Legislature(2017 - 2018)HOUSE FINANCE 519
04/12/2017 01:30 PM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB166 | |
| HB103 | |
| HB151 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 166 | TELECONFERENCED | |
| + | HB 151 | TELECONFERENCED | |
| += | HB 144 | TELECONFERENCED | |
| + | SB 51 | TELECONFERENCED | |
| + | HB 103 | TELECONFERENCED | |
| + | TELECONFERENCED |
HOUSE FINANCE COMMITTEE
April 12, 2017
2:35 p.m.
2:35:58 PM
CALL TO ORDER
Co-Chair Foster called the House Finance Committee meeting
to order at 2:35 p.m.
MEMBERS PRESENT
Representative Neal Foster, Co-Chair
Representative Paul Seaton, Co-Chair
Representative Les Gara, Vice-Chair
Representative Jason Grenn
Representative David Guttenberg
Representative Scott Kawasaki
Representative Dan Ortiz
Representative Lance Pruitt
Representative Steve Thompson
Representative Cathy Tilton
Representative Tammie Wilson
MEMBERS ABSENT
None
ALSO PRESENT
Representative Justin Parish, Sponsor; Katherine Eldemar,
Director, Division of Community and Regional Affairs; Lisa
Worl, Staff, Representative Justin Parish; Ms. Patience
Frederiksen, Director of Libraries, Archives, and Museums;
Representative Ivy Spohnholz, Sponsor; Dr. Paul Barney,
Doctor of Optometry; Joan Wilson, Assistant Attorney
General, Department of Law; Laura Chartier, Staff,
Representative Gara; Christy Lawton, Director, Office of
Children's Services, Department of Health and Social
Services; Representative Andy Josephson.
PRESENT VIA TELECONFERENCE
Sheila Wyne, Sheila Wyne Studios, Anchorage; Eva Malvich,
AVCP, Bethel; Bethany Follett, City of Wasilla/Wasilla
Museum and Visitor Center, Wasilla; Patricia Relay, Museums
of Alaska, Valdez; Angela Linn, Museums of Alaska,
Fairbanks; David Zumbro, Self, Anchorage; Dr. Janey Carl
Rosen, Self, Anchorage; Dr. Kelly Lorenz, Self, Anchorage;
Dr. Andrew Peter, Self, Homer; Dr. Jill Matheson, Self,
Juneau; Dr. Kurt Heitman, American Academy of
Ophthalmology, South Carolina; David Karpik, Self, Kenai;
Jeff Gonnason, Chair, Alaska Optometry Association,
Anchorage; Dr. Griff Steiner, Self, Anchorage; Rosalie
Rein, Self, Fairbanks; Amanda Metivier, Facing Foster Care
in Alaska, Anchorage; Marna Sanford, Tanana Chiefs
Conference, Fairbanks; Trevor Storres, Alaska Children's
Trust, Anchorage; Paul D. Kendall, Self, Anchorage; Byron
Charles, Self, Ketchikan.
SUMMARY
HB 103 OPTOMETRY & OPTOMETRISTS
HB 103 was HEARD and HELD in committee for
further consideration.
HB 166 MUSEUM CONSTRUCTION GRANT PROGRAM
HB 166 was HEARD and HELD in committee for
further consideration.
HB 151 DHSS;CINA; FOSTER CARE; CHILD PROTECTION
HB 151 was HEARD and HELD in committee for
further consideration.
Co-Chair Foster reviewed the agenda for the meeting. He
intended to hear the introduction of the three scheduled
bills, take public testimony, and ask for amendments. He
would set the bills aside. They would be brought up again
in the future.
HOUSE BILL NO. 166
"An Act establishing a museum construction grant
program in the Department of Commerce, Community, and
Economic Development."
2:37:16 PM
REPRESENTATIVE JUSTIN PARISH, SPONSOR, explained that HB
166 created a matching grant program. He read the sponsor
statement:
House Bill 166 establishes a matching grant program in
the Department of Commerce, Community and Economic
Development, for eligible museum construction,
expansion or major renovation projects.
Museums are eligible for this program if they are
located in Alaska, entitled to receive state grants,
and provide matching funds from other sources of at
least 50 percent of the project costs.
Alaska has more than 60 museums throughout the state
that provide cultural, tourism, and educational
programs. Alaska museums receive 380,993 annual
visitors and they serve 29,469 school children each
year. Alaskan communities are enriched with the art,
history, and cultural language and education provided
at the museums. The approval of this bill will enable
museums to access and leverage funding so that they
may improve, expand or upgrade as needed, when funds
are appropriated. Included with the bill documents you
will find twenty-three letters of support from nine
different Alaskan museums, four regional or statewide
museums organizations and Senator Bishop.
The award is subject to appropriation and cannot
exceed more than 50 percent of the total proposed
project costs. HB 166 is a companion bill for SB 7,
Sponsors: Stevens, Bishop, Stedman and Egan.
Representative Parish was happy to answer any questions.
Co-Chair Foster read the list of available testifiers.
Vice-Chair Gara thought the bill was straightforward. He
referred to Page 2, line 1 in subsection C. He thought the
subsection read that the state could only grant an amount
that was 50 percent of the grant amount. He suggested that
it would be half of the grant amount rather than 50/50. He
surmised that the maker of the amendment intended the
amount to be up to 50 percent of the cost of the project.
Representative Parish relayed that he had put grant project
together. He thanked Vice-Chair Gara for his observation.
He would be happy to work out a change.
Vice-Chair Gara was happy to be corrected. Clarification
could be provided at the next hearing. Representative
Parish thought there was someone available who could
clarify the language.
Representative Wilson was aware of one [grant] for
libraries. However, she did not believe it dealt with major
renovation and construction. She thought it applied to a
new library based on the community size. She asked if the
library grant encompassed a major renovation and expansion.
Representative Parish would field the question to someone
more familiar with the program. He would leave his staff to
answer any remaining questions.
2:42:50 PM
KATHERINE ELDEMAR, DIRECTOR, DIVISION OF COMMUNITY AND
REGIONAL AFFAIRS, introduced herself.
Representative Wilson suggested there was a similar program
for libraries based on population. She was under the
impression the program covered the cost of building a new
library. She wondered if the bills were similar. Ms.
Eldemar responded that she would have to research the
statute. She offered that there was never any funding to
the library program through other venues. She continued
that no applications were funded through the library
statute.
Representative Wilson thought she was incorrect. She
indicated that North Slope had a new library and it went
through a program. She was uncertain of the details. Ms.
Eldemar referred to two statutes. She referenced
AS.14.56.355 pertaining to a public construction and major
expansion matching grant program. She explained that there
was not an appropriation from the legislature under the
statute. She furthered that funding was granted under AS
37.05.315 - not through the library grant statute.
Representative Wilson commented that was the project she
thought was being funded. She asked about the definition
for major renovation but did not see one for expansion. She
wondered about the size of the expansion. Ms. Eldemar would
get back to the committee with an answer.
Representative Guttenberg wondered about a structure for
establishing a systematic approach to prioritizing museum
capital funding requests in the state. He did not see
anything in the bill outlining prioritization except for
major renovations. He was concerned with the definition of
a major renovation. He did not see anything that
prioritized one thing over another. He asked if the
amendment was only setting up a fund.
Ms. Eldemar pointed to HB 166 on Page 1, Line 10-11. She
read from the bill:
The department may not accept an application for a
grant under this section unless the legislature makes
an appropriation for the grant program.
Ms. Eldemar explained that it was put in procedurally
because previously there were many applications submitted
to the division for the library program. They were scored
and given a number. Typically, the grant was awarded based
on the score. Unfortunately, there was no appropriation.
The division had gone through the process of creating
regulations and reviewing and scoring the applications.
However, the grant was never funded. Subsequently, funding
was provided through the other statute she cited.
Representative Guttenberg remarked that the bill would
establish a new section on museum construction, expansion,
and major renovation. He did not see a reference to scoring
or prioritization of grant applications. He asked if a
scoring system like the previous one would be used. Ms.
Eldemar replied that if the bill became law, the division
would not accept applications until funding was in place.
Then, the division would start the process of putting
together regulations, which would take about a year. Once
the regulations were in place, the division would begin
processing applications. The division would not take any
action until appropriations were made. Criteria and
procedures would be established through regulations.
