues involved. I believe you
would be well served, and I would request, that you
listen to his brief testimony before you ask me any
questions.
Again, the narrow focus of this bill is about victims
of rape or sexual assault, and whether the fact that
the convicted perpetrator was previously diagnosed
with HIV/AIDS should be an aggravating factor at
sentencing.
4:33:38 PM
MIKE SICA, Staff to Representative Bob Lynn, Alaska State
Legislature, presented HB 258 on behalf of Representative Lynn
paraphrasing from the following prepared statement [original
punctuation provided]:
This is a good bill that deals with bad people doing
terrible things, and takes us into dark areas … It has
to do with some of society's worst offenders - sexual
predators who commit horrible crimes against innocent
men, women and children … It involves unspeakable
acts that leave victims devastated, not only by the
attack … but also from the nightmarish anguish and
terror of being exposed to HIV and AIDS …
Just hearing about the crimes and factors involved …
even second hand from law enforcement and victims'
agencies … can keep you up at night. Some witnesses
who will testify today have worked directly with
victims … They can do a better job of describing these
monstrous acts of rape and sexual assault and the
devastating consequences when these attacks expose
innocent victims to a terrifying disease that can take
up to six months to surface …
I can't imagine what it's like to be a sexual assault
victim … waiting so long for the test results,
worrying about infection, wondering how my family and
close friends will react, isolating myself from my
spouse or loved one due to fear of transmission …
The Centers for Disease Control sums it up this way:
"Fear and concern about possible HIV infection usually
intensify feelings of shock, fear, disbelief, anxiety,
depression and helplessness that may occur in victims
of sexual assaults."
As Representative Lynn mentioned, there is a Question
and Answer Paper included in your committee packet. It
addresses many of the issues raised about House Bill
258. Our office has talked with medical, legal and law
enforcement officials … as well as agencies for
victims of domestic violence and sexual assault …
Questions asked, and answered, range from … How do you
know a sexual offender even has HIV or AIDS … to … Why
did we not include other sexually transmitted diseases
in this bill …
For example, why did we exclude Hepatitis C … which
can also be a life-threatening disease? … It is
because Hepatitis C's main route of transmission is
through blood from infected persons, commonly with
shared needles when "shooting" illegal drugs.
The Centers for Disease Control does not even
recommend testing for people having sex with multiple
partners or people having sex with an infected steady
partner … They consider the risk of infection from
sexual behavior that low for Hepatitis C.
Another example is the question of aggravators … Must
the court apply them? … According to state law, the
Judge is not required to increase the sentence of a
defendant because an aggravator has been found. The
judge must consider all circumstances and then may
increase the sentence.
One last example is the issue of stigma. There was a
concern that a bill that only lists HIV/AIDS can
reinforce the stigma for victims of this disease. We
have nothing but compassion and concern for persons
with HIV or AIDS. If there is a stigma attached to
this virus or disease by uneducated or unthinking
individuals, that stigma and the additional pain and
suffering associated with it, should be an argument
for, not against, an aggravator at sentencing for a
convicted rapist or sexual offender who has been
previously diagnosed with HIV or AIDS.
There are stigmas attached to many things in life. A
man crossing a woman's path on a lonely street may be
considered a potential rapist. There is a stigma
attached to cigarette smoking, yet we pass laws
protecting others from smokers in public places.
Also, HIV and AIDS are already defined in state law
(in Sec. 18.15.310), not as a stigma, or a mark of
shame, but as a specific virus and disease as it
relates to the testing of defendants of sexual crimes.
This bill does nothing to change that.
Twenty-seven states and selected possessions have some
type of law that specifically criminalizes exposure or
transmission of HIV in their jurisdictions … It's time
Alaska get joins them … This state has the highest per
capita rape rate in the nation … by far …
This bill makes it possible to enhance the sentences
for convicted rapists and sexual offenders who have
been previously diagnosed with HIV and AIDS …
It may not deter many of these criminals … but it will
keep them in jail longer and thereby limit their
damage in society … And it sends a message to the
victims … that we acknowledge their additional pain
and suffering caused by exposure and possible
transmission of a life-threatening disease from a
rapist or sexual offender … by passing a law that can
hold them more accountable.
4:37:52 PM
REPRESENTATIVE GARDNER asked whether there is any opposition to
this bill.
4:38:03 PM
MR. SICA responded that Trevor Storrs of the Alaska Aids
Assistance Association [Four-A's] would be testifying in
opposition to bring concerns primarily around the stigma factor.
The committee took a brief at-ease from 4:38:18 PM to 4:39:04
PM.
4:39:04 PM
REPRESENTATIVE GARDNER explained that subsequent to the original
drafting of this bill additional subsections have been included.
She proposed and moved to adopt Amendment 1, as follows:
Page 1, line 4:
before "the" remove "(31)"
Insert "(33)"
There being no objection, Amendment 1 to HB 258 was adopted.
