Legislature(2011 - 2012)CAPITOL 106
04/07/2011 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR7 | |
| HB209 | |
| HB61 | |
| HB33 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SCR 7 | TELECONFERENCED | |
| *+ | HB 209 | TELECONFERENCED | |
| *+ | HB 61 | TELECONFERENCED | |
| *+ | HB 33 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 61-ADVANCE HEALTH CARE DIRECTIVES REGISTRY
3:40:19 PM
CHAIR KELLER announced that the next order of business would be
HOUSE BILL NO. 61, "An Act relating to a registry for advance
health care directives."
3:41:07 PM
REPRESENTATIVE LINDSEY HOLMES, Alaska State Legislature,
explained that HB 61 dealt with advance health care directives,
or living wills, which detailed end of life and health care
wishes, as well as designating a decision maker if the
individual was not able. She offered an example for the
difficulties encountered when a living will was not accessible.
She explained that HB 61 created a secure, voluntary, 24 hour,
on line registry for living wills, housed in the Department of
Health and Social Services (DHSS), which was accessible by other
hospitals and health care facilities. She pointed out that out
of state access would also be available during business hours.
3:44:02 PM
CHAIR KELLER asked how many states had implemented this.
REPRESENTATIVE HOLMES replied that Legislative Research had
researched a company to set this up more efficiently and less
costly than DHSS.
REPRESENTATIVE HOLMES, in response to Chair Keller, said that
the initial set up cost would be $194,800; in subsequent years,
the cost would be $82,400 for a part time employee and the cost
of the on line registry.
3:45:33 PM
JAMES WALDO, Staff, Representative Lindsey Holmes, Alaska State
Legislature, shared that Legislative Research did prepare a
report on the advanced health care directives and registries of
various states. He reported that seven states already
participated or had central state registries.
3:46:53 PM
MR. WALDO, directing attention to Section 1 of HB 61, said that
it protected health care facilities against liability for
accessing or not accessing the registry. He moved on to Section
2, which dictated into statute how the registry would work. He
reported that each subsection explained a piece of the bill: (a)
created the authorization for the registry within DHSS; (b)
established that it was voluntary; (c) reiterated the
confidentiality to the hospitals in the state; (d) discussed its
availability on line within the state; (e) clarified the legal
parameters; (f) addressed the removal of a directive from the
registry; whereas (h) stated that a fee could be charged for
filing a directive, but not for removing it; (g) clarified that
filing the directive or not filing it, did not affect the
validity of a directive; (i) authorized DHSS to write
regulations to protect the cyber-security of the registry; (j)
identified who could access a directive: (k) exempted DHSS from
liability; and (l) contained definitions for terms used within
the bill.
3:52:04 PM
CHAIR KELLER asked for clarification to page 2, lines 3-4.
MR. WALDO replied that this referred to one individual, not two.
He pointed to lines 12-13, which defined someone other than the
individual.
3:54:03 PM
CHAIR KELLER, referring to page 2, lines 14 and 15, asked if
this should be more specific.
3:55:24 PM
MR. WALDO replied that it required that the request must come
from the facility where the individual was a patient, and most
likely, the patient's doctor would request the directive.
3:56:04 PM
CHAIR KELLER, referring to subsection (c) on page 2, lines 5-8,
asked for clarity to the word "use."
3:57:32 PM
REPRESENTATIVE SEATON, directing attention to page 3, lines 7-8,
asked to clarify that the fee would not be any greater than its
cost to the department.
3:58:00 PM
REPRESENTATIVE HOLMES replied that the department was not
required to charge a fee but that it was allowed. The fee could
not exceed the actual administrative cost, as the intent was to
keep the cost low.
3:58:47 PM
REPRESENTATIVE SEATON asked about the costs incurred by other
states.
3:59:05 PM
MR. WALDO replied that three of the seven states participated in
a national data base, which was significantly more expensive,
and that the Arizona centralized registry was more comprehensive
than the one proposed in HB 61.
4:00:26 PM
REPRESENTATIVE SEATON, noting that the information form would be
scanned into the registry, asked to verify that DHSS was not
responsible for checking the validity of the information.
MR. WALDO agreed.
4:01:36 PM
MARIE DARLIN, Coordinator, AARP Capital City Task Force,
testified in support of HB 61. She stated that this was the
next necessary step for the access to advance directives. She
pointed out that some hospitals had joined a registry group, as
a way for other hospitals to access your records. She opined
that HB 61 had covered all the points for concern.
4:04:53 PM
REPRESENTATIVE KERTTULA asked to clarify that Bartlett Hospital
could release the advance directive to any hospital in the
nation.
MS. DARLIN offered her belief that Bartlett Hospital would place
your advance directive on this national registry.
4:06:00 PM
CHAIR KELLER asked how many national registers there were, and
if AARP sponsored a registry.
4:06:53 PM
MS. DARLIN, in response to Representative Herron, said that AARP
had worked hard to get the advanced directives into statute.
4:07:34 PM
MS. NENON testified in support of HB 61. She shared a personal
story of her father and his problems of advance directives
without registries.
4:10:58 PM
DR. WARD HURLBURT, Chief Medical Officer/Director, Division of
Public Health, Central Office, Department of Health and Social
Services, said that the administration did not have a position
on the bill. He opined, as a Public Health clinician, that
everyone should have a living will.
4:11:49 PM
REPRESENTATIVE SEATON asked how many hospitals inquired whether
a patient had a living will on file.
DR. HURLBURT replied that he did not know that specific for
Alaska. He offered his belief that every hospital should ask
that question, but that even with this legislation the question
might not be asked. He pointed to this as a failing of the
health care system.
4:13:24 PM
CHAIR KELLER remarked that all the necessary forms were
available in the statute.
DR. HURLBURT reminded the committee that the ethical default was
to keep people alive, although the result of that could
sometimes be tragic.
4:14:55 PM
REPRESENTATIVE SEATON asked the bill sponsor to survey for the
default position of the individual hospitals regarding living
wills.
4:15:47 PM
REPRESENTATIVE MILLETT reflected that end of life issues were
very difficult and emotional decisions. She opined that the
registry offered support for these decisions.
[HB 61 was held over.]