2:48:55 PM
Representative Guttenberg referred to information provided
in member packets. There was a variety of museums,
including the Tanana Valley Railroad Association. Some of
them were private, public, and non-profit. He asked which
entities would qualify for a grant. He asked if the Museum
of the North would qualify for a grant or if a privately
funded aviation museum would qualify. Ms. Eldemar responded
that if the bill became law, the division would start by
creating regulations. She would have to wait to see an
application to verify whether it was complete, whether it
satisfied requirements, or whether it was deficient in some
way. She would not know until she saw an application or
started the process.
Representative Guttenberg thought it was good that she was
not getting too far ahead. However, he suggested that it
would be nice to know in advance of passing legislation
where the line stood. He wondered, for instance, if a mom
and pop dime store museum on the corner, the downtown
Anchorage museum, a city-owned museum, or a university
museum would qualify. He could wait for an answer after the
meeting.
2:50:56 PM
Representative Kawasaki clarified that the division would
not be creating regulations that would specify certain
things until the legislation was passed and money was
appropriated. Ms. Eldemar indicated that the details would
come through regulations and that there would be
opportunity for public comment.
Representative Kawasaki wondered if the legislature needed
to place the criteria and eligibility in the bill to narrow
the scope. He wondered what kinds of museums the state
wanted to support. He asked her to comment about museum
funds being granted to places without museums versus places
that already had large museums. He thought that communities
without museums versus those that did would have priority.
LISA WORL, STAFF, REPRESENTATIVE JUSTIN PARISH, asked
Representative Kawasaki to repeat his policy question.
Representative Kawasaki asked about new museum construction
and whether it should be imbedded within the eligibility
criteria as laid out in statute. He wondered if places that
did not have museums would be a priority over those
communities that already had museums. He asked if it was a
priority of the bill sponsor. Ms. Worl responded that
Representative Parish had received 23 letters of support
for a host of different types of museums already
established that held many different public cultural items.
She encouraged members to invite a person from the city
museum who was involved in the bill drafting who could
respond.
2:54:48 PM
Representative Thompson wanted to clarify that the bill
would set up a fund for the legislature to deposit money
and entities could make application. He wondered if the
legislature could make a direct grant to a museum that
would not require a match. He mentioned an atmospheric
control. Ms. Eldemar responded affirmatively.
Representative Pruitt asked about the other programs
already in place. He wondered why there was a proposal to
institute a new program. He inquired whether the
legislature should be getting rid of other programs. Ms.
Worl responded that the last one was written specifically
for libraries and the current one applied to museums. She
continued that when the bill was drafted it took the form
of the proposal brought to the representative. She could
provide clarification as to the reason for a separate
account.
Representative Pruitt asked if it was an appropriate time
to be discussing additional capital funds for museums. He
mentioned the House of Representatives recently having a
massive debate on the floor about taking the Permanent
Fund. He thought it was more important for the state to
maintain what it already had. Ms. Worl agreed with his
comments about money being short. The point of the bill was
to set the mechanism in place when there were funds
available for museums.
2:58:41 PM
Representative Tilton asked if there was a listing of
current museums throughout the state. Ms. Worl indicated
Patience Fredrickson was on the line from the Archives
Library and Museum. She offered to get back with
Representative Tilton with an answer if Ms. Frederickson
was not online.
Co-Chair Foster OPENED PUBLIC TESTIMONY on HB 166.
SHEILA WYNE, SHEILA WYNE STUDIOS, ANCHORAGE (via
teleconference), spoke in support of HB 166. She mentioned
the success of her art studio. She had artwork in the
permanent collections of four museums in the state. She
opined that it was critical for businesses like hers that
museum institutions had access to programs that allowed for
construction, expansion, and major renovations to keep up
with advances in technology, the tourist industry, and
trade. These museum programs and collections were magnets
that attracted new and repeating clients. The quality was
critical to local economies. She provided a personal
experience as a designer for a performance event at the
Anchorage Museum. The budget for the event $185,000 of
which $160,000 came from sources outside of Alaska. There
were 5,000 attendees. Several businesses benefitted from
the event. She thought museum institutions were critical to
communities, artists, and businesses. The museum
construction matching grants will help with their mission.
She encouraged support for the bill.
3:02:54 PM
EVA MALVICH, AVCP, BETHEL (via teleconference), spoke in
favor of HB 166. She was the director and curator for the
Yupiit Piciryarait Museum and a tribal member of the native
village of Mekoryuk (A co-owner of the museum). She
mentioned a fire that burned the museum in 1980. It took 14
years from the time it burned to open the cultural center
and open the collection to the public. She reminded members
that the museum had not been able to be filled until 1967,
the 100th year anniversary of the sale of Alaska. The state
matched $2500 supplied by the community of Bethel, which
was used to purchase lumber. However, the money ran out for
the project. She noted that it would soon be the 150th
anniversary of the sale of Alaska. It had been a long time
since the museum was given an opportunity to ask for
funding. She provided more information about the museum and
its benefits. She spoke of a grant that would provide the
museum with a desperately needed HVAC system. There had
been several missed opportunities to house exhibits due to
a non-functioning HVAC system. She provided examples of
exhibits that had been damaged due to environmental factors
and spoke about the expense of replacing the system. HB 166
would help immensely.
Co-Chair Foster noted that Patience Frederickson was
available online.
3:10:02 PM
BETHANY FOLLETT, CITY OF WASILLA/WASILLA MUSEUM AND VISITOR
CENTER, WASILLA (via teleconference), reported increased
interest in local and state history. She spoke about the
community programs offered at the museum that infused
history and culture into a learning experience. She also
mentioned other activities housed there. She believed HB
166 was critical to the city's museum buildings and
programming and provided details about the current museum
structure. It was bursting at the seams. She advocated that
the museum needed more space and an update to its
technology. Many libraries and museums had different and
specific needs for providing services to the public. She
opined that HB 166 provided the framework for Alaskans to
support state museums and to preserve Alaska's heritage.
3:12:58 PM
PATRICIA RELAY, MUSEUMS OF ALASKA, VALDEZ (via
teleconference), had heard her colleagues share about the
needs of their museums. She clarified the definition of a
museum. A museum was an institution, whether public or
private or in partnership that conserved and preserved and
interpreted the collection of artifacts and objects of
artistic, cultural, historical, and scientific importance
making them available to the public as permanent or
temporary exhibits. Museums served the public by preserving
cultural heritage. Museums were facing critical
infrastructure issues (She read from a prepared statement):
I am contacting you today to thank you for your
support of HB166, establishing a museum construction
grant program and companion bill SB7. Research shows
that almost half of all museums in the state are
either currently involved in a construction project or
will be in the next five years. That is incredible.
This bill provides the structure for establishing a
systematic approach to prioritizing museum capital
project funding requests in the state.
Museums and cultural organizations in Alaska are a
critical part of the educational and economic
infrastructure, spurring tourism and partnering with
schools to teach the local curriculum. They contribute
to our economy and wellbeing by:
• Employing over 260 Alaskans;
• Spend over $23,553,294. annually in the State;
• Host over 624,695 visitors annually; and
• Server over 36,290 school children annually.
Despite this vital role of museums, our facilities and
collections are at risk through decreasing federal,
local and charitable giving. As collections grow and
visitation increases, the pressure on our aging
infrastructure must be managed. The Valdez Museum &
Historical Archive is no stranger to this dilemma. The
Valdez Museum & Historical Archive has accomplished a
lot within the past few years: incorporating a
successful expanded range of public programming, major
upgrades to several exhibits, increasing its
visitation, and raising its standards of collection
management. Despite these achievements, the
institution is now at a point in which its progress is
being hampered by limitations of space. In order to
maintain and improve its standards of professionalism,
and to preserve its vision for the future, the
organization needs to move away from its current
environment of shared-purpose space and move towards a
facility with dedicated space designed for single
use functionality.
At the core of our mission is education. Over the
years we have had numerous teachers share their
gratitude for how the Valdez Museum supports their
work. Recently, Sheri Beck, a 4th grade teacher with
the Valdez City Schools shared with our Museum
Educator,
"I just returned from a National Social Studies
Convention in New Orleans. I thought of you so
many times and wished we could be brainstorming
side by side! I was also reminded how fortunate
we are in Valdez and in my partnership with you,
to have our local museum available for help and
support. Thankyou! Your recent lesson with my
students using artifacts and primary sources was
such a wonderful example of what we heard at the
conference as stellar teaching."
Without the proper care and housing or the Museum's
collections we would not be able to offer robust
education programs.
Thank you for sponsoring HB 166 and supporting SB 7,
establishing a museum construction grant program, so
that museums throughout the state of Alaska may
continue to serve their communities. Help us make
these bills a reality and speak up for Alaska's
museums!