4:39:59 PM
TREVOR STORRS, Executive Director, Alaska AIDS Assistance
Association (Four A's), stated opposition to HB 258,
paraphrasing from the following written statement [original
punctuation provided]:
The Alaskan AIDS Assistance Association (Four A's)
recognizes and empathizes with individuals who have to
live with the trauma of a sexual assault. After
reviewing House Bill 258 - Sexual Assault of Persons
with HIV/AIDS, the Four A's has concerns of the
greater consequences of such a bill.
Stigma is the leading cause of the transmission of
HIV. Individuals have lost family support,
employment, medical care, and their homes because of
the fear and hate caused by HIV stigma. HIV stigma
causes people to not know their HIV status. If a
person is not tested, they usually take on the
identity of a person who is HIV negative. If a person
learns of their positive status, stigma has prevented
them from accessing services. Most HIV positive
individuals have concerns regarding disclosure due to
knowing the anger, hate and discrimination associated
with HIV/AIDS.
It is our opinion that House Bill 258 does not protect
the community but fuels to HIV stigma. The purpose of
a law is to hold an individual accountable for their
actions and to deter individuals from engaging in
specific behaviors. Although the bill does hold a
person accountable, laws already exist that achieve
the same goal. If an individual is sexually assaulted
and infected with HIV, the court system (i.e. the
judge) has the ability to increase the automatic
sentence due to an aggravating factor. Judges also
have the authority to require suspected rapists to be
screened for HIV/AIDS. From a public health
perspective, criminal punishment leads to prevention
of only negligible risks of disease transmission and
not the disease itself (L.O. Gostin; Studies in Social
Medicine).
House Bill 258 will not deter an individual from
committing rape. It will only encourage individuals
not to know their status. In addition, House Bill 258
will provide a new myth to be added to the already
long list that gives life to HIV stigma. Individuals
living with HIV/AIDS will now be seen as rapists
versus fellow community members. Such a perception
will only discourage anyone from knowing their status,
accessing services and taking the necessary steps to
help secure the safety of their community.
The supporting information attached to Bill 258 is a
perfect example of the stigma that exists today. The
quote from Minnesota Court of appeals stating, "If she
does become HIV-positive, it's a death sentence." is
incorrect. With the advancement of treatment (i.e.
medical, medications, social services), the life
expectancy of an individuals living with HIV/AIDS is a
natural life span. It is these statements and these
types of laws that allow HIV/AIDS to continue to
spread in our communities.
In addition, House Bill 258 only focuses on one
aggravating factor; HIV. However, the chance of
getting HIV from a rape is less than 1%. Yet the risk
of getting a sexually transmitted disease during a
rape is about 5% to 10%. The risk of pregnancy is
also disregarded. House Bill 258 is too narrow minded
which leaves sexual assault victims unprotected and
jeopardizes the elimination of HIV stigma.
It is our opinion that House Bill 258 is not required.
The purpose of the bill is already in existence within
our legal system. This bill will only add to HIV
stigma causing the disease to continue to affect and
infect our communities.
4:48:38 PM
REPRESENTATIVE ANDERSON requested clarity regarding the current
aggravated assault laws in relation to the conviction of an
HIV/AIDS carrier.
MR. SICA responded that the transmission of HIV/AIDS by the
rapist must be proven at the time of sentencing. Because it may
take a lengthy time for the HIV/AIDS antibodies to manifest in
the victim' system, the rapist could be convicted without the
aggravated assault being factored into the sentence. He
explained that once convicted, the sentence could not be amended
later due to the protective laws of double jeopardy.
4:50:18 PM
REPRESENTATIVE ANDERSON questioned whether Mr. Storrs was
minimizing the negative affects of HIV/AIDS as an aggravating
factor in a rape.
MR. STORRS maintained that today HIV/AIDS is a chronic disease
not a death sentence and thus does not warrant this type of
onus.
4:52:26 PM
REPRESENTATIVE GARDNER, setting the nomenclature aside, asked
whether Mr. Storrs would consider an assault a greater crime if
the perpetrator knowingly exposing the victim to a communicable,
incurable, and potentially life-changing, if not life-
threatening, disease.
MR. STORRS reiterated that this bill is not necessary because of
the current statute providing for aggravating factors in an
assault.
4:53:33 PM
REPRESENTATIVE GATTO offered that law holds separately an attack
with a deadly weapon versus other forms of attack, and said that
rape by an HIV/AIDS carrier is similar to an attack with a
deadly weapon.
4:54:17 PM
ROBERT BASSETT, Jr., Master Family Therapy (MFT), Certified
HIV/AIDS Counselor and Educator, State of Connecticut,
Washington D.C., stated support for HB 258, saying that it is
horrifying when someone with HIV/AIDS knowingly assaults and
infects another person.
