Legislature(2005 - 2006)CAPITOL 120

03/07/2005 01:00 PM JUDICIARY


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 85 PRESCRIBED MEDICATION FOR STUDENTS TELECONFERENCED
Moved CSHB 85(JUD) Out of Committee
*+ HB 149 SALE OF METHAMPHETAMINE AND PRECURSORS TELECONFERENCED
Heard & Held
*+ HB 148 TRAFFICKING OF PERSONS TELECONFERENCED
Heard & Held
*+ HB 101 SEX TRAFFICKING AND TOURISM TELECONFERENCED
Heard & Held
Bills Previously Heard/Scheduled
= HB 95 PUBLIC HEALTH DISASTERS/EMERGENCIES
Moved CSHB 95(JUD) Out of Committee
HB 95 - PUBLIC HEALTH DISASTERS/EMERGENCIES                                                                                   
                                                                                                                                
1:15:26 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE- announced  that the first order  of business would                                                               
be  HOUSE BILL  NO. 95,  "An Act  relating to  public health  and                                                               
public health  emergencies and disasters;  relating to  duties of                                                               
the  public  defender and  office  of  public advocacy  regarding                                                               
public  health matters;  relating  to certain  claims for  public                                                               
health matters;  making conforming amendments; and  providing for                                                               
an effective date."  [Before the committee was CSHB 95(HES).]                                                                   
                                                                                                                                
1:15:43 PM                                                                                                                    
                                                                                                                                
MICHAEL  "WES"  MACLEOD-BALL,  Executive Director,  Alaska  Civil                                                               
Liberties  Union (AkCLU),  said  he appreciates  the efforts  Dr.                                                               
Mandsager, Department of Health  and Social Services (DHSS), made                                                               
to address some  of the AkCLU'S concerns with HB  95, and relayed                                                               
that the AkCLU doesn't have any  interest in seeing the bill fail                                                               
- rather,  the AkCLU agrees  with Dr. Mandsager that  current law                                                               
is ambiguous and should be  clarified.  He summarized the AkCLU'S                                                               
concerns as follows:                                                                                                            
                                                                                                                                
     We're concerned  with three of  the items  of authority                                                                    
     that  are granted  to the  government under  this bill.                                                                    
     ...  In   particular,  the  government  is   given  the                                                                    
     authority to isolate  or quarantine individuals against                                                                    
     their  will,  and  the   government's  also  given  the                                                                    
     authority  to  access   identifiable,  private  medical                                                                    
     records.  So  with respect to those  three items, we're                                                                    
     interested in establishing  a separate, higher standard                                                                    
     that the  government needs  to clear  before it  can do                                                                    
     any one  of those  three actions.  ... We  have offered                                                                    
     some suggestions  to the [DHSS]  and I  believe members                                                                    
     of your committee  may have seen some  of that language                                                                    
     that we've suggested; we're  not particularly wedded to                                                                    
     the language  that we have  offered as  an alternative,                                                                    
     and  we think  there are  different ways  to accomplish                                                                    
     that goal. ...                                                                                                             
                                                                                                                                
     Our concern  is that when somebody's  liberty interests                                                                    
     are   directly   restricted   by  being   isolated   or                                                                    
     quarantined, whether  in their  own home  or elsewhere,                                                                    
     ... the  government should have  to pass a  fairly high                                                                    
     hurdle.   Now,  that hurdle  may be  a varying  hurdle,                                                                    
     because some diseases are going  to be more threatening                                                                    
     than others, and we understand  and recognize that.  We                                                                    
     would also ...  rely on the expertise of  the [DHSS] to                                                                    
     try  to help  us reach  a different  standard that  can                                                                    
     accommodate  that kind  of a  varying range  of threat.                                                                    
     ...  The  other issues  that  we  have  -- there  is  a                                                                    
     provision  in  here for  ex  parte  hearings; in  other                                                                    
     words, a hearing before a  judge where the [DHSS] would                                                                    
     make  its case  for  an isolation  or quarantine  order                                                                    
     without  giving  access  to   that  proceeding  to  the                                                                    
     affected  individual.     As  it's  described   in  the                                                                    
     original legislation,  the individual would  already be                                                                    
     aware  of the  [DHSS's]  concern on  the public  health                                                                    
     issue,  and so  therefore  we don't  see  any need  for                                                                    
     there to be an ex  parte hearing that bars the affected                                                                    
     individual from participating.                                                                                             
                                                                                                                                
MR. MACLEOD-BALL continued:                                                                                                     
                                                                                                                                
     To  [its] credit,  the [DHSS]  does  have a  subsequent                                                                    
     proceeding   that  would   allow   the  individual   to                                                                    
     participate, but  ... there would no  reason to exclude                                                                    
     that person from the [first]  hearing if [he/she wants]                                                                    
     to participate.  The [DHSS],  in some of its proposals,                                                                    
     has  addressed some  of the  confidentiality issues  we                                                                    
     are  concerned  with,  and   depending  upon  how  that                                                                    
     language actually  ends up, we  appreciate the  step in                                                                    
     that  direction.   In particular,  I think  one of  the                                                                    
     proposed amendments  calls for  the destruction  of the                                                                    
     confidential  information,   the  identifiable  medical                                                                    
     information, once the [DHSS's]  need for it has passed.                                                                    
     We think that is a good step in the right direction.                                                                       
                                                                                                                                
     ... And then finally, we  are interested in having some                                                                    
     additional  language  added  to the  bill  which  would                                                                    
     simply  protect  the  affected individual's  rights  if                                                                    
     they've  been  subject to  one  of  these isolation  or                                                                    
     quarantine  orders.   For example,  we believe  that if                                                                    
     somebody is isolated or  quarantined against their will                                                                    
     - or otherwise,  for that matter - ...  that should not                                                                    
     affect their right to housing,  ... their job, ... [or]                                                                    
     any  pending civil  or criminal  proceedings adversely.                                                                    
     ...  The  biggest area  of  concern  [pertains to]  ...                                                                    
     establishing  a  separate,  higher  threshold  for  the                                                                    
     government  to exercise  its  authority  to isolate  or                                                                    
     quarantine an  individual against  his or her  will, or                                                                    
     to access their private, identifiable medical records.                                                                     
                                                                                                                                
1:21:41 PM                                                                                                                    
                                                                                                                                
Beverly  Smith, Christian  Science Committee  on Publication  for                                                               
Alaska, indicated that her  organization had previously submitted                                                               
information  in a  letter  dated 2/24/05,  and  relayed that  she                                                               
would  be submitting  additional information  at this  time in  a                                                               
letter dated 3/7/05.  In  part paraphrasing from the letter dated                                                               
3/7/05, she said:                                                                                                               
                                                                                                                                
     I  understand   and  appreciate  the   complexities  of                                                                    
     balancing  individual rights  and the  common good.   I                                                                    
     believe   that   by   hearing   and   considering   all                                                                    
     perspectives,  the committee  will  amend  the bill  as                                                                    
     needed  to achieve  that balance.   In  my capacity  as                                                                    
     Christian Science Committee  on Publication for Alaska,                                                                    
     one of  my roles is  to watch legislative  proposals to                                                                    
     ensure  that   Alaskans  have  the  choice   to  pursue                                                                    
     spiritual  means   for  the  prevention  and   cure  of                                                                    
     disease,  including  Christian  Science  treatment  and                                                                    
     care.                                                                                                                      
                                                                                                                                
     The choice  of spiritual means  for treatment is  by no                                                                    
     means the refusal  of treatment.  It is  a provision of                                                                    
     another  effective   form  of  treatment.     Christian                                                                    
     Science is  one of  the religious non-medical  forms of                                                                    
     treatment  that  relies   on  spiritual  means  through                                                                    
     prayer   to   heal   illness,   injuries,   and   other                                                                    
     conditions.   Christian Science treatment and  care has                                                                    
     been    systematically     practiced,    quietly    and                                                                    
     successfully, in  many Alaskan families for  a century.                                                                    
     It  is  my  experience  and  the  experience  of  those                                                                    
     practicing  Christian   Science  that   this  spiritual                                                                    
     system of  healing has  both preventative  and curative                                                                    
     effects.                                                                                                                   
                                                                                                                                
     And we all are trying to  find ways to prevent and cure                                                                    
     disease,  and  I  wholeheartedly  join  in  that  goal.                                                                    
     However, I  believe that the  mode of  treatment should                                                                    
     not  be imposed  against  an individual's  wish, but  a                                                                    
     competent adult  should be  able to  chose the  form of                                                                    
     preventive and curative treatment  that he or she deems                                                                    
     best for  his or  her health  and well  being, provided                                                                    
     that the individual may be isolated or quarantined.                                                                        
                                                                                                                                
     Now,  in the  letter  I submitted  to  the Chair  dated                                                                    
     [2/24/05],   the   Christian   Science   Committee   on                                                                    
     Publication  [for  Alaska]  requested an  amendment  as                                                                    
     follows.   In  [proposed AS  18.15.375] ...  add a  new                                                                    
     [subsection]   (f)   to  read   [original   punctuation                                                                    
     provided]:   "The  provisions of  this  section do  not                                                                    
     apply  to an  individual  who objects  to the  testing,                                                                    
     examination  or screening  because of  the individual's                                                                    
     religious  beliefs; provided,  such  individual may  be                                                                    
     subject   to   isolation   or  quarantine   under   the                                                                    
     provisions of this  Act."  Attached to  the letter were                                                                    
     copies  of  statutes  from a  number  of  other  states                                                                    
     containing  language   providing  the   alternative  of                                                                    
     isolation  or quarantine  for  those declining  medical                                                                    
     examination or testing.                                                                                                    
                                                                                                                                
