Legislature(1997 - 1998)

01/31/1997 09:00 AM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
        SB  38 ANATOMICAL GIFTS,LIVING WILLS & DNR ORDER                      
  CHAIRMAN WILKEN  introduced  SSSB 38  as the final order of business         
 before the committee.                                                         
  SENATOR TAYLOR , Prime Sponsor of SSSB 38, said that SSSB 38 would           
 modify existing statutes regarding living wills and organ donors.             
 He explained that those provisions are found in different sections            
 and titles which creates some confusion.  Often hospitals and EMTs            
 do not know if a living will exists or if a person is an organ                
 donor.  Senator Taylor informed the committee that he had been to             
 a dinner at Providence Hospital in which statistics were revealed             
 indicating that living wills are being disregarded by care giving             
 institutions.  Much of the reason for that can be attributed to the           
 ineffective manner in which this information is communicated.                 
 Therefore, SSSB 38 would at least address those with driver's                 
 licenses.  The drivers' license would have a notice communicating             
 whether the person has a living will or is an organ donor or not.             
 Senator Taylor discussed statistics regarding the number of organ             
 donor recipients and those still waiting.  Anything facilitating              
 this process is necessary.                                                    
 Senator Taylor indicated that by adding this information to the               
 drivers' license, there could be a central depository at some                 
 point.  That notion is being reviewed as a possible amendment to              
 the legislation.  He discussed how a policeman can, in minutes,               
 access much information about a person from their license plate               
 number.  Senator Taylor expressed excitement with the possibility             
 that this same sort of system could be utilized by an EMT or                  
 hospital simply by using the driver's license in order to obtain              
 information regarding a living will or organ donation.                        
  TAPE 97-4, SIDE A                                                            
 Number 007                                                                    
 SENATOR TAYLOR    concluded by pointing out that if the statistics            
 from Providence Hospital are to be believed, there are many people            
 administering medical care in good faith to those who have                    
 specifications stating otherwise.                                             
  SENATOR GREEN  pointed out that SSSB 38 is before the committee, not         
 SB 38.                                                                        
  SENATOR ELLIS      asked Senator Taylor if he contemplated that there        
 would be a sticker indicating a living will on the license and if             
 no sticker was present, then   normal medical care would be given.            
   SENATOR TAYLOR      expressed concern with the sticker falling off.         
 Senator Taylor would like to place this information on the back of            
 the license before the license is laminated.  Perhaps, the entire             
 living will could be placed on the license so that when the license           
 was swiped the information would be available.    Before that can be          
 achieved, the care providers should at least be able to see an                
 indicator on a license which would prompt a call to a local                   
 dispatcher who can access the information.                                    
  SENATOR ELLIS  asked if there was any change in the nature of the            
 living will.   SENATOR TAYLOR  replied, no, and explained that now            
 the living will and organ donor application would be on the same              
  CHAIRMAN WILKEN  noted that he had just renewed his license and has          
 a sticker which he did not believe would come off.                            
  SENATOR TAYLOR  emphasized that this procedure will take a number of         
 years before it becomes effective on licenses due to the fact that            
 licenses are good for five years.                                             
  SENATOR ELLIS  asked if the bill required the DMV to talk to people          
 or have information in the mail-in for license renewals.   SENATOR            
 TAYLOR  believed that the DMV would ask a person if they have a               
 living will just as the DMV already asks if a person is interested            
 in being an organ donor.                                                      
  CHAIRMAN WILKEN  invited Mr. Anderson to give his testimony.                 
 Chairman Wilken also informed the committee that SSSB 38 would be             
 voted on Monday.                                                              
 Number 121                                                                    
  MATT ANDERSON , Emergency Medical Services Training Coordinator for          
 the Section of Community Health & Emergency Medical Services,                 
 informed the committee that he was involved in Alaska's Do Not                
 Resuscitate protocols.  As a result, he was in frequent contact               
 with EMS agencies, fire departments, and hospice organizations.               
 Therefore, SSSB 38 became of interest to Mr. Anderson.  Mr.                   
