Legislature(1997 - 1998)
03/31/1998 03:08 PM House HES
| Audio | Topic |
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL
SERVICES STANDING COMMITTEE
March 31, 1998
3:08 p.m.
MEMBERS PRESENT
Representative Con Bunde, Chairman
Representative Joe Green, Vice Chairman
Representative Brian Porter
Representative Fred Dyson
Representative J. Allen Kemplen
Representative Tom Brice
MEMBERS ABSENT
Representative Al Vezey
COMMITTEE CALENDAR
CONFIRMATION HEARINGS:
Board of Education
Bettye Davis - Anchorage
Mike Williams - Akiak
- CONFIRMATIONS ADVANCED
Alaska Mental Health Trust Authority Board of Trustees
Susan LaBelle, MSW - Anchorage
- CONFIRMATION ADVANCED
Professional Teaching Practices Commission
Georgia S. Cast - Bethel
Patricia E. Chitty - Nikolaevsk
Linda Connelly - Palmer
Judith Entwife - Juneau
- CONFIRMATIONS ADVANCED
State Commission for Human Rights
Christine R. Marasigan - Anchorage
James H. Chase - Anchorage
- CONFIRMATIONS ADVANCED
* HOUSE BILL NO. 270
"An Act relating to premarital relationship counseling; amending
Rule 9(e)(7), Administrative Rules of Court."
- HEARD AND HELD
* SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 372
"An Act placing limits on prescribing and providing a contraceptive
drug or device to a minor."
- HEARD AND HELD
* HOUSE BILL NO. 420
"An Act requiring that health care insurers offer certain coverage
for treatment of diabetes."
- SCHEDULED BUT NOT HEARD
* HOUSE JOINT RESOLUTION NO. 58
Proposing amendments to the Constitution of the State of Alaska
relating to the education fund.
- SCHEDULED BUT NOT HEARD
(* First public hearing)
PREVIOUS ACTION
BILL: HB 270
SHORT TITLE: REQUIRED PREMARITAL COUNSELING
SPONSOR(S): REPRESENTATIVES(S) KEMPLEN
Jrn-Date Jrn-Page Action
5/02/97 1467 (H) READ THE FIRST TIME - REFERRAL(S)
5/02/97 1467 (H) HES, JUDICIARY
3/31/98 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 372
SHORT TITLE: LIMITS ON CONTRACEPTIVES TO MINORS
SPONSOR(S): REPRESENTATIVES(S) DYSON
Jrn-Date Jrn-Page Action
1/30/98 2182 (H) READ THE FIRST TIME - REFERRAL(S)
1/30/98 2182 (H) HES, JUDICIARY
3/18/98 2647 (H) SPONSOR SUBSTITUTE
INTRODUCED-REFERRALS
3/18/98 2647 (H) READ THE FIRST TIME - REFERRAL(S)
3/18/98 2647 (H) HES, JUDICIARY
3/31/98 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
AL ZANGRI, Chief
Bureau of Vital Statistics
Department of Health and Social Services
P.O. Box 110675
Juneau, Alaska 99811-0675
Telephone: (907) 465-3392
POSITION STATEMENT: Testified in support on HB 270 as amended.
LISA TORKELSON, Legislative Assistant
to Representative Fred Dyson
Alaska State Legislature
Capitol Building, Room 428
Juneau, Alaska 99801-1182
Telephone: (907) 465-3467
POSITION STATEMENT: Testified on SSHB 372.
CYNTHIA BROOKE, M.D., Representative
American College of Obstetricians and Gynecologists
3340 Providence Drive, Number 454
Anchorage, Alaska 99508
Telephone: (907) 563-8588
POSITION STATEMENT: Testified in opposition to SSHB 372.
JANE CONARD
P.O. Box 2042
Bethel, Alaska 99559
Telephone: (907) 543-3629
POSITION STATEMENT: Testified in opposition to SSHB 372.
JENNIFER SCHMIDT
P.O. Box 82944
Fairbanks, Alaska 99708
Telephone: (907) 457-2312
POSITION STATEMENT: Testified in opposition to SSHB 372.
NANCY ROLLINS
P.O. Box 1492
Soldotna, Alaska 99669
Telephone: (907) 262-2622
POSITION STATEMENT: Testified in opposition to SSHB 372.