MS. SMITH continued:                                                                                                            
                                                                                                                                
     And last Friday,  March 4, in his  testimony before the                                                                    
     committee,  Dr.  Mandsager  mentioned that  the  [DHSS]                                                                    
     does not feel  it is a good idea  to exempt individuals                                                                    
     from  testing,  screening,  or  examination.    And  we                                                                    
     understand that he  may feel that this  is the position                                                                    
     to take but,  with all due respect, I'd  like point out                                                                    
     that  there   is  a  precedent  for   this  request  of                                                                    
     accommodation in at  least 11 other states.  ... To me,                                                                    
     these examples  show that you can  successfully achieve                                                                    
     the balance  between individual  rights and  the common                                                                    
     good   by  providing   such  an   accommodation.     We                                                                    
     respectfully  request that  the committee  follow these                                                                    
     other  state  legislatures   by  recognizing  that  the                                                                    
     common good of the  state's inhabitants is not lessened                                                                    
     by giving  accommodation to the right  of isolation and                                                                    
     quarantine instead of testing and medical examination.                                                                     
                                                                                                                                
     Our request  that this language be  included is further                                                                    
     supported by the  fact that the proposed  bill does not                                                                    
     now mandate testing, if objected  to, unless there is a                                                                    
     finding  that  the  individual has  or  may  have  been                                                                    
     exposed   to  a   contagious  disease   that  poses   a                                                                    
     significant  risk to  public health.    Once there  has                                                                    
     been such  a finding, isolation or  quarantine would as                                                                    
     fully  protect  the  rights  of  the  public  as  would                                                                    
     testing  or examination.    Further,  with [regard]  to                                                                    
     treatment of  an individual found to  have a contagious                                                                    
     disease, [Christian  Science] Committee  on Publication                                                                    
     [for  Alaska] supports  the language  of the  bill that                                                                    
     does not mandate medical treatment.   However, we would                                                                    
     recommend a  new section after [proposed  AS 18.15.380]                                                                    
     similar  to  ... AS  18.15.143,  [which]  ... would  be                                                                    
     repealed by  the passage of  HB 95.  And  I've attached                                                                    
     to the  ... last page  of this  [letter] ... a  copy of                                                                    
     that existing [statute - AS 18.15.143]. ...                                                                                
                                                                                                                                
MS. SMITH relayed that the Christian Science Committee on                                                                       
Publication for Alaska's proposed new section would read                                                                        
[original punctuation as provided in the letter dated 3/7/05]:                                                                  
                                                                                                                                
     Section 18.15.382.   Religious treatment for contagious                                                                
     disease.   (a)   A  person found  to have  a contagious                                                                  
     disease   may  utilize   spiritual  means   solely  for                                                                    
     treatment of the  disease.  A state  medical officer or                                                                    
     the court may  consider the means of  treatment as well                                                                    
     as the health  of the person in  determining whether to                                                                    
     order   isolation  of   that   person   by  the   least                                                                    
     restrictive means which may  include the person's home,                                                                    
     or other  suitable place of  the person's choice,  in a                                                                    
     manner that will protect the public health.                                                                                
     (b)   A  person with  a  contagious disease  who is  or                                                                    
     might  become   subject  to   an  order   issued  under                                                                    
     18.15.385,  at any  time  may  request recognition  and                                                                    
     consideration of spiritual  treatment described in this                                                                    
     section.                                                                                                                   
     (c)    In  this  section  "spiritual  treatment"  means                                                                    
     prayer,  or  a  substantially similar  activity,  by  a                                                                    
     religious practitioner.                                                                                                    
                                                                                                                                
MS. SMITH,  in conclusion, thanked the  committee for considering                                                               
her suggested changes to HB 95.                                                                                                 
                                                                                                                                
1:28:05 PM                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE, after  ascertaining that  no one  else wished  to                                                               
testify, closed public testimony on HB 95.                                                                                      
                                                                                                                                
RICHARD MANDSAGER,  M.D., Director,  Central Office,  Division of                                                               
Public Health,  Department of Health and  Social Services (DHSS),                                                               
in response to one of  Representative Dahlstrom's questions posed                                                               
at the  bill's last hearing, said  that safe water is  central to                                                               
public health and that it is  the state's responsibility - and in                                                               
its  best interest  - to  try to  ensure, to  the maximum  extent                                                               
possible, safe and  clean water for people to drink.   That being                                                               
said,  Alaska  has  chosen to  divide  the  responsibilities  for                                                               
public   health  between   the   DHSS  and   the  Department   of                                                               
Environmental Conservation (DEC).                                                                                               
                                                                                                                                
DR. MANDSAGER opined  that there are several ways  to address the                                                               
issue  of  [safe]  water,  two  of  which  would  be  either  via                                                               
regulation or  via a reporting  requirement and  private testing.                                                               
He remarked that  there is a "licensing" bill that  the DHSS, via                                                               
the legislature,  introduced last  week that proposes  to reframe                                                               
the  licenses  of  all  the   institutions  for  which  the  DHSS                                                               
certifies or  licenses.  He mentioned  that for all the  types of                                                               
water systems that that the DHSS  won't be regulating in the near                                                               
future, the  DHSS is considering requiring,  via regulation, that                                                               
the institutions  which have  such water  systems report  back to                                                               
the DHSS on a periodic basis  that they've had their water tested                                                               
by a private testing company.                                                                                                   
                                                                                                                                
1:30:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  DAHLSTROM said  Dr.  Mandsager's comments  verify                                                               
her  concern  and she  wants  to  ensure  that water  testing  is                                                               
completed and  that entities responsible  for water  supplies are                                                               
being regulated.                                                                                                                
                                                                                                                                
DR.  MANDSAGER,   in  response   to  another   of  Representative                                                               
Dahlstrom's  previously  asked  questions, said  that  the  state                                                               
medical examiner has three functions:   one is providing forensic                                                               
services, another  is providing  public health services,  and the                                                               
third  is   providing  support   to  families   experiencing  the                                                               
unexpected death of a loved one.   He offered his belief that the                                                               
state  medical examiner  office  completes  its forensic  mission                                                               
quite  well, completes  its public  health mission  somewhat, and                                                               
completes its support of families mission  almost not at all.  He                                                               
noted that the governor's budget  requests a small increment [for                                                               
the state  medical examiner's office]  and he  characterized this                                                               
as a  down payment and relayed  that he would be  back before the                                                               
legislature with  the goal of  slowly building that office  up so                                                               
that missions two and three are fully funded and met.                                                                           
                                                                                                                                
DR.  MANDSAGER,   in  response   to  another   of  Representative                                                               
Dahlstrom's  previously asked  questions, said  that the  bill is                                                               
silent at  the moment with regard  to what happens to  a business                                                               
if an employee is quarantined  or isolated.  The costs associated                                                               
with   isolation   and  quarantine   are   assumed   to  be   the                                                               
responsibility of  individual being isolated or  quarantined, not                                                               
the responsibility  of the  state.  With  regard to  a previously                                                               
asked question  of who will  take care  of the children  in cases                                                               
where the parents  are isolated or quarantined, he  said it would                                                               
be the same as in other  situations where a parent or parents are                                                               
hospitalized - parents would have  the opportunity to voluntarily                                                               
place their  children with a relative  or friend.  The  only time                                                               
the Office of Children's Services  (OCS) would get involved would                                                               
be  if the  children  were abandoned  in  typical abandonment  or                                                               
neglect circumstances; he said he  does not envision that the OCS                                                               
would be  involved in the  vast majority  of isolation/quarantine                                                               
situations.                                                                                                                     
                                                                                                                                
CHAIR McGUIRE asked whether there  is a procedure outlined in the                                                               
bill.                                                                                                                           
                                                                                                                                
DR. MANDSAGER  said no, adding  that the Department of  Law (DOL)                                                               
has researched the  issue and believes that the  bill would allow                                                               
parents  to  deal  with  the  situation in  the  way  they  would                                                               
ordinarily if they had to go into the hospital.                                                                                 
                                                                                                                                
1:34:01 PM                                                                                                                    
                                                                                                                                
DAN  BRANCH, Senior  Assistant Attorney  General, Human  Services                                                               
Section,  Civil  Division  (Juneau),  Department  of  Law  (DOL),                                                               
concurred, adding that current law  contains a provision allowing                                                               
a parent to grant a power of  attorney to a friend or relative so                                                               
that  that person  has the  authority  to make  medical or  other                                                               
decisions for a child.                                                                                                          
                                                                                                                                
CHAIR McGUIRE  remarked that quarantine/isolation  situations can                                                               
happen quickly and therefore it  is the legislature's intent that                                                               
the subjects of quarantine/isolation would  be given a reasonable                                                               
amount  of  time  to  have   that  power  of  attorney  executed,                                                               
particularly  given that  most Alaskans  don't already  have such                                                               
details worked out.                                                                                                             
                                                                                                                                