3:18:24 PM
ANGELA LINN, MUSEUMS OF ALASKA, FAIRBANKS (via
teleconference), reported having worked in Alaska for over
22 years, 20 of which she was the Senior Collections
Manager of Ethnology and History at the University of
Alaska, Museum of the North in Fairbanks. According to the
Alaska Travel Industry Association, over 2 million visitors
were coming to Alaska every year generating over $100
million in state revenues and $83 million in municipal
revenues through taxes and other fees. Alaska museums
provided a major draw for visitors. According to the
American Alliance of Museums, 76 percent of all leisure
travelers participated in cultural or heritage activities
such as visiting museums. These travelers spent 60 percent
more on average than other leisure travelers. Fairbanks had
museums that specialized in and featured the unique stories
of the indigenous people. She reported that there was a
museum that featured planes, trains, and automobiles that
have helped in building Alaska in the modern period. Alaska
also had a children's museum where kids engaged in hands-on
learning. There were many others including a museum where
they were undertaking world-class research on collections
that spanned millions of years of biological diversity and
thousands of years of cultural traditions in the North. In
the current year, there was a significant increase in
tourism from Asian countries. Those visitors connected with
Alaska through its museums. She continued to discuss the
advantages of Alaska museums. She emphasized the need for
museum construction and renovations funding and encouraging
members to support HB 166.
Representative Guttenberg asked if Ms. Linn thought the
Museum of the North would be eligible under the grant. Ms.
Linn hoped so. She was uncertain about the university's
budgeting process. Her museum was a member of Museums
Alaska and a major part of the museum community. She hoped
her museum would be eligible for the funding.
Co-Chair Foster CLOSED Public Testimony on HB 166.
Representative Guttenberg asked if Ms. Frederiksen was
still online.
3:21:50 PM
MS. PATIENCE FREDERIKSEN, DIRECTOR OF LIBRARIES, ARCHIVES,
AND MUSEUMS, introduced herself.
Representative Guttenberg asked about the definition of
museums. He referred to Chapter 57 indicating that some of
the definitions and functions were not aligned with the
language of the bill. He thought the definitions needed to
be strengthened. He asked if she had looked at the bill and
whether it worked. Ms. Frederiksen responded that she had
not looked carefully at the bill, as it was under a
different department. She was happy to look at the bill,
review the definition of museum, and provide feedback.
Representative Guttenberg referred to Chapter 57 [A.S.
14.57] under designated cultural and historical
depositories. He wanted to make sure there were not
conflicts between what was in statute and the bill language
regarding a museum and funding. He wanted to make sure
things were aligned. Ms. Frederiksen asked if
Representative Guttenberg wanted her to talk to the
Division of Commerce. Representative Guttenberg responded,
"Okay. Alright. Thank you."
Co-Chair Foster announced amendments were due at 5:00 pm
Thursday, April 18, 2017.
Representative Wilson relayed that several questions had
been asked during the meeting. She wanted those questions
answered prior to having to submit amendments, as the
answers would be pertinent to the bill. She queried about a
timeframe.
Co-Chair Foster would take a brief at ease to inquire about
a timeline.
3:25:13 PM
AT EASE
3:26:32 PM
RECONVENED
Co-Chair Foster would not set a deadline for amendments
until he had a better idea of when answers might be
provided.
HB 166 was HEARD and HELD in committee for further
consideration.
HOUSE BILL NO. 103
"An Act relating to the practice of optometry."
3:27:21 PM
REPRESENTATIVE IVY SPOHNHOLZ, SPONSOR, read a prepared
statement:
HB 103 gives authority to the Board of Optometry to
regulate the practice of optometrists, much as is done
by doctors, nurses, midwives, chiropractors and
dentists. It ensures that the Board of Optometry will
have the opportunity to update their current and
continuing standards and scope of practice based on
the best evidence available.
The bill will not allow optometrists to provide
services outside of their scope of practice like
performing invasive surgeries which will continue to
be illegal.
What it will allow is for optometrists to utilize the
State of Alaska's rigorous regulatory process to
manage themselves just as doctors, nurses, midwives,
chiropractors and dentists do.
HB 103 allows our robust regulatory process to work.
The process for developing new regulations is public
and transparent, ensuring that any new regulations
will be fully vetted by the board, the public and the
Department of Law before it becomes regulation.
The Board of Optometry has a strong track record of
regulating itself. In fact, the Board has implemented
higher continuing education standards on the
profession than the Legislature has required in
statute which makes a strong case for why this board
is more than capable of regulating its own education
and practice. (Statute: 15 hours of continuing
education while optometrists have required themselves
to have 36 hours of continuing education.)
It is my hope that this bill will get the Legislature
out of the business of managing optometrists, so we
can focus on our efforts and energy on issues which do
require our attention and optometrists can get on with
the business of caring for Alaskan's eye health.
Co-Chair Foster invited Dr. Barney to the table. He
reviewed a list of other available testifiers.
DR. PAUL BARNEY, DOCTOR OF OPTOMETRY, introduced himself.
Representative Wilson had been asked for a definition of
surgery. She wondered if the doctor would have any issues
if a definition was added to the bill for further
clarification.
Representative Spohnholz responded that she had strongly
resisted adding a definition of surgery to the bill. She
was intentionally trying to move the discussion out of the
legislature's hands. She asserted that adding a definition
of surgery would keep the discussion in the hands of the
legislature. An invasive surgery was already not allowed in
statute. It was unclear what the scope of practice would be
for optometrists in 20 years, 30 years, or 40 years. She
provided an analogous situation. She suggested that when a
person went to the dentist 20 years previously the things a
hygienist did versus what a dentist did were very different
from what they did presently. For instance, currently, she
visited the dentist's office twice per year. She saw the
dentist at one visit and the hygienist at both. A hygienist
provided almost all her oral health needs with very little
consultation from her dentist, which 20 years ago would not
have been imaginable. She did not think the legislature
needed to be a part of such a conversation. She believed
that the conversation should be had between the health care
professionals and providers who were keeping on pace with
the standards of practice and educational standards. She
made the case that the definition did not belong in the
bill.
3:32:25 PM
Representative Wilson asked for the reference to the
definition of invasive surgery in statute. Representative
Spohnholz read the statute:
AS 08.72.273 Removal of foreign bodies.
A licensee may remove superficial foreign bodies from
the eye and its appendages. This section is not
intended to permit a licensee to perform invasive
surgery.
Representative Kawasaki referred to Section 3. He asked
about the removal of language regarding the applicant and
continuing education including eight hours for
pharmaceuticals and 7 hours for non-topical therapeutic
pharmaceutical agents. The language would be replaced with
language that required continuing education requirements as
prescribed by the board. He asked her to clarify whether
the goal was to reduce the number of hours or to allow the
board to determine the requirements. Dr. Barney replied
that 8 hours of pharmaceutical requirements were written
into statute a couple of decades prior. At the time the law
was written, most of the education did not deal with
pharmaceuticals. The legislature wanted to make certain
that pharmaceutical education was required. Currently, the
education available had changed dramatically. Most
encompassed pharmaceuticals and their applications. He
stated that the board was more likely to increase the
number of required hours of education rather than reduce
them.
Representative Kawasaki mentioned concerns about the board
overseeing the establishment of regulations for licensed
optometrists, as they could permit them to do things
outside of their scope of practice. He asked Dr. Barney to
address the issue. Representative Spohnholz relayed that
the primary concern of the opposition to the bill was that
the board would start authorizing practices well outside of
practitioners' education and expertise. There were similar
professional distinctions such as those between dentists
and oral surgeons. Dentists did not perform oral surgery,
and there was no major concern or outcry that they were
expanding their authority to do so. It was not within the
scope of their training and practice. She highlighted that
there was a rigorous process for drafting new regulations;
they were required to be drafted in partnership with the
Department of Law. The goal of the process was to to
reconcile any proposed regulations with existing statute.
The regulations were also thoroughly vetted and included
public input. She was confident that the Ophthalmologists
would be happy to participate in the same process. The
Department of Law would go through a more rigorous review
of the process following public comment. She was confident
that the Department of Law and the attorney general would
not allow for an expansion of the scope of practice beyond
that which optometrists were trained and had the necessary
expertise.
3:36:52 PM
Representative Kawasaki asked how a licensed optometrist
was regulated versus a hygienist. He wondered how
optometrists were qualified. Representative Spohnholz
deferred to Dr. Barney.
