Legislature(2003 - 2004)

05/10/2003 09:05 AM Senate FIN

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
                                                                                                                                
     CS FOR HOUSE BILL NO. 229(FIN)                                                                                             
     "An Act relating to special medical parole and to prisoners                                                                
     who are severely medically or cognitively disabled."                                                                       
                                                                                                                                
                                                                                                                                
This was  the first  hearing for  this bill  in the Senate  Finance                                                             
Committee.                                                                                                                      
                                                                                                                                
Co-chair  Wilken stated  that this  legislation  would provide  the                                                             
Alaska Board of Parole  the flexibility to deny or  approve medical                                                             
parole.                                                                                                                         
                                                                                                                                
TOM WRIGHT,  Staff to Representative  John Harris, Co-Chair  of the                                                             
House Finance  Committee,  stated that Senator  Lyda Green's  staff                                                             
would  present  testimony  on  the  behalf  of  the  House  Finance                                                             
Committee, the bill's sponsor.                                                                                                  
                                                                                                                                
JACQUELINE TUPOU, Staff to Senator  Lyda Green, commented that this                                                             
bill  would allow  the Parole  Board  to grant  parole to  severely                                                             
disabled or  ill prisoners.  As a testament  to the Parole  Board's                                                             
"proven track record" regarding discretionary parole decisions, she                                                             
informed that prisoners who are released on mandatory parole have a                                                             
77-percent recidivism rate as compared  to a one-percent recidivism                                                             
rate for those prisoners awarded discretionary parole by the Parole                                                             
Board.                                                                                                                          
                                                                                                                                
Ms. Tupou stated that the State's inmate population is comprised of                                                             
430 individuals 50 years of age or older and that 23 percent of the                                                             
430 are  more than 60 years  of age. She  expressed that  the aging                                                             
prison population is incurring  great medical expense to the State,                                                             
as  she informed  that  people in  State  custody are  exempt  from                                                             
Medicaid  or Medicare  programs  and  Veterans or  Native  American                                                             
benefits. Therefore,  she communicated that this legislation  would                                                             
enable the Department  to formulate a release plan  for qualifying,                                                             
critically ill  prisoners provided  that such things as  where they                                                             
would live  and who their  caregivers would  be are addressed.  She                                                             
assured  the Committee  that  the release  plan  must be  developed                                                             
before a prisoner's name would be advanced to the Parole Board.                                                                 
                                                                                                                                
Ms.  Tupou stated  that even  though  some of  these prisoners  are                                                             
currently in a hospital or other care facility, because they are in                                                             
State custody, the State is required  to post a guard with them 24-                                                             
hours a day, regardless  of the patient's physical  situation. Were                                                             
these prisoners granted a medical  parole, she stated that the cost                                                             
of the  individual's  care would  be provided  by federal  matching                                                             
monies or by family  resources. She reiterated that,  under current                                                             
conditions, these funding options are not available.                                                                            
                                                                                                                                
Ms.  Tupou declared  that,  were the  medical  parole option  being                                                             
considered, the prisoner's victim  would be notified and allowed to                                                             
comment. She further attested that were the action "to diminish the                                                             
seriousness of the crime," the medical parole would not be granted.                                                             
                                                                                                                                
Ms. Tupou reiterated  that this legislation would grant  the Parole                                                             
Board the flexibility to make these discretionary parole decisions.                                                             
                                                                                                                                
Senator Bunde  asked whether  a prisoner must  be diagnosed  with a                                                             
terminal  medical condition  before  being considered  for  medical                                                             
parole.                                                                                                                         
                                                                                                                                
Ms. Tupou replied yes, the prisoner  should be experiencing a life-                                                             
threatening illness from which recovery is not expected.                                                                        
                                                                                                                                
Senator Bunde asked whether the  illness must have "a time certain"                                                             
death element.                                                                                                                  
                                                                                                                                
DR. JOHN  ROBERTSON, Medical Director,  Department of  Corrections,                                                             
testified via  teleconference from  an offnet site to  explain that                                                             
the general guidelines  of this legislation specify  that "the vast                                                             
majority"  of people  who would  be considered  for medical  parole                                                             
status would have  three to six months to live "with  a year at the                                                             
outside."  He  expressed  that  this bill  addresses  the  lack  of                                                             
flexibility  the  Parole  Board  currently  experiences   regarding                                                             
medical paroles.                                                                                                                
                                                                                                                                
Senator Bunde voiced support for the bill.                                                                                      
                                                                                                                                