MR. BRANCH  concurred with Dr.  Mandsager that the OCS  would not                                                               
take custody of a child unless he/she were truly abandoned.                                                                     
                                                                                                                                
1:36:28 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER, mentioning that  Representative Gara had expressed                                                               
concerns at the  bill's prior hearing, posited that  the DHSS has                                                               
come up with  a couple of proposed amendments  that could satisfy                                                               
members' concerns, and  said that one of  the proposed amendments                                                               
by  Representative Gara  would be  acceptable to  the DHSS.   Dr.                                                               
Mandsager referred to  a proposed amendment to page  11, line 23,                                                               
which would  create another subsection to  clarify that isolation                                                               
and  quarantine  shall  only  be  used  if  they  are  the  least                                                               
restrictive alternative  necessary to  prevent the spread  of [a]                                                               
contagious or  possibly contagious disease.   In other  words, in                                                               
the  hypothetical  example  posed  at  the  bill's  last  hearing                                                               
regarding   someone  with   acquired  immunodeficiency   syndrome                                                               
(AIDS), the DHSS  would seek other alternatives  first, and would                                                               
only  resort  to isolation  and  quarantine  if all  alternatives                                                               
proved unsuccessful.   Additionally,  if that  proposed amendment                                                               
were  to be  adopted, he  remarked, then  a definition  of "least                                                               
restrictive" could be  included in the definition  section of the                                                               
bill.                                                                                                                           
                                                                                                                                
DR.   MANDSAGER  noted   that  another   proposed  amendment   by                                                               
Representative  Gara would  alter page  11 by  adding the  caveat                                                               
that a  person could  choose confinement  in his/her  home absent                                                               
exceptional  circumstances that  would jeopardize  public health.                                                               
In response to  a question, he said  he has not yet  had a chance                                                               
to review the changes suggested  by the Alaska Nurses Association                                                               
(AaNA).                                                                                                                         
                                                                                                                                
CHAIR McGUIRE mentioned that one  of the AaNA's suggestions would                                                               
be  to add  a caveat  that  person would  not have  to submit  to                                                               
involuntary treatment if he/she  voluntarily takes steps outlined                                                               
by  the  state  medical  director  to prevent  the  spread  of  a                                                               
communicable disease.                                                                                                           
                                                                                                                                
DR. MANDSAGER relayed that in  response to a concern expressed by                                                               
the AaNA  regarding the isolation/quarantine of  a person exposed                                                               
to  hazardous  materials  that could  cause  serious  illness  or                                                               
injury via transmission, one of  the DHSS's proposed amendments -                                                               
which would  alter page  15 by  adding a  subsection (m)  - would                                                               
allow  the DHSS  to  isolate or  quarantine such  a  person.   He                                                               
predicted that  such a provision  would only apply  in situations                                                               
involving irradiation  or chemical toxins that  could potentially                                                               
be hazardous to others.                                                                                                         
                                                                                                                                
1:40:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA said  he still has a  major concern regarding                                                               
the  possibility that  the  bill, perhaps  even  with the  DHSS's                                                               
proposed amendment, would allow a  person with AIDS - which could                                                               
be considered a substantial risk  to public health because of its                                                               
contagious  nature -  to be  isolated, sent  through an  ex parte                                                               
hearing,  and  then  quarantined.     So  although  the  proposed                                                               
amendment  would allow  someone with  AIDS to  be quarantined  at                                                               
home,  the determination  regarding whether  that is  appropriate                                                               
would happen only  after the person is isolated,  sent through an                                                               
ex parte  hearing, and been issued  a quarantine order.   He said                                                               
he doesn't  ever want  to allow the  state to  bother individuals                                                               
who are  dealing with  AIDS responsibly.   He  opined, therefore,                                                               
that the  bill should  only address  diseases that  don't include                                                               
things like AIDS or other diseases that aren't of concern.                                                                      
                                                                                                                                
DR. MANDSAGER remarked:                                                                                                         
                                                                                                                                
     The  problem as  a  public health  practitioner is,  we                                                                    
     start  into   these  journeys  with  "a   suspicion  or                                                                    
     probable and not knowing."  If  I was God and knew what                                                                    
     the  cause  was going  to  be,  this  would be  a  much                                                                    
     simpler bill  to write, because  then it would  be much                                                                    
     easier to  write exclusions  as Representative  Gara is                                                                    
     suggesting.   We start  into an  outbreak investigation                                                                    
     or we start out with  concerns, and then, over the next                                                                    
     few  hours  to days,  it  becomes  clear whether  those                                                                    
     concerns were  real or not.   And  as time goes  by, it                                                                    
     becomes  more and  more  clear  [what] the  appropriate                                                                    
     next  steps  [are], how  [long]  a  time limit  [there]                                                                    
     should be, and so on.                                                                                                      
                                                                                                                                
     One  of the  [AkCLU's]  concerns initially  ... is,  we                                                                    
     ought to  time limit  this, and  I pushed  back against                                                                    
     that  saying, again,  for the  same  reason, it's  more                                                                    
     appropriate,  in our  view, that  we end  quarantine or                                                                    
     isolation as  soon as possible  rather than put  a time                                                                    
     limit on  it, because of  the uncertainty on  the front                                                                    
     end.      Now,  I   concur   100   percent  with   what                                                                    
     Representative  Gara is  saying, ...  we don't  want to                                                                    
     put  people   into  quarantine  and   isolation  unless                                                                    
     they're  a risk  to  public health  - their  individual                                                                    
     medical  problems are  not a  cause  for quarantine  or                                                                    
     isolation or any of the  other tools that this bill ...                                                                    
     [provides]. ...                                                                                                            
                                                                                                                                
     So  we're  only talking  about  this  in situations  in                                                                    
     which  there  is   a  risk.    So   the  situation  you                                                                    
     described,  in which  somebody  is dealing  responsibly                                                                    
     with  [his/her]  illness, [he/she]  is  not  a risk  to                                                                    
     public health.   Now ... somehow we have to  find a way                                                                    
     that  we can  all  be comfortable,  that  we allow  for                                                                    
     uncertainty on  the front end  but yet we don't  end up                                                                    
     "where you want to be" on  the back end.  Now, the only                                                                    
     other  thing I  would say  is ...  this [has]  been our                                                                    
     practice,  here,  for  50  years,  and  it's  not  been                                                                    
     abused.                                                                                                                    
                                                                                                                                
DR.  MANDSAGER  assured the  committee  that  the bill  will  not                                                               
expand or  limit the practices  the DHSS  has been using  to deal                                                               
with concerns to public health,  and suggested that the committee                                                               
keep in  mind that the  DHSS has historically used  its authority                                                               
responsibly.                                                                                                                    
                                                                                                                                
1:44:57 PM                                                                                                                    
                                                                                                                                
MR. BRANCH suggested that there  needn't be concern that the DHSS                                                               
would  isolate a  person just  for  having AIDS,  and noted  that                                                               
proposed subsection  (d) of the quarantine/isolation  provision -                                                               
located  on  page   12,  line  15  -  says  in   part:    "Before                                                               
quarantining  or isolating  an individual,  the department  shall                                                               
obtain a written order from the  superior court".  He also noted,                                                               
though,  that subsection  (e) of  that same  provision gives  the                                                               
department  extraordinary  authority  to  quarantine  or  isolate                                                               
somebody, but pointed  out that a very high  standard is required                                                               
- there has  to be a clear and immediate  threat to public health                                                               
for  the  department  to  isolate  or  quarantine  an  individual                                                               
without  a  court   order.    He  said  that   according  to  his                                                               
understanding,  the DHSS  will be  working in  incremental steps,                                                               
and so  isolation and  quarantine would  be the  last steps  in a                                                               
long process wherein the DHSS  tries to examine an individual but                                                               
may then  have to  reject lesser  restrictive alternatives.   The                                                               
aforementioned proposed amendment is designed  to "kick in at the                                                               
superior  court  level,"  adding  a  new  burden  of  proof  that                                                               
isolation and quarantine  is necessary in order  to [prevent] the                                                               
spread of contagion.                                                                                                            
                                                                                                                                
REPRESENTATIVE GARA  indicated that  that possibly  addresses his                                                               
concern, but opined  that a lesser standard of  proof is required                                                               
if isolation and quarantine via  a court order is the alternative                                                               
chosen.  The  bill doesn't currently specify that the  goal is to                                                               
address diseases  that are  communicable through  airborne means,                                                               
through touch,  or through casual  contact with  someone's sweat,                                                               
he remarked,  adding that  he would be  much more  comfortable if                                                               
the  bill did  specify that  goal, if  it were  narrowed to  only                                                               
those diseases the DHSS really wants  to address.  He opined that                                                               
under the  parameter currently proposed  in the bill -  a disease                                                               
that poses a substantial risk to  public health - one could argue                                                               
that AIDS qualifies as such.                                                                                                    
                                                                                                                                
MR.  BRANCH  offered  his  belief   that  Dr.  Mandsager  already                                                               
addressed most  of those points,  and predicted that  with regard                                                               
to people  with AIDS, it will  be unnecessary, most of  the time,                                                               
to use  isolation or quarantine  because most people  are dealing                                                               
with  that disease  responsibly.   However,  there  may still  be                                                               
times when a person with AIDS  will choose not to act responsibly                                                               
and thus  place other  people at  risk; such  circumstances would                                                               
warrant isolation or quarantine.                                                                                                
                                                                                                                                