4:55:54 PM
BARBARA BRINK, Vice President, Alaskan AIDS Assistance
Association, informed the committee that she is a former
Director of the Alaska Public Defenders Agency, and stated
opposition to HB 258 as unnecessary, unconstitutional, and
unfair. She explained that Alaska has a presumptive sentencing
scheme whereby factors of aggravation allow a judge to increase
a sentence up to the maximum. She cited the two current laws
which provide for aggravators that would apply in the sentence
of someone convicted of rape as a carrier of HIV/AIDS. Ms.
Brink refuted the example of the 1995 Minnesota case referred to
in the sponsor's statement, saying that the aggravator used in
that sentencing was due to other factors not HIV/AIDS. She
stressed that current law provides maximum sentencing power, and
maintained that HB 258 unnecessarily singles out HIV/AIDS from
other sexually transmitted diseases, effectively increasing
existing social stigmas.
4:59:21 PM
JON BENORDEN, as a person living with HIV/AIDS, stated
opposition to HB 258, echoing that this is no longer a life-
threatening disease, but a life-changing event. He related his
fear that he will be looked upon as a rapist if this bill
passes.
5:00:37 PM
ELIZABETH SCHENK SALTONSTALL, MD, Medical Director, Ryan-White
Title Three Program, Alaska Native Tribal Health Consortium
(ANTHC), stated opposition to HB 258, stressing that the data
referenced in the bill dates to 1995. Given today's approach,
she said that HIV/AIDS is no longer medically considered a life-
threatening disease. She explained the post exposure
prophylactics can be administered to people who are exposed via
any means to the virus. She maintained that this bill is not an
appropriate way to approach HIV/AIDs either from a medical,
legal, or moral standpoint.
5:02:02 PM
JOHN CYR, Business Manager, Public Safety Employees Association
(PSEA), stated support for HB 258, and quoted the numbers of
aggravated rapes committed in Palmer, Glennallen, and Juneau
last year, and pointed out that this bill deals with the
sentencing of convicted sex offenders.
5:03:54 PM
BARBARA MASON, Executive Director, Council on Domestic Violence
and Sexual Assault, Department of Public Safety (DPS), stated
support for HB 258, explaining that a rapist who knowingly
transmits this disease creates an additional layer of social,
health, and life changes to the anguish experienced by every
rape victim.
5:05:01 PM
BRENDA STENFILL, Executive Director, Interior Alaska Center for
Non-Violent Living; Chair, Alaska Network on Domestic Violence
and Sexual Assault validated the points made by the previous
supporters of HB 258, and added that contracting HIV/AIDS
through sexual assault affects the victim in a paralyzing way,
incurring life-long trauma.
5:06:30 PM
MR. SICA said that those opposed to this bill have focused on
the stigma of HIV/AIDS sufferers, but rape itself carries a
stigma. He stressed that HB 258 is about protecting potential
victims from rapists and sexual offenders who would expose other
people to this disease.
5:07:44 PM
REPRESENTATIVE SEATON directed the committee's attention to the
fiscal note from the Department of Corrections, which reports
that there are five inmates of the 5,001 currently housed, who
have been diagnosed with HIV, and none of those are incarcerated
for sexual crimes. He pointed out that this data does not
support the stigma that HIV sufferers commit sexual crimes, and
clarified that the bill is to impose an aggravator for someone
who does commit a sexual crime.
5:08:35 PM
REPRESENTATIVE GARDNER offered support for HB 258, stating that
there are other life-changing transmittable diseases that this
bill could be broadened to encompass.
5:10:07 PM
REPRESENTATIVE SEATON moved to report HB 258, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHB 258(HES) was
reported out of the House Health, Education and Social Services
Standing Committee.
5:10:18 PM
HB 412-TUITION WAIVERS:MILITARY/POLICE/FIRE
CHAIR WILSON announced that final order of business would be
HOUSE BILL NO. 412, "An Act relating to the waiver of
undergraduate expenses for a spouse or dependent of a deceased
resident peace officer or member of the armed services or fire
department."
5:11:22 PM
REPRESENTATIVE JAY RAMRAS, Alaska State Legislature, presented
HB 412 as prime sponsor paraphrasing from the following sponsor
statement [original punctuation provided]:
Everyday, we enjoy the freedoms and security granted
to us by our Constitution and laws. These rights, that
so many take for granted, are there because men and
women work everyday to assure they are protected.
Alaskans who put on a uniform and put their life on
the line, be it a police officer, a firefighter, or a
member of the armed services deserve our respect and
support.
When they give the ultimate sacrifice to protect us,
we as Alaskans have an obligation to help their
families, in more than just the short term. Most
families, have not only lost a spouse or a parent,
they have lost a major source of income. HB 412 will
offer these surviving family members an opportunity to
advance their lives by attending the University of
Alaska for a very reduced cost.