Dr. Robertson  commented  that safeguards,  based on other  states'                                                             
experiences,  are incorporated  into the  process,  and that he  is                                                             
confident that the Parole Board  would take all factors such as the                                                             
crime, the medical  condition, the prognosis, and the  release plan                                                             
into  consideration during  its  medical parole  determination.  He                                                             
stated that one of the prime considerations  in the release plan is                                                             
that an appropriate care environment  would be in available for the                                                             
person.                                                                                                                         
                                                                                                                                
Amendment #1: This amendment changes  the bill's title by inserting                                                             
new language  on page 1, line 2,  following the word "disabled"  to                                                             
read as follows.                                                                                                                
                                                                                                                                
     "An Act  relating to special  medical parole and  to prisoners                                                             
     who are severely  medically or cognitively disabled;  relating                                                             
     to a  severe acute respiratory  syndrome control program;  and                                                             
     providing for an effective date."                                                                                          
                                                                                                                                
Additionally,  two new sections are  inserted on page  1, following                                                             
line 3. The new sections read as follow.                                                                                        
                                                                                                                                
     Section 1. The uncodified law of the State of Alaska is                                                                    
     amended by adding a new section to read:                                                                                   
          PURPOSE. (a) The purposed of sec. 2 of this Act is to                                                                 
     clarify  the  law  and  expressly  establish  a  comprehensive                                                             
     program  for health  care decisions  to  control severe  acute                                                             
     respiratory   syndrome   (SARS)  in   this  state,   including                                                             
     reporting, examinations, orders,  and detention to protect the                                                             
     public health.                                                                                                             
          (b) The purpose  of secs. 3   7 of this Act is to clarify                                                             
     standards for special medical  parole and to address prisoners                                                             
     who are severely medically or cognitively disabled.                                                                        
          Sec.  2 AS 18.15  is amended by  adding a new section  to                                                             
     read:                                                                                                                      
          Article 1A. Severe Acute Respiratory Syndrome (SARS).                                                                 
          Sec. 18.15.112. SARS control program authorization. (a) A                                                             
     severe  acute respiratory syndrome  (SARS) control  program is                                                             
     authorized in  the department. The SARS control  program shall                                                             
     be administered  in the same  manner and has the  same powers,                                                             
     authority,  obligations, and  limited immunities  as does  the                                                             
     program for  the control of tuberculosis under  AS 18.15.120                                                               
     18.15.149, except for the following:                                                                                       
          (1) the provisions of the control program described in AS                                                             
     18.15.120(1) and (7);                                                                                                      
          (2) reports to state medical officers under AS 18.15.131;                                                             
          (3) examinations of persons under AS 18.15.133;                                                                       
          (4)  title  to and  inventory  of equipment  allotted  to                                                             
     private institutions under AS 18.15.140;                                                                                   
          (5) the screening of school employees under AS 18.15.145.                                                             
     (b)  In this  section,  "SARS"  or "severe  acute  respiratory                                                             
     syndrome" means the infectious  disease caused by the SARS-CoV                                                             
     or the SARS coronavirus and the mutations of that disease."                                                                
                                                                                                                                
Furthermore, a new bill section is inserted on page 4, line 12 that                                                             
reads as follows.                                                                                                               
                                                                                                                                
     Sec. 8. Sections  1 and 2 of this Act take effect  immediately                                                             
     under AS 01.10.070(c).                                                                                                     
                                                                                                                                
Senator Bunde moved for adoption of Amendment #1.                                                                               
                                                                                                                                
Co-Chair  Wilken objected to  discuss the  status of the  amendment                                                             
with Co-chair Green, the Chair of the Committee's subcommittees for                                                             
the Department of Health and Social  Services and the Department of                                                             
Corrections.                                                                                                                    
                                                                                                                                
Co-chair Green asked that the motion be temporarily tabled.                                                                     
                                                                                                                                
Co-Chair Wilken requested that the motion be withdrawn.                                                                         
                                                                                                                                
Senator Bunde WITHDREW the motion to adopt Amendment #2; however,                                                               
he asked that the amendment be discussed.                                                                                       
                                                                                                                                
DOUGLAS BRUCE, Director,  Division of Public Health,  Department of                                                             
Health and Social  Services stated that this amendment  would allow                                                             
the Department  to develop a program,  similar to its  tuberculosis                                                             
program, to address a possible outbreak of Sudden Acute Respiratory                                                             
Syndrome (SARS) or other issues  that might require quarantines. He                                                             
stated that the amendment would additionally provide the Department                                                             
with the  authority to address  the particulars  of the disease  as                                                             
they differ from those of tuberculosis.                                                                                         
                                                                                                                                
Co-Chair  Wilken  clarified  that  this amendment  would  affect  a                                                             
different section  of the bill than the medical parole  issue does,                                                             
and in addition, he stated, it would require a title change.                                                                    
                                                                                                                                
