Legislature(2005 - 2006)BUTROVICH 205

04/13/2005 02:00 PM HEALTH, EDUCATION & SOCIAL SERVICES


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02:17:38 PM Start
02:18:08 PM SB125
02:52:12 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Note Time Change --
+= SB 125 LICENSING MEDICAL OR CARE FACILITIES TELECONFERENCED
Moved CSSB 125(HES) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
          SB 125-LICENSING MEDICAL OR CARE FACILITIES                                                                       
                                                                                                                              
CHAIR FRED DYSON  announced SB 125 to be up  for consideration at                                                               
2:18:08 PM.  He recapped that  two amendments were  proposed last                                                             
week,  but were  not adopted  and  the committee  had prepared  a                                                               
substitute with them in it.                                                                                                     
                                                                                                                                
SENATOR GREEN moved to adopt CSSB 125, version G, and objected                                                                  
for the purposes of discussion.                                                                                                 
                                                                                                                                
2:19:23 PM                                                                                                                    
DR. MANDSAGER,  Director, Division  of Public  Health, Department                                                               
of Health and Social Services  (DHSS), explained that most of the                                                               
amendments incorporated  into the  CS relate to  renumbering. But                                                               
he  recommended withdrawing  one  of the  substantive changes  on                                                               
page  33, lines  22  ["includes a  facility  that performs  basic                                                               
diagnostic and  therapeutic services"]  that he had  proposed. It                                                               
was  too  broad  and  would   give  doctors  the  impression  the                                                               
department  would   be  regulating  into  their   offices.  Other                                                               
entities could be added in  the future if the Legislature decided                                                               
they  should be  licensed.   However,  he  recommended using  the                                                               
effective date of 2006.                                                                                                         
                                                                                                                                
The  other  element  that  was  talked about  last  time  was  in                                                               
response  to   the  Alaska  State   Hospital  and   Nursing  Home                                                               
Association (ASHNHA) comments about  if the department takes over                                                               
operation of  an entity that  the department licenses  because of                                                               
an immediate risk to clients,  that decision should be taken with                                                               
the  commissioner's involvement.  New language  on page  29, line                                                               
20, states:                                                                                                                     
                                                                                                                                
     The  department   may  not   take  action   unless  the                                                                    
     commissioner  has  reasonable  cause  to  believe  that                                                                    
     continue management  by the  entity would  be injurious                                                                    
     to  the  health,  safety   or  welfare  of  individuals                                                                    
     receiving services from them.                                                                                              
                                                                                                                                
2:23:24 PM                                                                                                                    
DR. MANDSAGER  said one  other change corrected  an error  in the                                                               
hearing  section,  AS  47.32.160,  on page  30,  lines  30-31  by                                                               
removing "not"  and it  now reads: "AS  44.64.060 applies  to the                                                               
hearing."                                                                                                                       
                                                                                                                                
SENATORS WILKEN and OLSON arrived at 2:23:52 PM.                                                                              
                                                                                                                                
SENATOR GREEN  removed her objection  and CSSB  125(HES), version                                                               
G, was adopted.                                                                                                                 
                                                                                                                                
SENATOR GREEN  moved to adopt  Amendment 1 to CSSB  125(HES) that                                                               
deleted  lines 22  and  23  on page  33  as  per Dr.  Mandsager's                                                               
suggestion and to renumber accordingly.  There were no objections                                                               
and Amendment 1 was adopted.                                                                                                    
                                                                                                                                
2:25:49 PM                                                                                                                    
CHAIR  DYSON noted  that he  had received  an Attorney  General's                                                               
opinion  on background  checks and  registry  in other  databases                                                               
stating  that  the state  has  no  right  to interfere  with  the                                                               
practice of abortion by a licensed practitioner.                                                                                
                                                                                                                                
DR. MANDSAGER  replied that this  document addressed a  number of                                                               
questions asked by both the House and Senate on that issue.                                                                     
                                                                                                                                
STACIE  KRALY, Assistant  Attorney  General,  said the  provision                                                               
referenced  AS  18.16.010(a)(2) that  says  an  abortion must  be                                                               
performed  in a  hospital  or  an approved  facility,  but it  is                                                               
unenforceable  with respect  to  first  trimester abortions.  The                                                               
Attorney General's letter opines that  is still his opinion after                                                               
subsequent Alaska Supreme Court decisions.                                                                                      
                                                                                                                                
CHAIR DYSON  said there is  no way  to verify that  the abortions                                                               
performed in those  facilities were done in  the first trimester.                                                               
"It's self reporting."                                                                                                          
                                                                                                                                
DR.  MANDSAGER reported  that abortions  are  being performed  in                                                               
licensed  facilities,  but  he does  license  ambulatory  surgery                                                               
centers for abortions  and he will continue to make  sure that is                                                               
done appropriately.                                                                                                             
                                                                                                                                
CHAIR  DYSON asked  if ambulatory  service centers  don't perform                                                               
abortions unless they  are licensed by his department  to do that                                                               
specifically.                                                                                                                   
                                                                                                                                
DR. MANDSAGER replied that is the case.                                                                                         
                                                                                                                                
SENATOR ELTON  asked if  other people who  have direct  access to                                                               
clients in licensed facilitates have  to be fingerprinted if that                                                               
access is unsupervised.                                                                                                         
                                                                                                                                