Dr. Barney responded that to be eligible for licensure, an
optometrist or student of optometry had to take a board
examination. The board process started when optometry
students were in school. A person had to take national
boards and pass all sections to be eligible to take the
state license test. For someone who graduated in 1980, for
example, the statutes had not changed significantly. There
had been a couple of scope-related bills that passed. Each
time there was a scope expansion in which continuing
education was required everyone had to get the training.
The credits were offered in accredited colleges of
optometry and had to be taken and successfully completed
before optometrists could conduct the expanded procedures.
The board would do something similar if HB 166 passed.
Representative Kawasaki spoke to the comment about a person
being licensed in 1970 versus presently. He mentioned
driver's licenses. His mom got her license in 1950 and did
not have to requalify for a license or take another test.
He wanted to ensure strict confines of performance. Dr.
Barney conveyed that continuing education was required on a
yearly basis. If anyone were to fall behind on that
requirement their license would be in jeopardy.
Representative Spohnholz added that in contrast with
Representative Kawasaki's mother's driver's license, which
she believed required a periodic update to maintain it, an
optometrist or another healthcare professional was required
to do continuing education to demonstrate that they were
keeping pace with the changing profession over time.
3:40:11 PM
Representative Wilson thought that the statute AS.08.72.273
did not define invasive surgery, rather, it discussed
foreign bodies. She was looking for the definition of
invasive surgery. Representative Spohnholz understood there
to be a definition. She had talked with the Department of
Law recently looking for the definition of invasive
surgery. The department indicated it would get the
definition of invasive surgery from the medical board. If
the medical board's standard was used, the invasive surgery
standard would be the same for dentistry, optometry,
podiatry, across professions for anyone wanting to use a
laser or knife to cut someone open. Representative Wilson
wanted to hear from the Department of Law.
JOAN WILSON, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW,
saw no definition for invasive surgery in statute. She
furthered the board would likely proceed to define
standards and practices, including eye surgery, in
regulations. A three-fold review process: the board would
draft regulations and a public notice stating that the
board was considering new regulations. The Department of
Law would then review the public notice to ensure the
adopting agency was identified, the statutory authority and
the statutes being implemented were identified, and
deadlines were set for comments. The department also made
sure that if an oral hearing was held, it was laid out
properly. The point was for due process and public input.
Co-Chair Seaton asked Representative Wilson to repeat her
questions. Representative Wilson wanted to know where the
definition could be found in statute. Representative
Spohnholz relayed that the definition was not in statute
but it was in regulations. She relayed that she had been
working on the bill with Harriette Milks, Assistant
Attorney General. Joan Wilson was pinch hitting while Ms.
Milks was unavailable.
Ms. Wilson would look up the medical regulation.
Co-Chair Seaton indicated there would be time to find the
definition, as there would be additional hearings on the
bill.
3:45:21 PM
Vice-Chair Gara liked the provision of the law that stated
that an optometrist could remove a foreign object from
someone's eye in case of an emergency. He asked what was in
Alaska law that prevented someone from doing Lasik surgery
compared to the laws of other states where optometrists
were able to conduct the procedure. Mr. Barney replied that
optometrists did not perform Lasik surgery in other states.
Co-Chair Seaton asked if Dr. Barney had a statement he
wanted to put on the record.
Mr. Barney read a prepared statement:
My name is Dr. Paul Barney, I am an optometrist and
the current chair of the Alaska Board of Examiners in
Optometry. I am also a past president of the Alaska
Optometric Association. I live and practice in
Anchorage and have done so for the past 17 years. I'm
here today in support of HB-103.
I support HB-103 because it will allow the Board of
Optometry to regulate the details of the practice of
Optometry, which is how Advanced Practice Nurses,
Dentists, and Medical Doctors are regulated in Alaska.
This legislation will not set a new precedence in
health ca re, nor will it be a risk to Alaskans since
this is already the way other health care providers
are successfully regulated in Alaska.
HB-103 will give Optometrists better opportunity to
practice to the highest level of their education by
allowing the Board of Optometry to write regulations
that are commensurate with educational advances that
occur with new technology. The current Optometry
statute was written over 40 years ago and requires
Optometry to pursue a statute change whenever there
are advances in education and technology. As you know,
statute changes are costly and time consuming.
You'll hear arguments against this legislation stating
that it will be dangerous to allow Optometrists to
regulate themselves. But like all other professional
regulatory boards, the Board of Optometry cannot
promulgate regulations for practices or procedures
that are beyond the education of Optometrists. The
Board of Optometry is overseen by the AK Department of
Law, just like other health care boards, and the AK
Department of Law would ensure that the Board of
Optometry's regulations were within the scope of
Optometric education.
Other safeguards are our medical legal system and
insurance system. Any healthcare provider who provides
care outside of their education is subject to
disciplinary action by their respective board, as well
as serious medical legal ramifications. Additionally,
insurance carriers do not pay providers for care that
they provide outside of their scope of education. As a
result, there is no incentive for any healthcare
provider to provide care outside of their education,
and, there are very serious consequences, both
financially and to their licensure, to practitioners
who do provide care outside of their education.
As chair of the Alaska Board of Optometry, I can
assure you that the primary concern of the Board is
the safety of the public. In the six years that I have
served on the Board we have had no complaints from the
public that were serious enough to even consider
disciplinary action.
Optometrists are conservative and cautious
practitioners and the passage of HB-103 would not
change their conservative nature.
I would also like to share with you how I practice.
I'm the Center Director of Pacific Cataract and Laser
Institute in Anchorage. Our practice is a referral
only practice and we specialize• in cataract care,
laser vision correction, and medical consultative
services. I work with an ophthalmologist and a nurse
anesthetist. We all practice to the highest level that
statutes will allow and by doing so, as a team we ca n
provide high quality, more affordable care to Alaska
ns. I have a very good relationship with the
ophthalmologist that I work with, but if I were to
provide ca re that is outside of my education it would
not only jeopardize my relationship with the
ophthalmologist but it would also undermine a n
already very successful practice.
Optometry provides over 70% of the eye care in the
U.S. In some rural areas of Alaska, Optometrists are
the only eye care provider in the community. HB-103
would be good for the state of Alaska, the bill puts
the regulatory details regarding the practice of
Optometry in the authority of the Alaska Board of
Optometry. These changes are important to allow the
profession and practice of Optometry to incorporate
new technologies and advances in eye care as they
occur. The citizens of Alaska deserve to be served by
a profession that is allowed to stay current with
advances in education and new technologies in eye
care. I respectfully urge you to support HB-103.
3:50:52 PM
DAVID ZUMBRO, SELF, ANCHORAGE (via teleconference), was an
eye physician and surgeon in Anchorage and was a partner
with Alaska Retina Consultants. He strongly opposed the
legislation. He indicated that the legislation was not a
simple house cleaning bill. Rather, it radically redefined
a profession. Although the bill seemed innocent and safe
and, as written, would allow non-physicians and non-
surgeons to determine what medical and surgical treatments
could be done to an eye. He believed it was special
interest legislation. It was not safe for patients. He
wondered where the public outcry was for the legislation.
He asked for proof that current practice regulations
adversely affected Alaska patients and the Alaska
optometrists. It had been stated that the bill was not
about surgery and that no surgeries would be done for which
optometrists were not trained. He was worried about
surgery. He relayed that a local optometrist told him that
when the bill was first crafted that optometrists wanted to
perform intraocular injections of medications currently
performed by retina physicians. The current bill removed
all previous regulations preventing injections. He wondered
why regulations would be removed that prevented injections.
He suggested that there were many bills in many states that
would allow optometrists to advance their scope of practice
into lasers and surgery. As a result, several states had
adopted definition of surgery language in their statutes.
Alaska could do the same thing. He opined that the bill was
about advancing the optometric scope of practice into the
practice of medicine for which they did not have training.
He used to teach ophthalmology residents when he was active
duty in the US military. One of the most difficult things
to impart to young physicians in training was when to take
a step back and not do something. He spoke of the
Hippocratic Oath which all medical physicians took
requiring them to do no harm. The surgical maturity to sit
back and observe a patient did not happen overnight. It
took many months of direct supervision and guidance by
qualified and experienced physicians. The field of
optometry did not have such a type of training background
when it came to procedures and lasers. They were not
trained in any ophthalmic procedures, lasers, or surgeries.
He had no problem with the Board of Optometry regulating
the Optometry profession in the practice of optometry.
However, if the bill became law optometrists would be
regulating themselves in the practice of ophthalmology. As
an ophthalmologist he felt he had a say in the issue. The
regulation would be without any physician or surgeon
oversight, without any training or experience or
background, and he had concerns about patient safety and
its dangers. He thanked the committee.