CHAIR McGUIRE suggested that perhaps  the language being proposed                                                               
as an  addition to page 11  - regarding the use  of isolation and                                                               
quarantine only if  they are the least  restrictive alternative -                                                               
could also be added to  the aforementioned subsection (e) located                                                               
on page 13, so that the  caveat would apply in situations where a                                                               
court order is  bypassed, thus requiring the DHSS  to perform one                                                               
more step in  proving that isolation or  quarantine is warranted.                                                               
She  acknowledged the  difficulty of  defining things  that might                                                               
pose a threat to public health,  since it is hard to predict what                                                               
types of  diseases they  will face in  the future,  and indicated                                                               
that the proposed amendments give her some comfort.                                                                             
                                                                                                                                
MR.  BRANCH  said  he didn't  believe  the  administration  would                                                               
object to Chair McGuire's suggested additional change.                                                                          
                                                                                                                                
1:50:06 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER, referring to a  question asked at the bill's prior                                                               
hearing regarding civil penalties for  an employee, said that the                                                               
DHSS's preference would be to leave  [the bill] as is, that being                                                               
that the state  already has immunity for quarantine  and the bill                                                               
would extend  immunity to  instances of  isolation.   However, if                                                               
the  committee  prefers to  change  the  provision such  that  it                                                               
becomes  similar  to  changes  recently   made  to  the  statutes                                                               
pertaining to the OCS, then the DHSS would consider that.                                                                       
                                                                                                                                
CHAIR McGUIRE asked what the "OCS penalty" is.                                                                                  
                                                                                                                                
DR. MANDSAGER said,  "It's a fine [and] a class  B misdemeanor, I                                                               
think, and it uses language like 'willful misconduct.'"                                                                         
                                                                                                                                
1:51:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA said that the  language on page 12, lines 28-                                                               
29,  does  comfort  him  somewhat;  that  language  says  that  a                                                               
petition for  isolation or quarantine must  include an allegation                                                               
that "the individual  is unable or unwilling to behave  so as not                                                               
to expose  other individuals to  danger of infection".   He asked                                                               
whether  it  will be  mandatory  that  the  state prove  such  an                                                               
allegation.                                                                                                                     
                                                                                                                                
MR. BRANCH offered his belief that it would be mandatory.                                                                       
                                                                                                                                
CHAIR McGUIRE noted that the bill uses the term "must".                                                                         
                                                                                                                                
REPRESENTATIVE GARA pointed  out, however, that in  the bill, the                                                               
term "must" applies to the term "allege".                                                                                       
                                                                                                                                
MR. BRANCH  opined that  such would be  interpreted to  mean that                                                               
the allegation must be proven.                                                                                                  
                                                                                                                                
REPRESENTATIVE  GARA  asked  whether   all  of  the  stipulations                                                               
outlined  in proposed  subsection (d)  must be  proven before  an                                                               
order authorizing  isolation or quarantine  is granted.   If such                                                               
is the case,  he remarked, then perhaps the language  on page 12,                                                               
line 19,  should be  changed to  say, "(1)  allege and  prove" or                                                               
"(1) allege and establish".                                                                                                     
                                                                                                                                
MR. BRANCH  noted that  page 14, lines  16-29, stipulates  that a                                                               
clear and convincing evidence standard  must be used by the court                                                               
when  issuing   a  finding  that  committing   an  individual  to                                                               
isolation or quarantine  is warranted.  He opined  that the court                                                               
would be given  the flexibility to make a  finding that isolation                                                               
or quarantine is necessary and  appropriate after considering all                                                               
the factors set out in the  petition.  He offered his belief that                                                               
amending  the bill  as Representative  Gara just  suggested could                                                               
prevent  the  court  from  issuing  an  order  for  isolation  or                                                               
quarantine  in  cases  where  such an  order  would  actually  be                                                               
warranted to  protect the public  health if the DHSS  wasn't able                                                               
to  allege and  prove all  of  the factors  outlined in  proposed                                                               
subsection (d).                                                                                                                 
                                                                                                                                
1:54:54 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE  said she doesn't  see a single factor  in proposed                                                               
subsection (d)  that she  wouldn't want  addressed by  the court;                                                               
the factors include:                                                                                                            
                                                                                                                                
     (A)   the identity  of each  individual proposed  to be                                                                    
     quarantined or isolated;                                                                                                   
     (B)  the premises subject to isolation or quarantine;                                                                      
     (C)  the  date and time the isolation  or quarantine is                                                                    
     to begin;                                                                                                                  
     (D)  the suspected contagious disease;                                                                                     
     (E)   that the individual  poses a substantial  risk to                                                                    
     public health;                                                                                                             
     (F)      whether   testing,   screening,   examination,                                                                    
     treatment, or related procedures are necessary;                                                                            
     (G)   that  the individual  is unable  or unwilling  to                                                                    
     behave so as not to  expose other individuals to danger                                                                    
     of infection; and                                                                                                          
     (H)   that the department  is complying or  will comply                                                                    
     with (b) of this section                                                                                                   
                                                                                                                                
CHAIR McGUIRE  opined that  although discretion  by the  court is                                                               
desirable,  the  court  ought  to  find all  of  the  factors  in                                                               
proposed subsection  (d) before  granting the DHSS  the authority                                                               
to isolate or quarantine someone.                                                                                               
                                                                                                                                
MR. BRANCH, acknowledging  Chair McGuire's point that  all of the                                                               
aforementioned factors  are important,  said his concern  is that                                                               
the  public health  will be  endangered just  because one  of the                                                               
factors outlined is not proven.   For example, he noted, proposed                                                               
subsection  (d)(1)(D) -  which  says,  "the suspected  contagious                                                               
disease"  -  does  not  constitute  a  factual  finding  strictly                                                               
speaking;  instead, the  DHSS  would merely  have  the burden  of                                                               
saying what  it thinks the disease  is.  Upon further  review, he                                                               
acknowledged  that perhaps  changing page  12, line  19, to  say,                                                               
"(1) allege and prove" would not really be a problem.                                                                           
                                                                                                                                
CHAIR McGUIRE suggested  that perhaps the language on  line 19 of                                                               
page  12 could  be altered  say, "(1)  must allege  these set  of                                                               
factors" or "(1) allege those  factors listed".  She posited that                                                               
there  are   two  separate  questions,  one   being,  should  the                                                               
allegation include  all the factors,  and the next  being, should                                                               
the factors  have to be proven,  not just alleged.   She said she                                                               
doesn't see  the danger  in requiring  the allegation  to include                                                               
all of the factors.                                                                                                             
                                                                                                                                
MR.  BRANCH  concurred  and  noted   that  language  in  proposed                                                               
subsection  (d)(2),  which   starts  at  the  top   of  page  13,                                                               
stipulates  that  the  allegations  must  be  accompanied  by  an                                                               
affidavit attesting to the facts asserted in the petition.                                                                      
                                                                                                                                
1:57:47 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARA   said  that  in  looking   at  the  factors                                                               
stipulated in proposed subsection (d),  he doesn't see a one that                                                               
the DHSS  wouldn't be  able to  establish if  it were  seeking to                                                               
isolate or quarantine a citizen.                                                                                                
                                                                                                                                
MR. BRANCH  agreed.  However,  he added,  the problem for  him is                                                               
that   proposed   subsection   (d)(1)(F)  -   "whether   testing,                                                               
screening,  examination,  treatment,  or related  procedures  are                                                               
necessary" - for  example, "is not a standard  of proof"; instead                                                               
it is a question the court would  like to know the answer to - in                                                               
other words, is  the DHSS also seeking an order  for treatment or                                                               
examination.                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE  noted  that clear  and  convincing  evidence,  as                                                               
required via  proposed subsection (h),  located on page 14,  is a                                                               
high standard  of evidence.   She posited  that the  Alaska State                                                               
Constitution's  right   of  privacy  will  also   be  taken  into                                                               
consideration  by  the courts  in  determining  whether to  issue                                                               
authorization for isolation or quarantine.                                                                                      
                                                                                                                                
2:00:48 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KOTT  asked  Dr.  Mandsager  to  comment  on  the                                                               
suggested   change   regarding   an   exemption   from   testing,                                                               
examination,  or screening  because  of  religious beliefs;  this                                                               
suggestion was offered by Ms.  Smith, Christian Science Committee                                                               
on Publication for Alaska.                                                                                                      
                                                                                                                                
DR.  MANDSAGER noted  that the  bill already  allows a  person to                                                               
exempt himself/herself  from medical  treatment, but  pointed out                                                               
that in certain situations, such  as those involving TB, it could                                                               
be  difficult for  the  DHSS  to determine  whether  a person  is                                                               
really infected if it cannot perform screening or testing.                                                                      
                                                                                                                                
2:02:36 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE indicated that the  committee would now be focusing                                                               
on proposed amendments.  She  turned the committee's attention to                                                               
Amendment 1, which read [original punctuation provided]:                                                                        
                                                                                                                                
     Page 11, following Line 23, insert:                                                                                        
     "Isolation and  quarantine shall  only be used  if they                                                                    
     are  the  least  restrictive alternative  necessary  to                                                                    
     prevent  the   spread  of  a  contagious   or  possibly                                                                    
     contagious disease to others;                                                                                              
                                                                                                                                
