Legislature(2017 - 2018)SENATE FINANCE 532
03/26/2018 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB116 | |
| SB198 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 116 | TELECONFERENCED | |
| *+ | SB 198 | TELECONFERENCED | |
| + | TELECONFERENCED |
SENATE BILL NO. 198
"An Act relating to a study of the effectiveness and
cost of providing long-acting reversible contraception
to women with substance abuse disorders."
10:13:32 AM
SENATOR PETE KELLY, SPONSOR, introduced the legislation. He
remarked that good people had spent time and effort to
correct social ills like sexual assault, addiction,
suicide, and alcoholism that were issues of despair. He
remarked that he had created Empowering Hope, and felt that
the meetings were very effective. He shared that the group
probably could not fix all of Alaska's ills. He stated that
the group narrowed its focus to fetal alcohol spectrum
disorder (FASD). He stated that there was decision not to
have efforts to manage the problem, rather focusing on
eradicating the problem. He clarified that FASD was part of
the Empowering Hope legislation. He noted that he had
funding the Empowering Hope mission through his legislative
office by hiring Ryan Ray as executive director. He stated
that Empowering Hope was moved to the Institute of
Circumpolar Health. He remarked that there were various
collaborations, and shared that there were approaches that
had been implementation.
10:22:22 AM
HEATHER CARPENTER, STAFF, SENATOR PETE KELLY, discussed the
Sectional Analysis (copy on file):
Section 1:
(A) Directs the University of Alaska Anchorage Center
for Alcohol and Addiction Studies to conduct a study
to evaluate the effectiveness of providing long-acting
reversible contraception (LARC) to women with
substance abuse disorders who are at high risk for
unintended pregnancies that may result in prenatal
drug or alcohol exposure.
The study shall be done in collaboration with
hospitals and health care providers in Alaska who
treat women with substance abuse disorders and:
(1) Establish an advisory council to assist with
designing and implementing the study,
(2) Evaluate best practices for treating women and
children when there is a high risk of neonatal
abstinence syndrome (NAS) or fetal alcohol spectrum
disorders (FASD),
(3) Facilitate a network for sharing of best
practices,
(4) Identify women and children to participate in the
study on a voluntary basis,
(5) Provide LARC to participants who are at a high
risk for unintended pregnancies that may result in
prenatal drug or alcohol exposure,
(6) Evaluate the cost and effectiveness of providing
LARC to reduce the occurrence of NAS and FASD,
(7) Develop a cohort of women and children who can be
evaluated in later studies regarding NAS and FASD,
(8) Provide a data driven framework to establish a
comprehensive strategy for using LARC to reduce NAS
and FASD in Alaska.
(B) Directs the University to complete two interim
reports by June 30 of 2019 and 2020 and a final report
by June 30, 2021.
(C) Provides definitions for "fetal alcohol spectrum
disorder," "long-acting reversible contraception," and
"neonatal abstinence syndrome."
Section 2:
Repeals Section 1 on June 30, 2021, which coincides
with the date of the final report on the project
10:25:17 AM
Senator Olson wondered where in the state the studies would
be conducted. He shared that the issues discussed often
occurred in rural Alaska. Senator Kelly deferred to Mr.
Ray.
JEFF JESSE, DEAN, COLLEGE OF HEALTH, UNIVERSITY OF ALASKA,
ANCHORAGE (via teleconference), discussed the bill. He
stressed that the abuse of alcohol and drugs had severe
consequences to Alaskans, especially to the unborn and the
consequences of that effect over their lifetime. He
remarked that fetal alcohol spectrum disorder was a problem
for many years in the state. He noted that over 120
children were diagnosed every year. He remarked that the
number did not include the many children who were affected
by alcohol exposure, but their symptoms did not rise to the
level of diagnosis. He remarked that there was also the
advent of the opioid crisis, which resulted in a 500
percent in neonatal abstinence syndrome over the recent
decade. He remarked that those were critical human and
financial issues for the state. He stressed that there was
an importance for financial investment in the university to
ensure that there was the capacity for assistance in
addressing major policy, by providing objective data to
have the best information available to make the best
decision.
10:31:50 AM
TREVOR STORRS, EXECUTIVE DIRECTOR, ALASKA CHILDRENS TRUST,
ANCHORAGE (via teleconference), testified in support of the
bill. He stated that there was a project to help reduce
child abuse, so Alaska was able to identify key social
determinants, which included unplanned and unwanted
pregnancies. He shared that the Center for Disease Control
(CDC) reported in 2006 that 49 percent of pregnancies were
unintended. He stated that 4 of 5 pregnancies for women
ages 19 and younger were unintended. He stressed that under
the age of 15, 98 percent of those pregnancies were
unplanned. He shared that births from unplanned pregnancies
were associated with adverse maternal and child health
outcomes.