DR.  MANDSAGER  replied that  he  thought  they should  add  that                                                               
regulations should be developed  stating that the only volunteers                                                               
this   should  include   would  be   those  who   have  "regular"                                                               
unsupervised direct access to clients.                                                                                          
                                                                                                                                
SENATOR GREEN  moved to adopt  Amendment 1 to CSSB  125(HES) that                                                               
would change  the title and  clarify possession language  on page                                                               
4, line 1.                                                                                                                      
                                                                                                                                
2:32:57 PM                                                                                                                    
CHAIR  DYSON explained  that the  amendment  would allow  someone                                                               
with an unloaded  firearm locked in the trunk of  his car to pick                                                               
up a  child at  a care  facility.  He  asked the  commissioner of                                                               
Department of  Health and  Social Services  (DHSS) to  comment on                                                               
whether  this amendment  would jeopardize  receiving any  federal                                                               
funding.                                                                                                                        
                                                                                                                                
JOEL GILBERTSON,  Commissioner, Department  of Health  and Social                                                               
Services (DHSS), said that he would look check in to it.                                                                        
                                                                                                                                
2:34:26 PM                                                                                                                    
SENATOR ELTON  objected saying that  he believes the  question of                                                               
whether  or not  the amendment  would jeopardize  federal funding                                                               
should be answered before the amendment is adopted.                                                                             
                                                                                                                                
SENATOR  OLSON  asked  if  the issue  of  federal  funding  would                                                               
influence his decision.                                                                                                         
                                                                                                                                
CHAIR DYSON asked  for a roll call vote.  Senators Wilken, Green,                                                               
Olson and  Chair Dyson  voted yea; Senator  Elton voted  nay; and                                                               
Amendment 1 was adopted.                                                                                                        
                                                                                                                                
2:37:09 PM                                                                                                                    
MIKE FORD,  Alaska Native Health  Board, said he  appreciated the                                                               
efforts of  the department  and thought they  would lead  to some                                                               
efficiencies. However, he was hoping  to work with the department                                                               
on some complexities the bill raises.   His board has two primary                                                               
concerns - that this bill  does not diminish nor disrupt services                                                               
provided in the bush.                                                                                                           
                                                                                                                                
CHAIR  DYSON   remarked  that   this  director   is  particularly                                                               
sensitive to these issues.                                                                                                      
                                                                                                                                
2:38:43 PM                                                                                                                    
MARTHA  ANDERSON,  Program  Manager, Child  Development  Program,                                                               
Municipality  of  Anchorage,  strongly urged  retaining  existing                                                               
language in  AS 47.32.030 that  allows municipalities  to request                                                               
the  state to  delegate municipalities  the authority  to license                                                               
facilities.   She  also urged  the committee  to retain  language                                                               
that clarifies the  process, which has been in  place since 1998,                                                               
of  the delegation  system. She  also  wanted section  (c) of  AS                                                               
47.35.010 retained, but moved to AS 47.32.030. It would say:                                                                    
                                                                                                                                
     The  department shall  within 90  days after  receiving                                                                    
     your  written  request  that it  do  so,  delegate  its                                                                    
     powers  relating to  child care  facilities under  this                                                                    
     chapter  to   a  municipality   that  has   adopted  by                                                                    
     ordinance  providing  for  child care  licensing  under                                                                    
     home rule  powers under AS  29.10.010 or  is authorized                                                                    
     under AS 29.35.200 - 29.35.210.                                                                                            
                                                                                                                                
And she strongly wanted the following language to be added:                                                                     
                                                                                                                                
     A  municipality   to  which  these  powers   have  been                                                                    
     delegated   may    adopt   by    ordinance   additional                                                                    
     requirements for childcare  facilities operating within                                                                    
     its boundaries  if the requirements meet  or exceed the                                                                    
     requirements adopted by the department.                                                                                    
                                                                                                                                
2:41:04 PM                                                                                                                    
MS.  ANDERSON  explained  that  she  is  concerned  that  if  the                                                               
language is not retained, the  department might exceed its powers                                                               
by   delegating  licensing   authority  to   municipalities.  She                                                               
explained that  her division was  first delegated  full licensing                                                               
responsibility  for  childcare  centers  in  1989  and  has  been                                                               
operating  under that  system until  when it  was delegated  full                                                               
authority to license  childcare homes in 2004. A  huge rewrite of                                                               
the division's code has just been finished to match state code.                                                                 
                                                                                                                                
2:43:31 PM                                                                                                                    
SENATOR ELTON commented  that he was concerned  that the registry                                                               
could be used  as a weapon by an employer  in a licensed facility                                                               
"to get that employee to go quietly."                                                                                           
                                                                                                                                
DR. MANDSAGER responded that the  only leveling activity he could                                                               
think  of is  if the  survey team  finds evidence  that employees                                                               
have been  performing abuse  or neglect  and the  provider hasn't                                                               
reported it  and in that case,  the employer would be  liable. He                                                               
said that  the registry only  contains incidents of abuse  and so                                                               
if  there  were no  abuse,  a  threat  to  place someone  on  the                                                               
registry would be an empty threat.                                                                                              
                                                                                                                                
2:49:16 PM                                                                                                                    
SENATOR GREEN  moved to pass  CS SB 125(HES) from  committee with                                                               
individual recommendations  and accompanying fiscal  notes. There                                                               
were no objections and it was so ordered.                                                                                       

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