     Page 20, following line 22, insert                                                                                         
         "(17) "least restrictive" means the policy or                                                                          
         practice that least infringes on the rights or                                                                         
     interests of individuals.                                                                                                  
                                                                                                                                
     [RENUMBER Following definitions]                                                                                           
                                                                                                                                
CHAIR McGUIRE  said that as part  of Amendment 1, she  would like                                                               
to   include,   conceptually,  on   page   13,   line  9,   after                                                               
"individuals", the  language in the  first part of Amendment  1 -                                                               
"Isolation  and quarantine  shall only  be used  if they  are the                                                               
least restrictive alternative necessary  to prevent the spread of                                                               
a  contagious or  possibly contagious  disease to  others".   She                                                               
noted that  this additional change  would apply to  the provision                                                               
allowing  the DHSS  to isolate  or quarantine  someone without  a                                                               
court order.                                                                                                                    
                                                                                                                                
CHAIR McGUIRE made  a motion to adopt Amendment 1,  as amended in                                                               
the aforementioned fashion.  There  being no objection, Amendment                                                               
1, as amended, was adopted.                                                                                                     
                                                                                                                                
CHAIR McGUIRE turned the committee's  attention to Amendment 2, a                                                               
handwritten amendment  which, with handwritten  corrections, read                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     Insert @ p.11 line 29 after "premises"                                                                                     
          ".  Absent exceptional circumstances that would                                                                       
     jeopardize public health, a person shall be allowed to                                                                     
     choose confinement in their own home."                                                                                     
                                                                                                                                
REPRESENTATIVE GARA  made a motion  to adopt Amendment 2.   There                                                               
being no objection, Amendment 2 was adopted.                                                                                    
                                                                                                                                
CHAIR McGUIRE  turned the committee's  attention to  Amendment 3,                                                               
which read [original punctuation provided]:                                                                                     
                                                                                                                                
     Page 15, following line 18, insert                                                                                         
                                                                                                                                
          "(m)  The department may quarantine or isolate                                                                        
     individuals   who  have   been  exposed   to  hazardous                                                                    
     materials that  can cause serious illness  or injury by                                                                    
     transmission of the hazardous material  to others.  The                                                                    
     provision  of  this  section concerning  isolation  and                                                                    
     quarantine  of individuals  to  prevent  the spread  of                                                                    
     contagious or possibly  contagious diseases shall apply                                                                    
     to  isolation or  quarantine  of  individuals who  have                                                                    
     been exposed to hazardous materials."                                                                                      
                                                                                                                                
CHAIR McGUIRE  made a motion to  adopt Amendment 3.   There being                                                               
no objection, Amendment 3 was adopted.                                                                                          
                                                                                                                                
2:05:45 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE again referred to  the AaNA's suggested change that                                                               
would add  the caveat that a  person would not have  to submit to                                                               
involuntary treatment if he/she  voluntarily takes steps outlined                                                               
by  the  state  medical  director  to prevent  the  spread  of  a                                                               
communicable disease.                                                                                                           
                                                                                                                                
DR. MANDSAGER  indicated that the  DHSS would not have  a problem                                                               
with such a  change, but noted that the AaNA's  suggestion in its                                                               
entirety  is  intended to  alter  language  that would  first  be                                                               
altered via  another of  the DHSS's  proposed amendment  that has                                                               
not yet been addressed.                                                                                                         
                                                                                                                                
2:06:54 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE  turned the committee's  attention to  Amendment 4,                                                               
labeled 24-GH1002\G.1, Mischel, 3/3/05, which read:                                                                             
                                                                                                                                
     Page 8, line 29, following "information":                                                                                  
          Insert "under this section"                                                                                           
                                                                                                                                
     Page 8, following line 31:                                                                                                 
          Insert a new section to read:                                                                                         
          "Sec. 18.15.362.  Acquisition and use of                                                                            
     identifiable   health    information;   public   health                                                                  
     purpose.     The   department  may   acquire  and   use                                                                  
     identifiable   health   information   collected   under                                                                    
     AS 18.15.355 - 18.15.390 only if the                                                                                       
               (1)  acquisition and use of the information                                                                      
     relates directly to a public health purpose;                                                                               
               (2)  acquisition and use of the information                                                                      
     is reasonably  likely to contribute to  the achievement                                                                    
     of a public health purpose; and                                                                                            
               (3)  public health purpose cannot otherwise                                                                      
     be  achieved  at  least as  well  with  nonidentifiable                                                                    
     health information."                                                                                                       
                                                                                                                                
     Page 20, following line 24:                                                                                                
          Insert a new paragraph to read:                                                                                       
               "(18)  "public health purpose" means the                                                                         
     prevention, control, or amelioration  of a condition of                                                                    
     public  health  importance,  including an  analysis  or                                                                    
     evaluation of  a condition of public  health importance                                                                    
     and an evaluation of a public health program;"                                                                             
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
CHAIR McGUIRE made a motion to adopt Amendment 4.                                                                               
                                                                                                                                
REPRESENTATIVE DAHLSTROM objected for the purpose of discussion.                                                                
                                                                                                                                
DR. MANDSAGER  explained that Amendment 4  defines "public health                                                               
purpose" and  establishes standards that  the DHSS would  have to                                                               
achieve   before  being   able  to   acquire,  access,   and  use                                                               
identifiable health information for a  public health purpose.  He                                                               
referred to  another of the  AaNA's proposed changes,  one that's                                                               
intended to alter  Amendment 4, and said that the  DHSS would not                                                               
agree with  that modification because it  believes that Amendment                                                               
4, as currently  written, provides a balance  between the privacy                                                               
of an individual's  health information and the DHSS's  need to do                                                               
outbreak investigations.                                                                                                        
                                                                                                                                
2:08:53 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  COGHILL   referred  to  Amendment   4's  proposed                                                               
paragraph  (3) and  asked for  clarification  regarding the  term                                                               
"nonidentifiable health information".                                                                                           
                                                                                                                                
DR. MANDSAGER  said that  much of  the time,  the DHSS  does work                                                               
involving  nonidentifiable health  information,  and provided  an                                                               
example of such.                                                                                                                
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
REPRESENTATIVE   GRUENBERG   referring  to   the   aforementioned                                                               
suggestion, by  the AaNA,  to change Amendment  4, asked  why the                                                               
DHSS wouldn't  be willing to  locate and receive  permission from                                                               
the persons it wishes to access the records of.                                                                                 
                                                                                                                                
DR.  MANDSAGER  said  he  is hesitant  to  answer  that  question                                                               
without  further review,  but indicated  that the  DHSS would  be                                                               
locating individuals  and obtaining permission to  access records                                                               
in most situations anyway.                                                                                                      
                                                                                                                                
CHAIR  McGUIRE mentioned  that the  committee could  give further                                                               
consideration to  the AaNA's suggested  changes after  the DHSS's                                                               
proposed amendments are addressed.                                                                                              
                                                                                                                                
2:11:06 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 4.  There being none, Amendment 4 was adopted.                                                                        
                                                                                                                                
CHAIR McGUIRE  made a  motion to adopt  Amendment 5,  labeled 24-                                                               
GH1002\G.2, Mischel, 3/4/05, which read:                                                                                        
                                                                                                                                
     Page 9, line 2, following "information":                                                                                   
          Insert "collected under AS 18.15.355 - 18.15.390"                                                                     
                                                                                                                                
REPRESENTATIVE DAHLSTROM objected for the purpose of discussion.                                                                
                                                                                                                                
DR. MANDSAGER indicated  that Amendment 5 would  clarify that the                                                               
[information  security  safeguards  in  the bill  apply  only  to                                                               
information being collected under Section 8 of the bill].                                                                       
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 5.  There being none, Amendment 5 was adopted.                                                                        
                                                                                                                                
CHAIR McGUIRE [made  a motion to adopt] Amendment  6, labeled 24-                                                               
GH1002\G.3, Mischel, 3/4/05, which read:                                                                                        
                                                                                                                                
     Page 9, line 1, following "safeguards.":                                                                                 
          Insert "(a)"                                                                                                          
                                                                                                                                
     Page 9, following line 4:                                                                                                  
          Insert a new subsection to read:                                                                                      
          "(b)  The department shall expunge, in a                                                                              
     confidential  manner,  identifiable health  information                                                                    
     collected under  AS 18.15.355 - 18.15.390 when  the use                                                                    
     of  the   information  by  the  department   no  longer                                                                    
     furthers  the public  health purpose  for  which it  is                                                                    
     required."                                                                                                                 
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
DR.  MANDSAGER   indicated  that  Amendment  6   is  intended  to                                                               
addresses  concerns   that  the   DHSS  would   hold  information                                                               
unnecessarily;  Amendment 6  would put  in statute  a stipulation                                                               
that information  no longer  needed for  a public  health purpose                                                               
will be confidentially expunged as soon as possible.                                                                            
                                                                                                                                
2:12:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 6.  There being none, Amendment 6 was adopted.                                                                        
                                                                                                                                
CHAIR McGUIRE  made a  motion to adopt  Amendment 7,  labeled 24-                                                               
GH1002\G.4, Mischel, 3/3/05, which read:                                                                                        
                                                                                                                                
     Page 14, line 19:                                                                                                          
          Delete "substantial"                                                                                                  
          Insert "significant"                                                                                                  
                                                                                                                                
