Legislature(1995 - 1996)

04/09/1996 01:45 PM House FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
  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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