Co-Chair Seaton asked how many ophthalmologists were in
Alaska. Dr. Zumbro responded that there were approximately
26.
Vice-Chair Gara agreed with not wanting optometrists to
perform surgery. The doctor prior had indicated there was
no intention of optometrists doing surgery. He asked Dr.
Zumbo if he agreed that in other states optometrists did
not perform Lasik surgery. Dr. Zumbro agreed that
optometrists did not do Lasik surgery in the United States.
3:55:32 PM
DR. JANEY CARL ROSEN, SELF, ANCHORAGE (via teleconference),
was a Doctor of Ophthalmology, specifically an
oculoplastics surgeon and neuro-ophthalmologist which meant
he was an eyelid surgeon and worked with neurology and
neuro surgery. He took care of bumps and cysts on eyelids.
He provided more information on his professional
background. He had heard repeatedly the bill was not about
surgery, optometry had no business doing surgery, and
optometrists did not want to do surgery. The sponsor had
said the bill was not about surgery and her aide had stated
that all surgery language was removed from the bill. He had
heard that as time changed the scope of practice should be
modernized by the optometry board and should a surgical
procedure be deemed within the scope of practice by the
board they did not want to come back to the legislature.
The assistant attorney general previously stated that
public testimony would help decide if a surgery was
appropriate for an optometrist. He wondered if members were
bothered by those statements. He suggested that not only
would no one have actual surgical experience on the board
and the legislature would ask the public for help. He
thought asking an expert with actual experience was more
appropriate. He reviewed several examples of problems from
botched surgeries. Dental boards and nurse practitioner
boards policed themselves because they learned procedures
in graduate school. Optometry students did not perform
surgery, lasers, or injections on real people. He did not
believe an 8-hour class was enough training. He was asking
folks to wake up and consider what was being proposed. He
read from the Journal of the American Medical Association
about a study done in Oklahoma where they performed laser
surgeries. He believed the legislation was racing towards a
slippery slope. He thought there should be more public
outcry.
3:59:06 PM
DR. KELLY LORENZ, SELF, ANCHORAGE (via teleconference), was
a board-certified Ophthalmologist and strongly opposed HB
103. She believed the bill was an unprecedented expansion
of practice. The legislation would allow for limitless
surgical procedures without any defined training in
surgical techniques. She indicated that she had met
patients that had been told by their optometrist that there
was only one cataract surgeon that came to Alaska. The bill
did not have the best interest of Alaskans in mind and
there was no public outcry for it. She spoke of the
importance of having a skilled professional with years of
training under the supervision of an experienced preceptor.
She read statistics from a medical journal about a recent
study regarding laser procedures in Oklahoma and the fact
that optometrists had repeated the laser more than twice as
much as ophthalmologists. She thought it was also essential
to have the ability to manage the inevitable complications
that arose from laser and traditional surgery. She brought
up other serious issues members should consider before
signing what she considered to be a blank slate. She
advised members to be cautious and to demand specifics. She
urged members to oppose the bill in its current form.
4:01:41 PM
DR. ANDREW PETER, SELF, HOMER (via teleconference), was an
optometrist from Homer and asked members to support HB 103.
He relayed a list of services he provided. He mentioned
that the clinic's daily schedule could accommodate 4 to 6
urgent care patients. It was common for the appointments to
be fully utilized. He spoke to the challenges of living in
rural Alaska. He quoted some statistics concerning the
number of optometrists and ophthalmologists in the state.
He encouraged members to help optometrists be more nimble
and accessible. He thanked the committee and made himself
available for questions.
Representative Wilson thought the definition of surgery was
the key issue. She wondered if it would be something that
could be discussed. Dr. Peter responded that one of the
ophthalmologists had defined surgery as cutting, blading,
or altering tissue. Under that definition, tattoo artists
and tattoo removal specialists performed surgery. He
relayed that if a patient came in with a piece of metal in
their eye and he removed it, it would be considered
surgery. He provided other examples of potential surgeries.
He hoped the legislature could take itself out of the
business of managing optometry eyecare.
4:06:16 PM
DR. JILL MATHESON, SELF, JUNEAU (via teleconference), was
an optometrist in Juneau. She spoke of her previous
experience on the Board of Optometry. Over the previous 25
years she had testified numerous times before several
legislative committees in support of changes to the Alaska
optometry statute. Efforts had been successful due to the
level of trust legislators had given optometrists over time
and after sifting through testimony. She asked for member's
support in having the optometry board regulate
optometrists. The bill did not give any expansion of
privilege to optometrists. It allowed the optometry board
to decide what optometrists were trained and qualified to
do via the regulatory process of the board and within their
scope and training. She assumed that the members of the
state board were appointed and confirmed by the legislature
to do the same. There were separate boards because each
profession was unique. She suggested that only optometrists
knew what doctors of optometry were trained and qualified
to do. She was aware members were trying to figure out what
"fiscally responsible" looked like. The bill had been heard
by four committees multiple times. She suggested that if
the optometry board could regulate optometrists there would
still be a very public process via open public testimony.
Also, boards had to be self-sufficient. The bill allowed
the profession of optometry to evolve. She trusted the
appointed optometry board members to make any necessary
changes.
4:09:15 PM
DR. KURT HEITMAN, AMERICAN ACADEMY OF OPHTHALMOLOGY, SOUTH
CAROLINA (via teleconference), strongly opposed HB 103. He
remarked that the bill was a surgery bill. The bill made
two crucial changes to existing Alaska law. First, it
removed surgery restrictions already in existing law. It
also inserted a new definition of the word optometry in
Section 6 that included the words "treatment" and
"procedures". The insertion of the word treatment put no
limitations on the type of treatment. In other words, all
surgeries in the eye would be allowed under the law because
the Board of Optometry could define invasive surgery any
way they wanted. HB 103 allowed the board cart blanch
authority to redefine their field into a surgical field. He
had seen an example in North Carolina where optometrists
defined laser as non-invasive. He wondered why proponents
of the bill opposed the inclusion of language that clearly
specified that surgery was outside the scope of practice of
optometrists avoiding patient harm. Without specific
language restricting surgery, Alaska would be the first
state in the country to adopt such broad, unprecedented
legislation. There would be no restrictions of optometrists
being able to obtain surgical privilege. Optometrists
provided a valuable service to communities and were an
integral part of the eyecare team. However, they were not
medical doctors and did not graduate from a comprehensive
surgical residency. There were only three states that
allowed optometrists restricted surgical authority. The
first was Oklahoma. In Oklahoma, optometrists expanded
scope to include surgeries because of language in a bill
similar to HB 103. He continued to provide background
regarding Oklahoma law. He had reminded the board of an
incident at the Palo Alto VA hospital where veterans were
hardened because of poor glaucoma follow-up. Because of the
incident the VA strengthened its directives prohibiting
optometrists from performing laser procedures - the same
procedures that would be allowed by the current language in
HB 103. He disagreed that the bill was similar to other
bills governing professional boards such as nursing,
dentistry, or engineers. Unlike nursing and dentistry,
optometry school was not a medical or surgical education.
Optometrists received about 1900 hours of clinical
education in their 4-year training compared to 20,000 hours
that ophthalmologists received, about one-tenth the medical
education. He disagreed that the bill was about governing
boards. He continued to provide a comparison between
education received by optometrists and ophthalmologists. He
thanked committee members.
4:13:47 PM
DAVID KARPIK, SELF, KENAI (via teleconference), was a
Doctor of Optometry. He spoke in support of HB 103. He
provided information on his professional background. He
suggested that the optometrist might be the only doctor
that a patient had access to because of Alaska's wide
geographic distribution. He reported that a recent
publication ranked Alaska 50th in access to health care.
All health care providers should practice within the scope
of their training. He supported the legislation due to its
simplicity. It would replace the aging current optometry
law that needed updating. He asserted the delay in updating
the old optometry statute hindered access to eyecare and
increased Medicaid travel costs in the state. Other
prescribing professions such as dentistry and advanced
practice nurses were regulated by their state board. The
Board of Optometry ensured protection of the public and
timely updates of practice. He thanked members for their
support of the bill. He brought up the procedures that had
been performed for decades by optometrists in their offices
legally and safely in Alaska. He suggested that opposition
had not familiarized themselves with current law. Treatment
was an integral part of the profession. He thanked him for
his time.
Co-Chair Seaton asked if there was opposition to removing
laser surgery from the scope of practice. Dr. Karpik
responded that training and technology changed all the
time. He thought the purpose of the bill was a durable
statute that would stand the test of time like the state
constitution. He was in favor of the current statute
language in the bill.