     Page 15, line 3:                                                                                                           
          Delete "substantial"                                                                                                  
     Insert "significant"                                                                                                       
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
DR. MANDSAGER explained  that Amendment 7 would  clarify that the                                                               
DHSS  must  prove   to  the  court  that  a   situation  poses  a                                                               
"significant" risk to public health.                                                                                            
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 7.  There being none, Amendment 7 was adopted.                                                                        
                                                                                                                                
2:13:12 PM                                                                                                                    
                                                                                                                                
CHAIR McGUIRE made a motion to adopt Amendment 8, labeled 24-                                                                   
GH1002\G.5, Mischel, 3/3/05, which read:                                                                                        
                                                                                                                                
     Page 11, line 20, following "treatment.":                                                                                  
          Insert "However, an individual who exercises the                                                                      
     right  to refuse  treatment  under  this subsection  is                                                                    
     responsible for paying all costs  incurred by the state                                                                    
     in seeking  and implementing a quarantine  or isolation                                                                    
     order made necessary  by a refusal of  treatment by the                                                                    
     individual.  The department  shall notify an individual                                                                    
     who refuses  treatment under  this subsection  that the                                                                    
     refusal  may   result  in   an  indefinite   period  of                                                                    
     quarantine or  isolation and  that the  individual will                                                                    
     be  responsible  for  payment   of  the  costs  of  the                                                                    
     quarantine or isolation."                                                                                                  
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
DR. MANDSAGER indicated  that the change proposed  by Amendment 8                                                               
has  been suggested  in previous  committees,  and would  provide                                                               
that  if someone  refuses  treatment in  favor  of quarantine  or                                                               
isolation,  then he/she  is responsible  for the  costs incurred.                                                               
He  mentioned  that  this  is   the  language  that  one  of  the                                                               
aforementioned changes suggested by the AaNA proposes to alter.                                                                 
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE,  in response to comments  and questions, clarified                                                               
that the question  of whether to adopt Amendment 8  - labeled 24-                                                               
GH1002\G.5, Mischel, 3/3/05 - was before the committee.                                                                         
                                                                                                                                
REPRESENTATIVE  GARA   objected  [for  the  purpose   of  further                                                               
discussion].   Mentioning  that a  person might  refuse treatment                                                               
for a  variety of reasons,  he said  that Amendment 8  appears to                                                               
not be drafted narrowly enough.                                                                                                 
                                                                                                                                
DR.  MANDSAGER  relayed that  the  language  of Amendment  8  was                                                               
adopted  in the  Senate.   Acknowledging  that  one could  refuse                                                               
treatment for a  number of reasons, he  offered his understanding                                                               
that Amendment 8  merely says that if one  does refuse treatment,                                                               
regardless of the  reason, that one is responsible  for the costs                                                               
incurred.                                                                                                                       
                                                                                                                                
REPRESENTATIVE GRUENBERG  said he  is concerned about  the impact                                                               
Amendment 8 could have on  those who live a subsistence lifestyle                                                               
and may  not have the  cash to  pay for quarantine  or isolation;                                                               
Amendment 8 could  have devastating consequences if  that lack of                                                               
funds   results  in   people   [being   subjected  to   treatment                                                               
unwillingly].  He opined that  there should be some discretion to                                                               
waive the costs of isolation and quarantine.                                                                                    
                                                                                                                                
DR.  MANDSAGER  offered   his  interpretation  of  Representative                                                               
Gruenberg's concern.                                                                                                            
                                                                                                                                
REPRESENTATIVE  GRUENBERG made  a  motion to  adopt a  conceptual                                                               
amendment to Amendment 8, "to  allow the department to waive that                                                               
cost  requirement  if  ...  there   are  sufficient  equities  to                                                               
requirement."                                                                                                                   
                                                                                                                                
2:17:49 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KOTT suggested  instead  that  they simply  alter                                                               
Amendment  8  in  two places  so  that  it  says  in part:    "an                                                               
individual  who exercises  the right  to  refuse treatment  under                                                               
this  subsection   may  be  responsible  for   paying  all  costs                                                               
incurred"  and  "that  the  individual  may  be  responsible  for                                                               
payment".                                                                                                                       
                                                                                                                                
CHAIR McGUIRE opined that such a  change would be a better way to                                                               
accomplish Representative Gruenberg's goal.                                                                                     
                                                                                                                                
REPRESENTATIVE  GRUENBERG, in  response to  a question,  withdrew                                                               
his  previous amendment  to Amendment  8, and  [made a  motion to                                                               
adopt  Representative Kott's  suggestion as]  a new  amendment to                                                               
Amendment 8.                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE asked  whether there  were any  objections to  the                                                               
amendment to Amendment 8.   There being no objection, Amendment 8                                                               
was amended.                                                                                                                    
                                                                                                                                
CHAIR McGUIRE  asked whether there [were  any further objections]                                                               
to Amendment  8, as amended.   There  being none, Amendment  8 as                                                               
amended, was adopted.                                                                                                           
                                                                                                                                
CHAIR McGUIRE  made a  motion to adopt  Amendment 9,  labeled 24-                                                               
GH1002\G.6, Mischel, 3/4/05, which read:                                                                                        
                                                                                                                                
     Page 11, lines 27 - 28:                                                                                                    
          Delete "or hazardous material"                                                                                        
          Insert "that poses a significant risk to public                                                                       
     health"                                                                                                                    
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
DR. MANDSAGER indicated that Amendment  9 is in order because the                                                               
issue  of  hazardous  material  is   now  addressed  by  the  new                                                               
subsection (m)  inserted via  Amendment 3,  and that  Amendment 9                                                               
also  attempts   to  elevate  the   standard  for   isolation  or                                                               
quarantine.                                                                                                                     
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 9.  There being none, Amendment 9 was adopted.                                                                        
                                                                                                                                
CHAIR McGUIRE  made a motion  to adopt Amendment 10,  labeled 24-                                                               
GH1002\G.7, Mischel, 3/3/05, which read:                                                                                        
                                                                                                                                
     Page 11, following line 15:                                                                                                
     Insert a new subsection to read:                                                                                           
          "(b) A state medical officer may direct an                                                                            
     individual  who  has or  may  have  been exposed  to  a                                                                    
     contagious  disease that  poses a  significant risk  or                                                                    
     danger to  others or to  the public health  to complete                                                                    
     an appropriate  prescribed course of treatment  for the                                                                    
     contagious disease,  including medication  and directly                                                                    
     observed  therapy,   if  appropriate,  and   to  follow                                                                    
     measures to prevent the spread of disease."                                                                                
                                                                                                                                
     Reletter the following subsections accordingly.                                                                            
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA objected.                                                                                                   
                                                                                                                                
DR.  MANDSAGER indicated  that Amendment  10 addresses  a problem                                                               
that  the  DHSS  has  had internally  with  current  tuberculosis                                                               
statutes,  specifically  regarding what  the  role  of the  state                                                               
medical  examiner  is  in directing  someone  to  get  treatment.                                                               
Amendment  10 would  clarify  in statute  that  giving notice  to                                                               
someone  that he/she  should be  treated is  just a  step in  the                                                               
journey,  and recognizes  that the  individual can  always refuse                                                               
treatment.                                                                                                                      
                                                                                                                                
CHAIR McGUIRE noted that Amendment 10 does specify "may".                                                                       
                                                                                                                                
REPRESENTATIVE GARA  offered his understanding that  Amendment 10                                                               
would allow a state medical  officer to tell somebody that he/she                                                               
has to  take the state medical  officer's "appropriate prescribed                                                               
course of treatment".  He said  his concern with this is that for                                                               
some diseases -  for example, AIDS - there  are some experimental                                                               
drugs that  are appropriate, some that  are "likely" appropriate,                                                               
some that  may not be  safe at all,  and some that  have unwanted                                                               
side effects.   Amendment  10, as  currently written,  he opined,                                                               
would allow the  state to tell someone to take  what it considers                                                               
to be  a prescribed  course of  treatment even  if the  person is                                                               
unwilling to do so.                                                                                                             
                                                                                                                                
CHAIR McGUIRE,  referring to proposed  AS 18.15.380(a)  - located                                                               
on  page 11,  lines 12-15  - posited  that this  language already                                                               
addresses the DHSS's concerns; thus amendment 10 is not needed.                                                                 
                                                                                                                                
2:22:47 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER concurred.                                                                                                        
                                                                                                                                
CHAIR  McGUIRE  suggested that  Amendment  10  would create  more                                                               
problems  than it  solves,  and mentioned  that  she agrees  with                                                               
Representative Gara's comments on this issue.                                                                                   
                                                                                                                                
CHAIR McGUIRE withdrew Amendment 10.                                                                                            
                                                                                                                                
2:23:53 PM                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE -  indicating  that the  next  amendment would  be                                                               
called Amendment 11  - referred to the  AaNA's suggested changes,                                                               
one  of   which  recommends  the  following   language  [original                                                               
punctuation  provided] for  proposed AS  18.15.380(c), which  has                                                               
already been amended via Amendment 8, as amended:                                                                               
                                                                                                                                