Existing language in AS.14.43.085 allows a waiver of
fees and tuition. HB 412 expands that language to
include on-campus room and board. The cost to the
State and the University is small when compared to the
price of giving ones life in service to our state and
country.
By combining these cost reductions with the limited
compensation provided by the Federal Government, an
Alaskan student could receive a University of Alaska
education at little or no expense. HB 412 will show
our men and women who selflessly give of themselves
that we support them, not only while they serve, but
we will also be there should they make the ultimate
sacrifice
5:13:18 PM
REPRESENTATIVE RAMRAS explained that this bill is to add
language to existing statute. On page 1, line 8, following
"fees" insert ", and on-campus room and board costs". On page
2, line 1, before "who" insert "service, or first responder
service", on line 4, following "fighter" add ";or", and on lines
5 and 6 add a new sub-paragraph "(C) duties as an ambulance
service or first responder service provider". Expanding on
these changes he said, the inclusion of room and board costs is
an expansion on the current tuition and fees waiver, and the
benefit is extended to policeman, law enforcement, firefighters,
and emergency firefighters. He pointed out that the attached
fiscal note is difficult to interpret because of the lack of use
of this waiver based on the state's safety record. He said he
expects that some eligible dependants may not have enjoyed the
benefit as it exists, due to the room and board costs not being
covered.
5:14:32 PM
REPRESENTATIVE CISSNA highlighted that other states who provide
a similar benefit do not provide room and board, but often
include a limit on the number of years for eligibility. She
suggested establishing a maximum number of years for this
benefit, which represents an additional annual cost to the state
of approximately $1,000 per recipient.
5:15:45 PM
REPRESENTATIVE RAMRAS responded that it was his understanding
that an age limit was stipulated in the bill, and suggested that
the House Finance committee could address that situation when
the bill appears before it. Regarding the additional cost of
the fiscal note, he said, "I would be quite proud to
participate" in providing an additional benefit to the
dependents of uniformed Alaskans who have sacrificed themselves
in the line of service.
5:17:07 PM
REPRESENTATIVE CISSNA cautioned that providing young adults a
benefit without limits is not always helpful, stressing that an
age limit might be a reasonable part of this legislation.
REPRESENTATIVE RAMRAS pointed out that this benefits children
whose parents will have died in uniformed service of the state
or federal government. Further, he said that at the federal
level an age limit of 23 does apply, and, as sponsor, he would
find it acceptable to entertain an age limit amendment.
5:19:28 PM
REPRESENTATIVE SEATON said that the bill also includes spouses,
which would make it difficult to impose an age limit. Also he
asked who the addition of "first responder" would include.
REPRESENTATIVE RAMRAS answered that first responder would
include paramedics and members of the volunteer fire
departments. Addressing Representative Cissna, he said that the
Iowa War Orphans Education Aid has no income or age limits but
provides a maximum of $3,000 per year, per student.
5:20:47 PM
REPRESENTATIVE ANDERSON stated his support for HB 412, and
expressed opposition to an amendment that would be restrictive.
He provided a hypothetical scenario, and suggested that there
could be any number of scenarios which are not readily evident.
5:21:54 PM
CHAIR WILSON indicated that by including ambulance and first
responder service providers, it appears to encompass more than
uniformed officers of the state or federal government.
5:22:31 PM
REPRESENTATIVE RAMRAS offered that a uniformed officer is lost
on the average of one per decade in Alaska.
5:22:48 PM
REPRESENTATIVE CISSNA clarified that she does not oppose this
bill but is looking for a possible limit on the number of years
that this benefit could be received rather than an open door
policy. She pointed out that this is a generous benefit
equating to $5,500 per year for a recipient.
5:23:46 PM
REPRESENTATIVE KOHRING stated his support for HB 412, and asked
if this bill covers Village Police Safety Officers (VPSOs).
REPRESENTATIVE RAMRAS offered that he assumed VPSOs would be
included, but could not give an absolute answer. To a further
question, he confirmed that to remain in good standing for this
benefit a student would be required to maintain a 2.0 grade
point average.
5:24:52 PM
REPRESENTATIVE SEATON pointed out that a VPSO does not qualify
as a peace officer for definition purposes under existing
statute, and requested that this eligibility be firmed up as the
bill moves through committee. He stressed that this is a
generous benefit, that should be provided to the appropriate and
deserving dependants.
5:26:10 PM
REPRESENTATIVE SEATON offered and moved Amendment 1 on page 1,
line 8, following "costs" insert for a period up to five years".
There being no objection, Amendment 1 was adopted.
5:27:55 PM
REPRESENTATIVE KOHRING moved to report HB 412, Version 24-
LS1553\F, as amended, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CSHB 412(HES) was reported out of the House
Health, Education and Social Services Standing Committee.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:28:17 PM.
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