Legislature(1995 - 1996)
04/29/1996 09:09 AM Senate HES
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HB 529 APPROVE CENTRALIZED PUBLIC HEALTH LAB
Number 002
CHAIRMAN GREEN called the Senate Health, Education and Social
Services (HESS) Committee to order at 9:09 a.m. and introduced
HB 529 as the first order of business before the committee.
COMMISSIONER KAREN PERDUE, Department of Health & Social Services,
emphasized that the public health laboratory is one of the most
essential pieces of a public health system. Every state has a
public health laboratory, Alaska has three. Alaska's public health
laboratories were established as regional labs in the 1930s and
1940s due to the technology and transportation of that time.
Technology and transportation has improved which has lead the labs
in Alaska to serve a specialized function. The Anchorage
laboratory processes about 60 percent of all the samples in the
state, the Fairbanks lab processes about 30 percent, and the Juneau
lab processes about 10 percent of the samples. The labs are in
leased facilities.
Number 050
Commissioner Perdue said that the Anchorage and Juneau labs are not
safe, the labs do not meet health codes, and they are unsafe for
people to work in. The buildings were not designed to support
laboratory functions. These labs present some risks to the
employees and the public. She noted that the Fairbanks facility
was designed as a lab and is a safe facility, however, it has
limitations for future growth. Commissioner Perdue informed the
committee that a State Medical Examiner's System is being developed
and is currently located in the crime lab in Anchorage. She
expressed the desire to incorporate the state medical examiner into
the state laboratory function which could be accomplished with the
new building.
Commissioner Perdue discussed the history of public health in
Alaska when pointing out that the core responsibility to protect
public health has not changed. When there is a threat to public
health, it must be presented to the executive branch and the
legislature. Furthermore, Commissioner Perdue felt that as an
employer, if she felt that her employees were not working in a safe
environment then that must be presented as well. She also believed
that she should point out any possible cost efficient measures that
could be taken. HB 529 addresses all three of those issues. There
have been 14 separate studies of the laboratory system since
Commissioner Perdue has been involved with the department; each of
the studies have shown that something must be done. There is no
longer the need to study this issue.
Number 091
With regards to the Fairbanks laboratory, it is not a feasible
option in the long-term. The Anchorage situation must be
addressed. Commissioner Perdue explained that in the last 10
years, each time this matter was discussed nothing was resolved
because the regional differences could not be worked out.
Therefore, the most critical issues in Anchorage and Juneau have
not been addressed. Under any plan by the department, the lab
would not be built until the year 2,000 when attrition plans would
be created. Commissioner Perdue believed that no one would lose
their job in an untimely manner. Through attrition, no one would
lose their job if they would transfer.
SENATOR LEMAN asked if any of the public health functions in other
states were contracted. Would that be a possibility?
Number 130
DR. GREG HAYES, Chief of Laboratories for DHSS, informed the
committee that no core laboratory functions are contracted.
However, every public health lab does contract some work. For
example, the Environmental Lab contracts for work that they are not
capable of performing; it would not be cost effective for the lab
to perform that work. There are core functions of tests, state
regulatory functions, which are not contracted in any state.
SENATOR LEMAN inquired as to why these functions cannot be
contracted. DR. GREG HAYES explained that the state is responsible
for many regulatory activities which is difficult to contract and
have oversight. There are many costs associated with oversight.
DR. JOHN MIDDAUGH, Chief of the Epidemiology Section of DHSS,
identified one of the key functions of a state public health lab as
maintaining special expertise and capacity to protect the public.
The tests that are done may not occur frequently, but require much
expertise. Dr. Middaugh used diphtheria and tuberculosis as an
example. A certain number of tests must be run in order to
maintain a high level of confidence in the result; those results
determine public health decisions. Dr. Middaugh discussed some
examples of the need to run many tests in order to maintain a high
level of confidence. Today's technology also helps track and
fingerprint viruses. In conclusion, Dr. Middaugh emphasized that
the functions of state medical laboratories are important as well
as their expertise and capacity to respond.
Number 272
SENATOR LEMAN said that he was impressed with the state laboratory
and Dr. Middaugh's work. He asked if there were any other medical
laboratories in the state and if there was a sharing of specialist
in order to avoid duplication when the test may occur so
infrequently. DR. GREG HAYES acknowledged that testing is
available in the private sector. Often that technology would be
transferred to the private sector. Dr. Hayes pointed out that the
state lab tries to maintain communicable disease testing and the
latest technology.
DR. JOHN MIDDAUGH said that the state lab works closely with many
of the private labs around the state. Some of the tests these labs
offer are not offered by the state medical lab. The state lab
serves as a reference lab for all the private labs. He pointed out
that the state lab can do serial groupings which the private labs
cannot. It would be unethical for private hospitals to fingerprint
antibiotic resistance tests because that would not help the
patient, but it is a core public health function to target better
intervention. There are 650 infectious and controlled communicable
diseases known to man which are adopted in the state laboratory
regulations for surveillance.
Number 328
COMMISSIONER PERDUE emphasized that the state medical lab looks for
trends. If the public health system works, no one notices; but if
it does not work, it could effect our economy. The public health
system needs to be ready for the future.
SENATOR LEMAN asked if the other facilities the state works with
such as Alaska Regional Providence support this centralized lab in
Anchorage. DR. JOHN MIDDAUGH replied yes. The State Medical
Association passed a formal resolution in support of HB 529 and the
efforts to obtain the funds for the new lab. In response to
Senator Leman, COMMISSIONER PERDUE said that the preferred location
of the lab would be next to the crime lab.
SENATOR LEMAN said that he was satisfied with the networking being
done between the state and private medical labs.
DR. JOHN MIDDAUGH reiterated that all states maintain a central
core public health laboratory.
CHAIRMAN GREEN assumed that the state lab was obliged to be
connected with the nationwide disease control centers. DR. GREG
HAYES informed the committee that data is transferred on a daily
basis.
SENATOR LEMAN asked if the Municipality of Anchorage had a public
health laboratory. DR. JOHN MIDDAUGH replied no, the municipality
uses the states.
SENATOR SALO commented that HB 529 is an excellent bill. She
inquired as to why it would take until the year 2,000 to begin.
COMMISSIONER PERDUE explained that this would begin from the very
beginning. No design work has been done. There is a fair amount
of complicated design work for this building.
CHAIRMAN GREEN announced that the department requested that HB 529
be held until Wednesday.
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