      Sec. 18.15.380(c) shall read:  An individual has the                                                                      
      right to refuse treatment and may not be required to                                                                      
     submit  to involuntary  treatment so  long as  they are                                                                  
     voluntarily  willing  to  take steps  outlined  by  the                                                                  
     state  medical  director to  prevent  the  spread of  a                                                                  
     communicable  disease to  others.    An individual  who                                                                  
     exercises  the right  to  refuse  treatment under  this                                                                    
     subsection   is  responsible   for  paying   all  costs                                                                    
     incurred  by the  state in  seeking and  implementing a                                                                    
     quarantine  or  isolation  order made  necessary  by  a                                                                    
     refusal   of  treatment   by  the   individual.     The                                                                    
     department  shall  notify  an  individual  who  refuses                                                                    
     treatment under  this subsection  that the  refusal may                                                                    
     result  in  an  indefinite   period  of  quarantine  or                                                                    
     isolation and  that the individual will  be responsible                                                                    
     for  payment   of  the  costs  of   the  quarantine  or                                                                    
     isolation.                                                                                                                 
                                                                                                                                
DR. MANDSAGER opined that this recommended change is a good one.                                                                
                                                                                                                                
CHAIR McGUIRE made  a motion to adopt the  foregoing as Amendment                                                               
11.                                                                                                                             
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE  recapped  the AaNA's  comments  from  the  bill's                                                               
previous   hearing  regarding   wanting  individuals   to  accept                                                               
responsibility  for  taking steps  to  prevent  the spread  of  a                                                               
communicable disease.                                                                                                           
                                                                                                                                
REPRESENTATIVE DAHLSTROM removed her objection.                                                                                 
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 11.  There being none, Amendment 11 was adopted.                                                                      
                                                                                                                                
CHAIR  McGUIRE   offered  her  belief  that   the  other  changes                                                               
suggested  by  the AaNA  have  either  been addressed  via  other                                                               
amendments already adopted  or are objected to by  the DHSS, such                                                               
as  the  one  that  proposes  to alter  the  language  added  via                                                               
Amendment  4,  and  which  pertains  to  locating  and  receiving                                                               
permission from persons it wishes to access the records of.                                                                     
                                                                                                                                
REPRESENTATIVE GRUENBERG  opined that  if there isn't  an eminent                                                               
threat of an emergency, the  DHSS should make a reasonable effort                                                               
to contact the individuals whose records it wishes to access.                                                                   
                                                                                                                                
DR. MANDSAGER said his only  concern pertains to those reportable                                                               
conditions that fall under other  parts of the public health law,                                                               
such as  those included in  reports from hospitals and  for which                                                               
individuals are not ordinarily notified.                                                                                        
                                                                                                                                
CHAIR  McGUIRE suggested  that Representative  Gruenberg consider                                                               
researching this issue  more after the bill  moves from committee                                                               
but before it is heard on the House floor.                                                                                      
                                                                                                                                
REPRESENTATIVE GRUENBERG agreed to do so.                                                                                       
                                                                                                                                
2:27:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA  made a motion  to adopt Amendment  12, which                                                               
read [original punctuation provided]:                                                                                           
                                                                                                                                
     At Page 15, Line 19                                                                                                        
                                                                                                                                
          Insert a new section:                                                                                                 
                                                                                                                                
     "18.15.386 Penalty  for Violation.   Notwithstanding AS                                                                
     09.50.250, a person who  knowingly violates a provision                                                                  
     of  18.15.365, 18.15.375,  18.15.380  or 18.15.385,  is                                                                  
     liable in  a civil action for  compensatory damages and                                                                  
     is liable for a fine of up to $1000 per violation."                                                                      
                                                                                                                                
     At Page 2, line 31                                                                                                         
                                                                                                                                
           After "18.55.390" insert ", except in the                                                                          
     circumstances provided in AS 18.15.386."                                                                                 
                                                                                                                                
REPRESENTATIVE DAHLSTROM objected.                                                                                              
                                                                                                                                
REPRESENTATIVE  GARA made  a  motion to  amend  Amendment 12,  to                                                               
delete the reference to AS  18.15.375.  There being no objection,                                                               
Amendment 12 was amended.                                                                                                       
                                                                                                                                
REPRESENTATIVE  GARA offered  his  belief that  Amendment 12,  as                                                               
amended, would impose a necessary  safeguard.  He relayed that it                                                               
has  been explained  to him  that  Alaska is  currently the  only                                                               
state  that does  not have  a comprehensive  quarantine law,  and                                                               
that this  is due to the  state's history of forced  and improper                                                               
quarantines of its Native  population during pre-statehood years.                                                               
He  opined that  [HB  95]  will be  an  appropriate  law only  if                                                               
[agency  personnel]  do not  purposely  violate  it in  order  to                                                               
quarantine people.   He said that Amendment 12,  as amended, will                                                               
say  that if  [agency  personnel] knowingly  violate proposed  AS                                                               
18.15.365,  which pertains  to  information security  safeguards;                                                               
18.15.380, which  pertains to allowing someone  to refuse medical                                                               
treatment;  or 18.15.385,  which pertains  to the  standards that                                                               
allow for  isolation and quarantine,  then the violator  "and the                                                               
state" will be liable for any damages that result.                                                                              
                                                                                                                                
CHAIR McGUIRE  asked whether the  penalty proposed  via Amendment                                                               
12, as  amended, mirrors that  of Representative  Coghill's "CINA                                                               
[child in need of aid] bill."                                                                                                   
                                                                                                                                
REPRESENTATIVE  COGHILL  indicated  that  some  of  the  language                                                               
regarding civil  liability is  similar but  it doesn't  specify a                                                               
particular penalty.                                                                                                             
                                                                                                                                
CHAIR McGUIRE  indicated that she  wants to know what  the mental                                                               
intent is in Representative Coghill's bill.                                                                                     
                                                                                                                                
[The response was inaudible.]                                                                                                   
                                                                                                                                
CHAIR McGUIRE raised  the issue of "wilful  misconduct" and asked                                                               
Dr. Mandsager to comment.                                                                                                       
                                                                                                                                
DR.  MANDSAGER  said he'd  originally  thought  that perhaps  the                                                               
Senate had  adopted some language  regarding that issue,  but now                                                               
he is not sure that such is the case.                                                                                           
                                                                                                                                
2:31:55 PM                                                                                                                    
                                                                                                                                
CHAIR  McGUIRE  asked  him  to   comment  [on  Amendment  12,  as                                                               
amended].                                                                                                                       
                                                                                                                                
DR. MANDSAGER replied:                                                                                                          
                                                                                                                                
     On one hand, I'm  kind of personally ambivalent because                                                                    
     I  think we  ought  to  hold our  employees  to a  high                                                                    
     standard,  and  I  think   that's  what  you're  after,                                                                    
     Representative  Gara,  is  that employees  should  know                                                                    
     that  they can't  do  something wrong.    On the  other                                                                    
     hand,  if it  opens up  [employee] actions  to a  whole                                                                    
     series of legal  actions in the which  the state's sued                                                                    
     -- we're trying  to find a balance point  in there, and                                                                    
     I can only speak personally  here because I don't think                                                                    
     we in the department have taken a position on this.                                                                        
                                                                                                                                
REPRESENTATIVE   COGHILL    surmised   that   certain    of   the                                                               
aforementioned violations  would occur before a  quarantine order                                                               
is sought from  a judge, and suggested that this  might provide a                                                               
safeguard against  any violation  of proposed  AS 18.15.380.   He                                                               
mentioned aspects of his aforementioned CINA bill.                                                                              
                                                                                                                                
CHAIR McGUIRE asked why Amendment  12, as amended, provides for a                                                               
mental state of knowingly as opposed to intentionally.                                                                          
                                                                                                                                
REPRESENTATIVE  GARA   said  he  would  be   amenable  to  having                                                               
Amendment  12,  as  amended,   say  "intentionally"  rather  than                                                               
"knowingly".  He  remarked that his thought  was that "knowingly"                                                               
is the term  used with regard to criminal law,  and that it would                                                               
provide for a  very high burden before one could  be held civilly                                                               
liable under Amendment 12, as amended.                                                                                          
                                                                                                                                
2:34:04 PM                                                                                                                    
                                                                                                                                
MR. BRANCH  offered his belief  that anyone  [adversely] impacted                                                               
by  quarantine,  isolation,  or  medical  treatment  already  has                                                               
recourse  under  the  bill, even  in  cases  involving  emergency                                                               
orders.  He surmised that  the main concern pertains to violating                                                               
the  provision  regarding  confidentiality  of  information,  and                                                               
opined  that  such  a  violation   would  more  appropriately  be                                                               
addressed as a criminal offense rather  than as a cause for civil                                                               
action.                                                                                                                         
                                                                                                                                
REPRESENTATIVE COGHILL  asked what  a person's recourse  is under                                                               
the bill if his/her confidentiality is knowingly violated.                                                                      
                                                                                                                                
MR.  BRANCH relayed  that  [Section  2 of]  the  bill amends  the                                                               
waiver  of  liability  provision  in   Title  9,  and  that  such                                                               
insolates the department from liability.                                                                                        
                                                                                                                                
REPRESENTATIVE COGHILL said that is  a concern, adding that he is                                                               
interested in ensuring  that the state be held  liable for misuse                                                               
of information.   He asked  at what  point can an  individual get                                                               
satisfaction for such a violation.                                                                                              
                                                                                                                                