4:18:44 PM
JEFF GONNASON, CHAIR, ALASKA OPTOMETRY ASSOCIATION,
ANCHORAGE (via teleconference), spoke in favor of HB 103.
He was born and raised in Ketchikan and Craig and was the
first Alaska Native optometrist. He practiced in Anchorage
and performed clinics in the villages when he was a young
man. He suggested that HB 103 did not authorize any
optometrist to do anything. He relayed that of the four
independent prescribing professions only optometry had been
treated unfairly for several years. The Alaska Optometry
Board deserved to receive the same level of trust as other
health care professions. He opined that the optometry board
would never authorize any practice outside the scope of
education and training. Doctors of Optometry were held to
the same standard of care as any medical provider treating
patients. Section 5 of HB 103 was clear on the topic. The
optometry practice definition in Section 6 was modeled
after the exact wording from the Alaska dental statutes.
Dr. Gonnason continued that two opposition arguments had
prevailed over the course of the previous 40 years. The
first argument was that optometrists were a danger to the
public. The second argument was that optometry education
was not adequate. He thought both arguments had been proven
to be untrue. Optometry education and training was
identical to the dentist model requiring 8 years to 10
years of university level education and residencies.
Optometrists were real doctors. He relayed that optometrist
had been prescribing medications for 25 years including
prescribing scheduled narcotics for the past 10 years with
no issues of harm. Alaska optometry supported limiting
opioid use. Optometrists were defined as physicians under
federal Medicare. There had never been a case of patient
harm before the state optometry board involving
prescriptions of treatment. Yet, over the past 40 years,
the opposition had testified predicting terrible harm that
never occurred.
Dr. Gonnason argued that the clinical education of
optometrists did not have to parallel that of an
ophthalmologist any more than the education of a family
physician having to parallel that of a neuro surgeon. He
commented that optometrists and ophthalmologists did very
little of the same things. Optometrists did not do any of
the advanced specialty surgeries done by subspecialists.
Rather, they did minor procedures in which they were
competent. He suggested that surgery would be difficult to
define in statute because technically anything that touched
human tissue was surgery. He provided examples of surgery.
He thought the definition should be in regulations rather
than in statute to avoid having to come back to the
legislature for changes. He pointed to a letter in member
packets from a VA hospital where an optometrist did laser
procedures with zero incidents of harm. He referred to an
Oklahoma study which he thought was flawed. He was
available for questions.
4:23:20 PM
DR. GRIFF STEINER, SELF, ANCHORAGE (via teleconference),
was an ophthalmologist in Anchorage. He read from a
prepared statement:
The ophthalmologists and others that oppose this bill
(HB103) in no way want to prevent optometrists from
practicing to the full extent of their specialty and
training. This boils down to whether they intend to do
surgery, which would truly be inappropriate.
The bill should not pass as it currently written.
If the optometrists want an autonomous board, but no
surgery, then a concise definition of surgery can
easily be added. If they oppose a definition of
surgery, it can only mean they want to perform
surgery. More than one optometrist has approached you
indicating a desire to do a type of laser called YAG
laser capsulotomy. They have not used these words,
because capsulotomy means to cut a hole in the
capsule. They instead have described this as "shining
a light in the eye to clear up some clouding." But,
the laser does not shine as it is invisible. The
invisible light needs a second laser "HeNe" beam
(Helium-neon) to focus the primary cutting laser. This
laser cuts a hole in the membrane that holds the lens
implant in place following cataract surgery (the
removal of the natural lens when is has become
cloudy). This is not a benign procedure, particularly
in those without proper surgical training. This laser
cuts a hole in a critical tissue in the eye and there
is no shining involved.
This is just one example, but is the first surgery
they intend to approve.
Ask them if they want to do surgery. It was not
appropriate.
Dr. Steiner was available for questions.
Representative Wilson clarified that optometrists did the
procedure currently. Dr. Steiner indicated that they did
not do the procedure in Alaska. He thought only one or two
states allowed it, Oklahoma and maybe Kentucky. He believed
that it would be the first procedure approved by the Board
of Optometrists. It was the type of procedure optometrists
would advance into - something they have not been trained
to do or have ever done.
Representative Wilson asked if additional training had been
offered in the two states he mentioned. Dr. Steiner was
aware that a weekend course was offered on how to do a
laser procedure. Following the training, optometrists were
approved by their boards.
4:27:57 PM
AT EASE
4:28:10 PM
RECONVENED
Co-Chair Foster CLOSED Public Testimony.
Co-Chair Foster relayed that amendments were due by Monday,
at 5:00 PM.
HB 103 was HEARD and HELD in committee for further
consideration.
4:28:35 PM
AT EASE
4:31:48 PM
RECONVENED
Co-Chair Foster indicated that he was going to change the
deadline for the amendments to HB 103. He relayed that they
were now due by Friday, April 14th by noon.
HOUSE BILL NO. 151
"An Act relating to the duties of the Department of
Health and Social Services; relating to training and
workload standards for employees of the Department of
Health and Social Services; relating to foster care
licensing; relating to placement of a child in need of
aid; relating to the rights and responsibilities of
foster parents; relating to subsidies for adoption or
guardianship of a child in need of aid; requiring the
Department of Health and Social Services to provide
information to a child or person released from the
department's custody; and providing for an effective
date."
Foster youth in Alaska are not getting the chances
they deserve. The Children Deserve a Loving Home Act
aims to increase the likelihood that foster youth will
have the same opportunities in life, and same health
and well-being, as their peers. When roughly 40% of
our foster youth end up homeless at some point in
their lives after leaving care, and roughly 20% end up
in jail, it's a call for reform. The nation's leading
foster care non-profit, Casey Family Programs, has the
correct goal to reduce the number of youth languishing
in foster care by 50% by 2020. Alaska should join that
effort. We should achieve it not by leaving youth in
neglect and abuse to keep our foster care numbers
down, but by getting neglected and abused youth out of
the foster care system, into a permanent, loving home,
much more quickly than we do now.
Many Alaskans recognize that our child welfare system
has room to improve; this bill seeks to make real
positive changes that support youth and families, as
well as the caseworkers who serve them. It's been well
documented by many sources that when case workers are
overworked, outcomes for children and families suffer.
The Office of Children's Services (OCS) recommends
standards of approximately 12 cases or families per
worker - but today, most caseworkers are carrying
caseloads that vastly exceed that amount (as high as
43 families in Wasilla, 36 in Homer, and 30 or more in
six of the state's main OCS offices). Conditions in
rural Alaska, especially the challenges of remote
travel, make even a 12-family caseload overwhelming
for workers in such regions. Beyond the risk of poorer
outcomes, high caseloads contribute to high worker
turnover, a costly problem that slows timelines to
permanency.
This bill seeks to improve both caseload levels and
worker retention by implementing significant new
training and workforce standards. New workers would
receive a minimum of six weeks of training and would
carry no more than six cases/families in the first
three months, and 12 families in the first six months.
These standards are recognized to improve outcomes,
enable faster timelines to permanency, and allow
caseworkers to perform their duties as intended.
In addition, this bill provides for a number of other
changes to support the well-being of youth in care,
and to promote quicker timelines for children
returning to, or finding new, permanent homes. The
bill extends subsidies for adoptions and guardianships
to age 21, to incentivize permanency and the closing
of cases, and promotes contact with siblings and with
previous out-of-home caregivers to promote the well-
being of children and maintain a network of support
for them. Another important tenet of this bill is
enacting timelines for waivers to licensing
requirements for relatives who may want to care for a
child, but are not licensed foster parents.
The bill also makes it easier for youth and foster
parents to engage in normal day-to-day activities,
such as going on vacation without prior caseworker
approval, with fewer requirements. In addition, youth
at age 14 are empowered to participate in their case
plan. This bill also strengthens the requirement to
search for relatives before placing a child with
foster parents, recognizing that placements with
family are often the best and most loving option for
youth.
Providing support, and a voice, for youth and families
who need our help is perhaps one of our most important
duties in public service. This bill seeks to give
caseworkers the tools they need to carry out their
duties to the best of their abilities, and it seeks to
support youth and families with provisions that
support well-being, make it easier for children to
move out of the system and into a permanent home more
quickly, and provide the necessary resources for a
system that can function well. This bill is intended
to create an environment where loving homes are the
priority for all youth.
4:32:35 PM
Co-Chair Seaton MOVED to ADOPT proposed committee
substitute for HB 151, Work Draft 30-LS0451\I (Glover,
4/17/17).
Representative Wilson OBJECTED for discussion.