 Anderson identified the following two goals as the most important:            
 the visibility of the program and the ease with which on-scene                
 responders can identify those persons who have executed these                 
 provisions.  Mr. Anderson noted that DHSS would have to develop               
 symptoms and designs for cards and jewelry indicating a persons               
 participation in these procedures.  No national insignias have been           
 Mr. Anderson pointed out that with the development of these                   
 standardized designs, the public will expect there to be a system             
 in place to deal with the procedures.  Currently, the bill does not           
 address this aspect nor does DHSS' fiscal note.  Providing very               
 clear guidelines to the 4,000 licensed and certified emergency                
 responders is of major importance.  Mr. Anderson informed the                 
 committee that there is a Do Not Resuscitate (DNR) program in place           
 with a standardized insignia and requested that program be left in            
 place and only enhanced by this legislation.  Perhaps, this would             
 be an appropriate time to add language requiring the State Medical            
 Examiner's permission prior to the decedent's tissue and organs               
 being released for donation.  In conclusion, DHSS is in support of            
 the intent of SSSB 38.                                                        
 Number 174                                                                    
  JUANITA HENSLEY , Chief of Drivers Services for the Division of              
 Motor Vehicles, explained that when a person is at the DMV counter            
 to apply or renew a drivers' license the counter person is                    
 instructed by law to ask the individual if he/she would like to be            
 an organ donor.  If the individual wants to be an organ donor, a              
 card is signed by the individual and witnessed by the counter                 
 person and subsequently laminated.  The individual receives the               
 laminated card with his/her license and a sticker indicating the              
 individual is an organ donor is placed on the drivers' license.               
 Ms. Hensley informed the committee that the organ donor notation is           
 not placed inside the laminate of the drivers' license because the            
 DMV believes that a person can revoke the organ donor choice at any           
 time during the license period.  The living will identification               
 could be added to the card with the organ donor information.  Ms.             
 Hensley stated that this information cannot be placed on the back             
 of the license because there is not enough room.  Further, the                
 separate card allows the individual to retain the ability to revoke           
 a living will, a do not resuscitate order, and an organ donor                 
 With regards to the indicator on the system so that a dispatcher              
 would have access to this information, that could be programmed               
 into the system.  Ms. Hensley pointed out that if this information            
 is programmed into the system, then the individual would have to              
 contact DMV in order to revoke one or all of these specifications.            
 The DMV wants to keep people out of the office, therefore Ms.                 
 Hensley said that she would want to discuss that with the sponsor             
 in order to determine how to make the process viable.                         
 Number 224                                                                    
  SENATOR ELLIS  asked if a sticker on the license would still be              
 used.   JUANITA HENSLEY  explained that the sticker would still be            
 used indicating an organ donor and now there would be a sticker               
 indicating the presence of a living will.  Ms. Hensley reiterated             
 that there would be nothing added to the back of the license.  The            
 individual would receive a separate laminated card specifying an              
 organ donor, a living will and/or a do not resuscitate order.  The            
 individual could revoke these specifications at any time by                   
 destroying the card and the sticker, there is no need to contact              
 the DMV because there is no record of the specifications.                     
  SENATOR ELLIS  believed that the bill, as the sponsor statements             
 indicated, goes further than the second laminated card and the                
 stickers.   SENATOR TAYLOR  interjected that his previous comments            
 spoke to his hope for the future.  In response to Senator Ellis,              
  JUANITA HENSLEY  said that there would be no additional record               
 keeping required on the part of DMV under this legislation.  If the           
 desire is to have these specifications in a database, that would              
 require program changes and funding for those changes.                        
  SENATOR TAYLOR  inquired as to what happens to the separate laminate         
 card.   JUANITA HENSLEY  reiterated that the separate laminated card          
 is given to the individual to carry with their drivers' license.              
 There is no information on who is an organ donor at the DMV.                  
  SENATOR ELLIS  did not recall being informed of his ability to               
 revoke his designations; he thought that the DMV kept a record.               
  SENATOR TAYLOR  clarified that this legislation would merely add             
 another sticker on the front of the license with the separate                 
 laminated card.                                                               

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