Senator  Hoffman asked  the potential  for a SARS  outbreak in  the                                                             
State.                                                                                                                          
                                                                                                                                
DR. BETH  FUNK, Epidemiology  Section, Division  of Public  Health,                                                             
Department   of  Health   and   Social  Services,   testified   via                                                             
teleconference from an offnet site  in Anchorage and specified that                                                             
this amendment would provide the  State with the ability to develop                                                             
a program  to specifically  address  the particulars  of SARS.  She                                                             
noted  that  the  State  has  observed  the  various  international                                                             
reactions  to SARS outbreaks  and has determined  that the  regions                                                             
that moved quickly to test and  quarantine suspected outbreaks have                                                             
been the most successful in disease  control. She stated that while                                                             
most  people  voluntarily  comply  with  quarantine  requests,  the                                                             
State's  lack  of  enforcement  capability   might  hinder  disease                                                             
control.                                                                                                                        
                                                                                                                                
Dr.  Funk  informed   that  the  incubation  period   for  SARS  is                                                             
approximately two to ten days. She stated that this timeframe could                                                             
provide the opportunity for SARS  to be introduced to the State due                                                             
to the  fact that  Alaskans travel  so much  and that national  and                                                             
international travel is so "rapid."                                                                                             
                                                                                                                                
Senator Taylor  questioned why one  specific infectious  illness is                                                             
addressed in  this amendment, as he  suggested that a  more generic                                                             
approach  should be presented  to allow  the Department to  address                                                             
infectious illnesses as deemed necessary.                                                                                       
                                                                                                                                
Dr.  Bruce agreed  "that  more general  powers"  would be  welcome;                                                             
however, he stated that this is the initial step of a long process.                                                             
                                                                                                                                
Senator Taylor voiced support for the overall Department objective.                                                             
However;  he stated that  previous legislative  attempts to  change                                                             
regulations  to address a medical  outbreak, specifically  acquired                                                             
immunodeficiency  syndrome  (AIDS),  were unsuccessful;  partly  he                                                             
noted,  due to a  lack of cooperation  from  the medical field.  He                                                             
avowed that he has "no problem  with this amendment," but he voiced                                                             
"strong concern ? with the inability of the Department to react" to                                                             
medical emergencies  because of  "political sensibilities,"  rather                                                             
than "the appropriate medical response."                                                                                        
                                                                                                                                
Co-Chair Green questioned  whether this concern could  be addressed                                                             
in current Public  Health regulations, as specified  on page 267 of                                                             
the Alaska Statutes, Year 2002, Volume 5, that read as follow.                                                                  
                                                                                                                                
     Section 18.05.040 Regulations (a) The commissioner shall adopt                                                             
     regulations   consistent  with   existing  law  for   (1)  the                                                             
     definition,  reporting,  and  control  of diseases  of  public                                                             
     health significance" should  provide the Commissioner with the                                                             
     authority to address major health issues.                                                                                  
                                                                                                                                
Mr. Bruce responded  that this amendment would address  the concern                                                             
that  this  regulation   does  not  provide  the  Department   with                                                             
sufficient ability to quarantine individuals.                                                                                   
                                                                                                                                
Co-chair  Green suggested  that the  language could  be amended  to                                                             
include SARS under the tuberculosis program authority.                                                                          
                                                                                                                                
Mr. Bruce voiced  support for the establishment of  a separate SARS                                                             
program, similar to that specified for tuberculosis, as he stressed                                                             
that the program  must contain language and procedures  specific to                                                             
SARS.                                                                                                                           
                                                                                                                                
Mr. Bruce  asserted that  this amendment  would provide an  interim                                                             
approach  to providing  the more  generic authority  that would  be                                                             
required.                                                                                                                       
                                                                                                                                
Co-Chair Green asked whether existing  State statutes, specifically                                                             
Title 26.  Military Affairs and  Veterans. would provide  the State                                                             
with the authority to make decisions regarding State disasters such                                                             
as an epidemic situation.                                                                                                       
                                                                                                                                
Mr. Bruce commented that "the Department  of Law has indicated that                                                             
they  would  be much  more  comfortable"  were  this  clarification                                                             
provided.                                                                                                                       
                                                                                                                                
Co-Chair  Green  agreed  with Senator  Taylor's  comment  that  the                                                             
amendment's language should be  generic as opposed to being crafted                                                             
to address  one specific virus. She  stated that she would  revisit                                                             
the language of the  amendment to provide a more generic  approach.                                                             
                                                                                                                                
Co-chair  Wilken  commented that  the  amendment would  be  further                                                             
revised.                                                                                                                        
                                                                                                                                
The bill was HELD in Committee.                                                                                                 
                                                                                                                                

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