REPRESENTATIVE LES GARA, SPONSOR, DISTRICT 20, introduced
himself.
LAURA CHARTIER, STAFF, REPRESENTATIVE GARA, would walk the
committee through the newest version of the bill, version
I.
4:33:52 PM
AT EASE
4:36:18 PM
RECONVENED
[Co-Chair Foster passed the gavel to Representative
Guttenberg]
Representative Gara indicated his staff would walk through
the committee substitute changes to the bill.
Ms. Chartier proceeded to explain that Section 1 provided a
short title. Section 2 reflected the main change made from
the previous committee substitute (CS) version. The section
provided for funding for adoptions and guardianships for
older youth. In the previous version of the bill it was
written in such a way that all youth who were adopted,
regardless of the age which they were adopted, would
receive subsidies for adoptions and guardianships up to age
21. The current draft specifies that those adoption and
guardianship subsidies would only apply only to youth ages
18 to 21. They were limiting it to the older youth
population, which was the original intent of the bill.
Also, the word "subsidy" was replaced with "stipend" to
differentiate from any federal language or federal
programs. She reiterated the most significant change from
the previous version of the bill was limiting those
adoption and guardianship subsidies to older youth, ages 18
through 21.
Representative Wilson asked if she was talking about
children who did not get adopted until they were 18. In
other words, if they were to get adopted at 18 they would
have the subsidy from 18 to 21 years of age. Representative
Gara responded that the language would likely remove this
portion of the bill. Currently, the state would pay a daily
rate if a person adopted or was a guardian for a youth but
only until age 18. The problem was that there was youth who
were 18, 19, and 20 who did not have a permanent home. The
goal was to extend the subsidies to age 21. However,
federal law prohibited states from doing that for just 18,
19, and 20-year-old youths. If a person was adopted at age
1 they would receive the subsidy through age 21 even if
they did not need the incentive. It became a $7.4 million
fiscal note, something the state could not afford. It was
not the priority piece of the legislation. Instead, as a
work around, he suggested coming up with a state program in
which federal law would not be used for youth 18, 19, and
20. However, it created a perverse incentive so that if a
person was thinking about adopting a child at age 16 they
might wait until age 18 to get 3 years of subsidies. There
was no way to make the provision work and would likely be
removed.
Ms. Chartier continued to Section 3 which enabled contacts
with previous out-of-home caregivers. She relayed there
were 2 pieces of the bill that encouraged contact with
people who might be close to a youth in their life and one
of them was a previous out-of-home care giver. Section 4
required that a supervisor had to certify in writing at
different times in the foster care process that a search
for relatives had been carried out. She relayed that what
was being added was that a supervisor had to certify in
writing at different points in the foster care placement
process that a search for relatives had been carried out.
In other words, a supervisor would literally sign off that
such a search had been carried out. Section 5 of the bill
included language on what was called a prudent parent
standard. It was language to make it easier for foster
parents to make day-to-day decisions involving a child's
activities. Section 6 engaged youth who were 14 and older
in their case planning process, something adopted from
federal language like the prudent parent standard.
4:40:41 PM
Representative Wilson was not aware of case plans for
adults. She wondered if there was a case plan for children.
Representative Gara responded in the negative. He explained
that youths 14 or older did not have the right to designate
certain people to be part of their case planning. Youth
over 14 years old would be able to nominate up to 2 extra
people important to them to be part of their case planning
team.
Representative Wilson asked if it was a different type of
plan than that of their parents. She agreed youth should
have a say on where they were going. She was trying to
figure out if there were two kinds of case plans.
Representative Gara indicated it was a hybrid case. The
case would involve both the interest of the child and the
parents. He believed the child had a right to have a say in
their future. In Section 6 it stated that a youth age 14
and older should be able to have a say in those involved in
their case plan. The change would allow for up to 2 other
people to be included in the case planning process.
Representative Wilson expressed confusion. She relayed that
she was only familiar with the way the case plans were run
where a parent had to attend a parenting class, get a
psychological evaluation, and follow an evaluation.
Hopefully, if a parent followed the plan, they would be
reunified with their child. If they chose not to
participate, it could result in adoption. She was trying to
better understand the section. She wondered if a child
would be able to request where they wanted to go.
Representative Gara responded affirmatively. He stated that
the early case plan that had to be filed within the first
60 days was to figure out if the child would be able to
return to their parents and what the parents would have to
do to get their child back. After the first 60 days, there
was still a case plan for a child. The Office of Children's
Services (OCS) could provide more information about the
later stages of the case plan.
Representative Wilson agreed with the concept. She just was
trying to figure out the mechanics. Representative Gara
responded that it was the same case plan. He was hopeful
that the result would be reunification early on.
4:45:26 PM
Representative Thompson mentioned that earlier in the
conversation the bill sponsor referred to a child over 14.
He heard the representative clarify that it applied to 14
years or older.
Ms. Chartier continued with Section 7. The section included
the language to promote contact between siblings. It
allowed for OCS to share contact information for siblings
if it was in the best interest of both parties involved.
Section 8 and 9 had a provision requiring a certification
that a search for relatives had been carried out. It
changed throughout the statute. In Section 10 there was a
minor change to statutory language replacing the phrase,
"One parent" with "Adult family member." She continued with
Section 11 was another mention about sibling contact
provisions. The main change in the bill could be found in
Section 12. The change reflected the implementation of new
training and workload standards for staff. She was sure
Representative Gara would discuss the information in more
detail. Essentially, it extended training for new workers
up to 6 weeks and lowered their caseloads. Workers in their
first 3 months would have 6 cases. Workers in their first 6
months would have a caseload of 12. There was a very minor
language change to the section from the previous version of
the bill. She referred to page 10 at the top of the page.
It clarified the staff that was covered by the section of
the bill. It was a small change to the language to make
sure all the staff would be covered under the training and
workload standards. She continued to Section 13 that
encouraged assistance with family members obtaining
variances to foster care licensing. If an adult family
member did not necessarily want to go through the typical
licensing process they could obtain a variance. Section 14
outlined that youth leaving care would be provided with
official documents or receive assistance in obtaining their
official documents. The bill contained a list of specific
documents that were covered. Section 15 implemented a
timeline for decisions to be made on applications for
foster care home licensing or on variances to that
licensing. They were not changing the process of applying
but adding a timeline for a decision to be made either way
within 45 days. Section 16 and 17 related to the
applicability of the act. In the final section, Section 18
on the timeline. In version N of the bill the training
standards were to be implemented in the first year and in
year 2 there would be enough staffing to meet the new
caseload standard. Version I pushed out the staffing to
year 3. The department would have 3 full years to meet the
staffing requirement. There were a couple of additional
provisions to be implemented in year 1 including the
involvement of children 14 years old and older in their
case planning and the prudent parent standard as well as
the certification of relative searches.
Alternate-Chair Guttenberg referred to Section 13. He asked
Representative Gara to speak to assisting a family member
and attaining a license or any variances.
4:50:04 PM
Representative Gara replied that it was a complicated
process. Sometimes there was a family that was not a foster
parent. He explained that there were 2 types of foster
parents - relatives and out-of-home caregivers. Relatives
did not need a license. There was a category of people who
might not receive the daily reimbursement rate. In rural
areas, especially in areas where there was little
caseworker contact, the application process was complex. He
hoped the bill would fix the caseworker contact issue. The
provision stated that an out-of-home caregiver should be
helped in the application process.
Representative Wilson asked whether Section 13 would
require family members to be certified or whether they
would be able to get help if they wanted to be certified.
She thought Representative Gara was responding
affirmatively, as his head was nodding up and down.
[Representative Gara nodded his head]. She also asked what
would prevent a family member from getting any funding
without being certified. Representative Gara deferred to
OCS for the answer.
Alternate-Chair Guttenberg asked if there were other items
Representative Gara wanted to discuss. Representative Gara
responded that he had reviewed all the changes from the
version that passed the Health and Social Services
Committee to the CS. It would be up to the committee to
adopt the CS, then he could explain the bill.
Representative Wilson WITHDREW her OBJECTION.
There being NO OBJECTION, the CS for HB 151 was ADOPTED.
Representative Pruitt commented that obviously Health and
Social Services (HSS) had reviewed the bill, yet there was
a CS. He wondered why some of the changes had not been
identified in the subcommittee process. Representative Gara
conveyed that the bill was his bill rather than a HSS bill.
