Legislature(1995 - 1996)
04/09/1996 01:45 PM House FIN
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HOUSE BILL 529
"An Act giving notice of and approving the entry into,
and the issuance of certificates of participation in, a
lease-purchase agreement for a centralized public
health laboratory."
KAREN PERDUE, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, spoke in support of HB 529. The public health
laboratories are an essential component of the public health
system in each state and in the national public health
system. Alaska must have sufficient public health
laboratory capacity in order to identify, evaluate and
control public health threats.
She continued, Alaska has three public health laboratories.
They were established as regional laboratories when
transportation linkages and technology dictated that
laboratory services could only be delivered effectively
through a regional structure.
Adequate facilities are critical to safe, effective and
efficient laboratory operations. Because of the special
nature of laboratory functions we must have facilities
capable of supporting operations involving bio-hazards and
accommodating specialized equipment and changing
technologies.
Commissioner Perdue added, in the future to maintain the
facilities as laboratories would require specialized
upgrades and some improvements that are not feasible at a
reasonable cost. Alaska must develop a permanent facility
to support the specialized activities of the State Medical
Examiner program which also involves bio-hazards. The
program supports law enforcement and public health efforts
by determining the cause and manner of deaths that occur in
suspicious or unexplained circumstances or which may present
a public health threat.
Objective analysis indicates that the most cost and
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operationally efficient solution to these problems would be
the construction of a new facility that centralizes
laboratory operations in Anchorage. Centralization of the
functions to a single facility would provide the most
economical permanent solution to the critical facility
problems, while improving overall accessibility, enhancing
the Department's ability to perform disease surveillance,
evaluation and control activities, and avoid unrecoverable
costs related to current laboratories.
Commissioner Perdue pointed out that HB 529 provides the
mechanism to implement a solution, authorizing the issuance
of certificates of participation for lease/purchase
financing of a centralized laboratory total cost in the
amount of $23.5 million dollars. A centralized facility
would house public health laboratory staff from Anchorage,
Fairbanks, and Juneau as well as the laboratory chief and
the State Medical Examiner staff.
Commissioner Perdue acknowledged how difficult it was to
propose a project which would centralize services and at the
same time could adversely affect the economies of Fairbanks
and Juneau. She noted her belief in regional government,
although, pointed out that the project was necessary for the
state as a whole. She spoke to the transudation plan.
JOHN MIDDAUGH, MD., CHIEF, EPIDEMIOLOGY SECTION, DIVISION OF
PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES,
echoed that the current facilities were no longer adequate.
The laboratory function of a public health lab is the core
building block of state's health department and a critical
component of protection from infectious diseases. Alaska
must keep their prevention efforts in the forefront.
The State's ability to employ new technology in rapidly
diagnosing infections and establishing diagnosis will enable
the State to facilitate control measures as a critical
component of the public health laboratory. A close
relationship exists with physicians around the State who
submit specimens causing illness among Alaskans. The State
Medical Association has fully endorsed the central new lab
in Anchorage and the co-located staff. On a scientific
basis, the practice of housing facilities in various
locations around the State is not a good, sound idea.
DR. GREGORY HAYES, CHIEF, LABORATORIES, DIVISION OF PUBLIC
HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, advised
that the services for the public health laboratory are
directed towards prevention and control of disease in the
community. These services differ from the clinical
laboratories directed at individual patient care.
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The core functions of a centralized lab would include:
* Support of disease control and prevention
programs, maternal child and family health
programs and epidemiological programs;
* Support surveillance activities, outbreak
investigations and monitor for, the emergence of
new infectious agents or re-emergence of
infectious agents;
* Focus on the development of methods for
testing when those tests are not readily
available and transfer that technology to the
private sector;
* Perform diagnostic product evaluation;
* Data collection;
* Testing of high quality at a reasonable rate;
* Provide training, laboratory expertise and
reference services to the private laboratory
community in the laboratory diagnosis of
diseases of public health significance.
Dr. Hayes continued, the Juneau and Anchorage laboratories
perform primarily microbiological testing. Juneau
specializes in Mycology and Water Bacteriology while in
Anchorage the specialty is Tuberculosis (TB) testing. The
Fairbanks laboratory performs almost exclusively Virology
testing. The facilities are in urgent need of repair,
having mechanical and structural inadequacies for conducting
laboratory testing. All three laboratories have poor
facility layouts and have space limitations for future
growth.
In order to operate, Alaska must meet Federal Regulations,
under the Clinical Laboratory Improvement Amendments.
During the last survey, Alaska was found out-of-compliance
and given 90 days to correct some major ventilation
deficiencies or face loss of license. The surveyors will be
looking for resolutions in long range planning to address
laboratories health and safety concerns.
Representative Therriault voiced concern in closing the
Fairbanks lab. Dr. Hayes advised that there are no major
health and safety problems with the Fairbanks facility.
That facility is very dated and the lab is spread out over
several floors and poorly laid out. Commissioner Perdue
added that the Anchorage facility must be replaced because
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it is unsafe. She added that when purchasing property, it
would be most cost effective to purchase one location and
consolidate the services from that spot. The turn around
time is also predictable in Anchorage. Co-Chair Hanley
asked the costs of maintaining the current facilities.
TOM LANE, JUNEAU FACILITIES MANAGER, DIVISION OF
ADMINISTRATIVE SERVICES, DEPARTMENT OF HEALTH AND SOCIAL
SERVICES, replied that fiscal costs are included in the
fiscal notes provided to the Committee. Lease and personnel
costs would be saved, providing a total savings of $710
thousand dollars per year. If a new facility was built in
Anchorage and the facility in Fairbanks continued operation,
$210 thousand dollars would be saved in the long term.
Operating costs would diminish through centralization.
RUSS WEBB, HEALTH PROGRAMS MANAGER, DIVISION OF PUBLIC
HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stated
that centralizing services would be scientifically sound
management and would enable the lab to achieve more
efficiency.
Discussion followed between Representative Therriault and
Dr. Hayes regarding continued use of the Fairbanks facility.
Dr. Hayes stressed that the current Alaskan system does not
work well nor benefit the citizens of Alaska. Mr. Lane
noted that an analysis had been done indicating the benefits
of building the facility in Anchorage. He pointed out that
Anchorage is the hub of the transportation network.
Representative Kohring voiced concern with the cost analysis
of the legislation. Mr. Webb stressed that the Juneau and
the Anchorage facility can not be added on too. The
Fairbanks facility would be difficult to add to in a cost
effective way. None of the current facilities would be able
to support the long-term functions of the lab.
Representative Martin supported passage of the legislation.
(Tape Change, HFC 96-106, Side 2).
REPRESENTATIVE JOHN DAVIES voiced support for the lab
services continuing to be housed in Fairbanks.
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