CHAIR McGUIRE  noted that the  bill pertaining to  the collection                                                               
of deoxyribonucleic  acid (DNA)  samples provides for  a criminal                                                               
penalty if a person's confidentiality is violated.                                                                              
                                                                                                                                
2:38:34 PM                                                                                                                    
                                                                                                                                
DR. MANDSAGER mentioned that "the  model Act" suggests a standard                                                               
of gross negligence or wilful misconduct.                                                                                       
                                                                                                                                
CHAIR McGUIRE  made a motion  to amend Amendment 12,  as amended,                                                               
to say  "intentional".  There  being no objection,  Amendment 12,                                                               
as amended, was again amended.                                                                                                  
                                                                                                                                
CHAIR McGUIRE expressed disfavor with  using a standard of "gross                                                               
negligence."                                                                                                                    
                                                                                                                                
REPRESENTATIVE GARA  said he did  not want  to use a  standard of                                                               
gross  negligence.    He  offered his  belief  that  "this  whole                                                               
system"  is predicated  upon  an honest  affidavit  from a  state                                                               
employee,  and  he  did  not  want a  [state  employee]  to  make                                                               
something up in an affidavit.                                                                                                   
                                                                                                                                
CHAIR McGUIRE agreed.                                                                                                           
                                                                                                                                
REPRESENTATIVE DAHLSTROM  withdrew her objection to  Amendment 12                                                               
[as amended].                                                                                                                   
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
amendment 12,  as amended.   There being  none, Amendment  12, as                                                               
amended was adopted.                                                                                                            
                                                                                                                                
REPRESENTATIVE  GARA  made a  motion  to  adopt Amendment  13,  a                                                               
handwritten amendment  which, with handwritten  corrections, read                                                               
[original punctuation provided]:                                                                                                
                                                                                                                                
     Insert at p. 13 line 2                                                                                                     
          after "in the petition"                                                                                               
     as follows:                                                                                                                
       "including    specific   facts    supporting   the                                                                       
     allegations required by AS 18.15.385(d)(1)(D) & (G)."                                                                      
                                                                                                                                
CHAIR McGUIRE objected for the purpose of discussion.                                                                           
                                                                                                                                
REPRESENTATIVE GARA  relayed that Amendment 13  provides that the                                                               
affidavit  required by  proposed AS  18.15.385(d)(2) cannot  just                                                               
include  general allegations  but must  specifically state  facts                                                               
pertaining  to the  suspected contagious  disease and  to whether                                                               
someone is  unable or  unwilling to  behave so  as to  not expose                                                               
other individuals to danger of infection.                                                                                       
                                                                                                                                
CHAIR McGUIRE withdrew her objection.                                                                                           
                                                                                                                                
CHAIR McGUIRE asked whether there  were any further objections to                                                               
Amendment 13.  There being none, Amendment 13 was adopted.                                                                      
                                                                                                                                
REPRESENTATIVE   GRUENBERG   referred   to   the   aforementioned                                                               
Christian Science Committee on  Publication for Alaska's proposed                                                               
new section, AS 18.15.382 [text  provided previously], and made a                                                               
motion to adopt it as Amendment 14.                                                                                             
                                                                                                                                
DR.  MANDSAGER  characterized  Amendment  14  as  simply  further                                                               
clarification "about the treatment side."                                                                                       
                                                                                                                                
REPRESENTATIVE   DAHLSTROM   objected   [for   the   purpose   of                                                               
discussion].                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRUENBERG said  that Amendment  14 "allows  these                                                               
people to practice their  religion without particularly impinging                                                               
on the public  health, and I think it's important  to a number of                                                               
Alaskans."                                                                                                                      
                                                                                                                                
REPRESENTATIVE DAHLSTROM  indicated that she was  maintaining her                                                               
objection to Amendment 14.                                                                                                      
                                                                                                                                
2:44:55 PM                                                                                                                    
                                                                                                                                
A role call  vote was started but interrupted for  the purpose of                                                               
further discussion.                                                                                                             
                                                                                                                                
MS. SMITH,  in response to a  question, said that the  concern of                                                               
the  Christian Science  Committee  on Publication  for Alaska  is                                                               
that  the  existing  statute addressing  treatment  by  spiritual                                                               
means  in cases  involving  tuberculosis, AS  18.15.143, will  be                                                               
repealed via passage  of HB 95, and Amendment  14 simply proposes                                                               
to  reinsert a  similar  accommodation regarding  treatment of  a                                                               
contagious disease by spiritual means.                                                                                          
                                                                                                                                
DR. MANDSAGER opined that adoption  of Amendment 14 will not make                                                               
a  practical difference  because provisions  in the  bill already                                                               
allow   someone  to   exempt   himself/herself  from   treatment,                                                               
regardless of  the reason.   Amendment 14  just clarifies  that a                                                               
person  can  exempt  themselves   from  treatment  for  religious                                                               
reasons.                                                                                                                        
                                                                                                                                
REPRESENTATIVE GRUENBERG  again made a motion  to adopt Amendment                                                               
14.                                                                                                                             
                                                                                                                                
REPRESENTATIVE GARA  objected.  He  said it seems  that Amendment                                                               
14  provides that  one has  the  absolute right  to treatment  by                                                               
spiritual  means  even  if  the accepted  science  is  that  such                                                               
treatment won't  keep one from  becoming contagious.   That being                                                               
the case, he remarked, he  understands the conflict between those                                                               
who,  for religious  reasons, don't  accept  western science  and                                                               
those who  do, but opined  that state law  should go with  one or                                                               
the other.                                                                                                                      
                                                                                                                                
REPRESENTATIVE GRUENBERG  pointed out, though, that  Amendment 14                                                               
says that  although a person  may utilize solely  spiritual means                                                               
for the  treatment of disease,  the state may order  isolation of                                                               
that person.  So the person has  the right to do with his/her own                                                               
body  as he/she  wishes, and  the  state may  order isolation  to                                                               
protect society.   Amendment 14 stipulates that a  person has the                                                               
right to control his/her own body, he opined.                                                                                   
                                                                                                                                
DR.  MANDSAGER reiterated  his  belief that  Amendment  14 is  no                                                               
different than provisions already in  the bill, but will create a                                                               
separate  section.    He   surmised  that  Representative  Gara's                                                               
concern is that doing so may create an absolute right.                                                                          
                                                                                                                                
2:50:15 PM                                                                                                                    
                                                                                                                                
A roll call  vote was taken.  Representatives  Kott and Gruenberg                                                               
voted  in  favor  of  Amendment  14.    Representatives  McGuire,                                                               
Anderson,  Coghill,   Dahlstrom,  and  Gara  voted   against  it.                                                               
Therefore, Amendment 14 failed by a vote of 2-5.                                                                                
                                                                                                                                
2:50:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GARA   indicated  that  he  wanted   to  offer  a                                                               
conceptual  amendment  that  would  address  the  AkCLU's  points                                                               
regarding the ex parte hearing issue.                                                                                           
                                                                                                                                
REPRESENTATIVE GARA  made a motion  to adopt Amendment  15, which                                                               
"would say  that you can't make  your decision ex parte,  that is                                                               
without any participation by the  person who you want to isolate,                                                               
... if participation  by the person is feasible".   He said he is                                                               
not  sure   whether  [the   bill's]  language   already  provides                                                               
protection,  but   characterized  ex  parte  decisions   as  very                                                               
dangerous because  only one side gets  to present its story.   "I                                                               
don't think you  want to have an ex parte  hearing, where you get                                                               
to quarantine somebody,  unless its impossible to  ... [let] that                                                               
person participate," he concluded.                                                                                              
                                                                                                                                
MR. BRANCH  offered his belief  that the AkCLU  misspoke, because                                                               
the ex  parte provision only  applies to testing,  not quarantine                                                               
or  isolation.    He  noted   that  in  unusual  situations,  the                                                               
department  can act  on its  own, but  would then  still have  to                                                               
bring the  person before the court  for a hearing.   Referring to                                                               
language on  proposed 18.15.375(d) -  beginning on page  10, line                                                               
29 - he offered  that the key point of this  provision is that it                                                               
allows the department  to get a search warrant  and test someone,                                                               
but if the person refuses to  be tested, then testing won't occur                                                               
until he/she  has gone  before the  court, though  the department                                                               
can  isolate  the  person  meanwhile to  prevent  the  spread  of                                                               
disease.  He characterized this  as a timesaving device, allowing                                                               
the department to act quickly to protect the public health.                                                                     
                                                                                                                                
MR. BRANCH,  in response  to a question,  noted that  proposed AS                                                               
18.15.375(e) - beginning  on page 11, line 6 -  says in part that                                                               
an individual  subject to  an ex  parte hearing  must be  given a                                                               
form to request a hearing to vacate the ex parte order.                                                                         
                                                                                                                                
REPRESENTATIVE GARA  withdrew Amendment 15, adding  that he would                                                               
research the issue further before the  bill is heard on the House                                                               
floor.                                                                                                                          
                                                                                                                                
REPRESENTATIVE  ANDERSON   moved  to  report  CSHB   95(HES),  as                                                               
amended,  out of  committee with  individual recommendations  and                                                               
the accompanying  zero fiscal  note.   There being  no objection,                                                               
CSHB  95(JUD)  was reported  from  the  House Judiciary  Standing                                                               
Committee.                                                                                                                      
                                                                                                                                

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