10:37:11 AM
PATRICK REINHART, EXECUTIVE DIRECTOR, GOVERNORS COUNCIL ON
DISABILITIES, ANCHORAGE (via teleconference), spoke in
support of the bill. He remarked that the council had a
large FASD work group that included individuals from around
the state, which included a prevention subcommittee. He
stated that there was a submitted letter of support in the
packet.
10:38:22 AM
ART DELAUNE, GOVERNORS COUNCIL ON DISABILITIES, FAIRBANKS
(via teleconference), spoke in support of the bill. He
echoed Mr. Rienhart's comments. He shared that he was the
parent of two men who were exposed to alcohol in the womb.
He stressed that he was very aware of the consequences of
unintended pregnancies of women who had addictions. He
shared that one of his sons had siblings who were all
alcohol-exposed and in state custody. He shared that he was
involved in consequences for women who were finding homes
for children who were exposed to alcohol. He understood
that there was a stigma attached to mothers of children
with FASD. He shared that the mothers felt guilty and were
judged by others. He stressed the no women would
intentionally expose their children to the lifelong
disability. He stressed that the addictions impaired
judgment and resulted in poor decisions.
10:42:11 AM
ALYSON CURREY, LEGISLATIVE LIAISON, PLANNED PARENTHOOD
VOTES, JUNEAU, addressed some concerns with the bill. She
shared that Planned Parenthood, in 2016, provided long-
acting reversible contraception (LARC) to more than 1000
patients in Alaska. She strongly support efforts to address
barriers to access to the full range of birth control
methods. She supported efforts to evaluate best practices
for treatment, and facilitate the efforts. She shared that
there was a history of coercion around provider-controlled
contraceptive methods such as LARC. She share that because
of the history and potential for ongoing coercion, nobody
should be directed toward any particular method solely
because it was cost effective or more effective at
preventing pregnancy, which may not be a woman's primary
goal when using contraception. She felt that women with
substance use disorders were just as deserving of the right
to make their own reproductive health decisions. She felt
that the state should ensure that every person receives
complete, unbiased information on the full range of birth
control methods. She stated that she submitted written
comments.
Co-Chair MacKinnon wondered whether Ms. Currey was in
opposition to the bill, or whether there was a request for
amendments. Ms. Currey replied that she was asking for
amendments.
10:45:51 AM
Senator Micciche wondered whether the eight pieces of the
study in Section 1 were understood. Ms. Currey replied in
the affirmative. She stressed that her concerns were not
related to that section. She remarked that the legislation
did not clarify the need for collaboration with experts,
contraception, and family planning.
Senator Micciche looked at item 3, which related to
facilitating a network for sharing of best practices. He
appreciated the discussion outside of the bill. Ms. Currey
responded that there was a desire to be aware of the
concerns and use a reproductive justice approach when
working with women with substance use disorders. She hoped
that the women would not be pushed toward one method,
without information on the full range of birth control
methods.
10:48:59 AM
MARY NANUWAK, SELF, BETHEL (via teleconference), felt that
the contraceptive studies have been controversial. She felt
that the studies were often biased. She remarked that FASD
was preventable. She considered Bethel a "third world
country." She stressed that individuals should be given
informed consent to make their own decisions. She felt that
Senator Giessel should not be considered the medical
authority. She shared that there were many native people
who did not speak English, which could be complicated. She
stressed that she did not like the attitudes of some
professionals, because it caused confusion.
Co-Chair MacKinnon CLOSED public testimony.
10:52:47 AM
RYAN RAY, HEALTH POLICY FELLOW, UNIVERSITY OF ALASKA,
shared that he had been involved in the Empowering Hope
mission since the beginning. He shared that he was integral
in conducting the pregnancy test dispenser study.
Senator Olson wondered where the concentration of the study
would be conducted. He noted that some of the issues were
concentrated in rural Alaska, where women did not have
access to information and contraception. Mr. Ray replied
that the goal was to develop a network of hospitals and
birthing centers to ensure that those in rural Alaska were
not left out of the study. He stated that the primary
partnership was with the Alaska Regional NEST Program,
which had taken the lead in addressing NAS. He stated that
other hospitals would be partnering with the study.
Co-Chair MacKinnon stated that the fiscal note would be
updated.
Co-Chair MacKinnon announced that the public hearing for
the operating budget is cancelled.
Senator Micciche looked forward to hearing from the public
once the committee had received the budget.
SB 198 was HEARD and HELD in committee for further
consideration.