Legislature(1997 - 1998)
01/31/1997 09:00 AM HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= 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 form. 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 identified. 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 notification. 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.