However, he had worked with the department as much as
possible. The largest change was that there was a handful
of youth, ages 18, 19, and 20 who he wanted to see get into
an adoptive home or into a permanent guardianship. He
thought it would be great to be able to offer a subsidy to
families that could not afford to take children in. He
reported not being able to find a workable and affordable
way to do so. The big change came when he saw the $8
million fiscal note. He realized that by covering 18-year-
old children, the state would have to cover 1-year-old, 2-
year-old, and 3-year-old children as well which would be
too costly. He was unable to find an affordable way to do
it.
Representative Pruitt confirmed that because of the fiscal
note and the bill being heard in the House Finance
Committee, the section was pulled out along with the fiscal
note. Representative Gara relayed that the fiscal note came
out late in the HSS committee process. He indicated that
when he saw it he promised the committee he would fix or
get rid of it.
4:54:28 PM
Alternate-Chair Guttenberg OPENED Public Testimony for HB
151.
Representative Gara indicated Ms. Metivier and Ms. Rein
were online and could provide expert testimony. He asked if
they could elaborate on the bill.
4:55:07 PM
ROSALIE REIN, SELF, FAIRBANKS (via teleconference), was a
licensed social worker on the front lines of OCS. She
highlighted 2 components of HB 151 that were particularly
helpful in improving relationships between workers and the
families they served: training and caseloads. She reported
that caseloads were directly tied to the worker being in
contact with the children and families on a regular basis.
She had heard over 5 hours of testimony at a townhall
meeting held in Fairbanks. One of the main concerns raised
by parents was a lack of communication with their workers.
She could not adequately express the responsibilities of
caseworkers. There were not enough hours in a day to keep
good communication with invested parties. Many workers used
nights and weekends to respond to the most urgent phone
calls yet did not have time to do high level social work.
She explained that high level social work encompassed
fostering connections between siblings in separate homes
and diligent relative searches. She spoke to the advantages
of making these connections. Actual social work was about
educating the parties of the importance of providing each
child with a network of support. She reviewed the time-
consuming grunt work it took to facilitate connections. She
saw HB 151 as an opportunity to ensure that caseworkers had
the training they needed to develop a skill set specific to
child protection and to learn how to foster resiliency. She
reviewed research that suggested that caseworkers who had
social work education and appropriate training were better
able to facilitate permanency. Higher caseloads and the
high rate of frontline staff turnover was a growing problem
within OCS. She favored the caseload cap in HB 151 and
reviewed the consequences of staff turnover and the
associated domino effect.
Representative Gara indicated he had to attend another
meeting. His staff would remain available for questions.
4:59:15 PM
AMANDA METIVIER, FACING FOSTER CARE IN ALASKA, ANCHORAGE
(via teleconference), spoke in support of HB 151. She
reported having been in foster care for 3 years and had
aged out of the system. She had been a licensed foster
parent for the previous 10 years to teenagers within OCS.
She highlighted a few things in the bill that were
recommended by youth in the foster care system presently.
Identifying relatives promoted kinship placement for
children. The bill added a provision that an OCS supervisor
had to certify that a relative search had been conducted.
By doing this early on it avoided the risk of having to
pull a child away from a foster parent they bonded with
because of a grandmother coming forward. Sibling contact
was a very important piece, as youth separated from their
siblings often experienced more trauma. Older siblings were
often caregivers to younger children. Being separated from
them felt like having one's own child removed. The bill
promoted ongoing contact with siblings. For example, if a
young child was adopted while the sibling remained in the
system, they would have the right to have their sibling's
information, maintain contact through phone calls and
social media, and have in-person visits to continue their
relationship. She has had contact with countless young
people who had been split up from their siblings in the
system. She shared a story about a child who had seen her
brother on the bus but had not spoken to him because she no
longer knew him. She continued that another large piece of
the bill dealt with older youth potentially being involved
with their case planning. It was about engaging older
youth, 14 and older, in the development and ongoing process
of their case plan. For young people 14 and older, they
should be at court hearings and attending team meetings.
The bill would give them the option of inviting 2 people to
be advocates on their behalf at meetings and to be a voice
for them. She suggested that young people engaged in their
plan were more likely to follow through and be onboard. She
mentioned the idea of normalcy, which came from the federal
language around the reasonable and prudent parent standard.
It would allow foster parents to do things like sign a
permission slip for a field trip. She provided an
additional example. The largest piece of the legislation
was the training and workload standards and burnout. She
provided an example.
5:04:30 PM
MARNA SANFORD, TANANA CHIEFS CONFERENCE, FAIRBANKS (via
teleconference), testified in favor of HB 151. She
expressed excitement about the bill. She highlighted a
provision related to youths remaining in state custody
until the age of 21. She supported the provision. She
stated that foster children were not allowed to do many
things such as attend sleepovers. She spoke about extremely
high caseloads for social workers in Alaska. She understood
state expenditures were under the gun, but she assured the
committee the bill was a good investment.
5:07:29 PM
TREVOR STORRES, ALASKA CHILDREN'S TRUST, ANCHORAGE (via
teleconference), testified in strong support of HB 151. He
remarked that the most valuable resource in the state was
its children. Events such as child abuse and neglect had
great impacts on brain and social development. It created
more trauma for a child when OCS had to remove them from
their home. He spoke to ensuring that the system did not
hamper the treatment of trauma or add more trauma to a
child's life. He suggested that due to high caseloads and
the lack of training at OCS it was difficult to maintain
assurances. The bill ensured that OCS had appropriate
caseloads and training to provide the needed support for
children in the system. The things case workers dealt with
were difficult to manage with very high caseloads (2,3, or
4 times the national average). He discussed high staff
turnover rates. He spoke to additional benefits of the
legislation.
5:09:57 PM
PAUL D. KENDALL, SELF, ANCHORAGE (via teleconference), did
not have a position on the bill. He spoke to several items
unrelated to HB 151. He wondered if any of the children
were borderline babies or illegal aliens. He referred to
money paid monthly to foster parents. He continued to relay
testimony unrelated to the bill.
5:14:07 PM
BYRON CHARLES, SELF, KETCHIKAN (via teleconference),
relayed a personal experience where he witnessed a child
being told a GED was not enough. He did not understand why
the legislature could not make a right decision. He
advocated careful background checks and careful monitoring.
He thought the system was too cumbersome. He spoke of
having college students work with children.
Alternate-Chair Guttenberg CLOSED Public Testimony for HB
151.
Alternate Chair Guttenberg reported that amendments for HB
151 were due in the chairman's office by 5:00 PM Friday,
April 14, 2017.
5:17:27 PM
Representative Wilson asked for a moment to talk to the
department about a case plan and a 14-year-old.
CHRISTY LAWTON, DIRECTOR, OFFICE OF CHILDREN'S SERVICES,
DEPARTMENT OF HEALTH AND SOCIAL SERVICES, introduced
herself.
Representative Wilson was unclear about children
participating in their own case plan. She asked about a
child that was 14 years old or older attending the team
decision making with the parents underneath the case plan
for the parents or another type of case plan. Ms. Lawton
responded that every child was provided a case plan when
they came into care in addition to their parents.
Representative Wilson wondered if the children would
participate in team decision making with their parents, or
just their own plan with 2 adults of their choice. Ms.
Lawton responded that typically team decision making
meetings were not about case planning. She believed the
provision of the bill was that when they were having a
meeting about case planning and talking about permanency or
services for youth that were 14 or older they could bring
in adult supports. Currently, they should be including
children in the discussion about their case planning
development as age appropriate. The Office of Children's
Services did that in various forms including home visits
and various means.
Representative Wilson asked if there were 2 separate
meetings. Ms. Lawton believed the intent of the sponsor on
the specific language was about a meeting for the child. It
might be possible that the parent would be there and
sometimes older youth participated in team decision making
meetings with their parents when they were discussing
placement. The preferred practice was for older youth to be
engaged in all the meetings as appropriate.
Representative Wilson asked if a case plan was written for
the parent. She had never known a child to be involved in
case plan meetings, as they were more about the parents
following through. She asked if there were currently older
children involved in the parents' case plan. Ms. Lawton
responded that typically a child did not participate in a
case plan meeting. However, she heard the representative
using the term "team decision making meetings" which were
different.
Representative Wilson would have a big problem with
children suddenly being in with their parents because it
could cause a significant amount of misunderstanding. She
did not have a problem if the child was having a meeting
separate from the one their parents had. She did not have a
problem with 2 separate meetings. Ms. Lawton responded,
"Correct."
Alternate-Chair Guttenberg reviewed the agenda for the
following day.
HB 151 was HEARD and HELD in committee for further
consideration.
ADJOURNMENT
5:21:25 PM
The meeting was adjourned at 5:21 p.m.