ANGELA MOEHRING
49301B Palmer-Wasilla Highway
Wasilla, Alaska 99654
Telephone: (907) 357-5559
POSITION STATEMENT: Testified on SSHB 372.
JO CAMPBELL
3701 Amalga Street
Juneau, Alaska 99801
Telephone: (907) 789-2080
POSITION STATEMENT: Testified in opposition to SSHB 372.
PATRICIA MARK, Representative
Anchorage American Civil Liberties Union
419 Barrow Street
Anchorage, Alaska 99507
Telephone: (907) 495-0044
POSITION STATEMENT: Testified on SSHB 372.
CYNTHIA MOEHRING
4930B Palmer Wasilla Highway
Wasilla, Alaska 99654
Telephone: (907) 373-5559
POSITION STATEMENT: Testified on SSHB 372.
KAREN PEARSON, Health Programs Manager
Division of Public Health
Department of Health and Social Services
P.O. Box 110610
Juneau, Alaska 99811-0610
Telephone: (907) 465-3090
POSITION STATEMENT: Testified on SSHB 372.
ROBIN SMITH
14100 Jarvi
Anchorage, Alaska 99515
Telephone: (907) 345-4407
POSITION STATEMENT: Testified on SSHB 372.
ANDREA ELLENSON
P.O. Box 877276
Wasilla, Alaska 99687
Telephone: (907) 376-2206
POSITION STATEMENT: Testified on SSHB 372.
PETER NAKAMURA, M.D., MPH, Director
Division of Public Health
Department of Health and Social Services
P.O. Box 110610
Juneau, Alaska 99811-0610
Telephone: (907) 465-3090
POSITION STATEMENT: Testified on SSHB 372.
LANA HENLEY
P.O. Box 3136
Palmer, Alaska 99645
Telephone: (907) 746-1327
POSITION STATEMENT: Testified on SSHB 372.
RON KREHER, Program Policy Analyst
Division of Public Assistance
Department of Health and Social Services
P.O. Box 110640
Juneau, Alaska 99811-0640
Telephone: (907) 465-2680
POSITION STATEMENT: Testified on SSHB 372.
BECCA BROWN
536 Park Street
Juneau, Alaska 99801
Telephone: (907) 586-1448
POSITION STATEMENT: Testified on SSHB 372.
ACTION NARRATIVE
TAPE 98-35, SIDE A
Number 0001
CHAIRMAN CON BUNDE called the House Health, Education and Social
Services Standing Committee meeting to order at 3:08 p.m. Members
present at the call to order were Representatives Bunde, Green,
Porter and Kemplen. Representatives Dyson and Brice arrived while
the meeting was in progress. Representative Vezey was absent.
Number 0115
CHAIRMAN BUNDE announced the first order of business to come before
the committee was confirmation hearings. Committee members had a
packet containing background information and recommendations for
each of the nominees; resumes of the nominees had been previously
distributed to committee members for their review. He announced
the committee would review the recommendations and forward them to
the full session of the House of Representatives. It does not
reflect the intent of any committee member to vote for or against
an individual in further legislative sessions for the purpose of
confirmation.
Board of Education
Number 0232
REPRESENTATIVE JOE GREEN made a motion to advance the slate of
nominees for the Board of Education. There being no objection, the
confirmations of Bettye Davis and Mike Williams were advanced from
the House Health, Education and Social Services Standing Committee.
Alaska Mental Health Trust Authority Board of Trustees
Number 0285
REPRESENTATIVE BRIAN PORTER made a motion to advance the name of
Susan LaBelle for the Alaska Mental Health Trust Authority Board of
Trustees. There being no objection, the confirmation of Susan
LaBelle was advanced from the House Health, Education and Social
Services Standing Committee.
Professional Teaching Practices Commission
Number 0313
REPRESENTATIVE FRED DYSON made a motion to advance the slate of
nominees for the Professional Teaching Practices Commission. There
being no objection, the confirmations of Georgia S. Cast, Patricia
E. Chitty, Linda Connelly and Judith Entwife were advanced from the
House Health, Education and Social Services Standing Committee.
State Commission for Human Rights
REPRESENTATIVE J. ALAN KEMPLEN made a motion to advance the slate
of nominees for the State Commission for Human Rights. There being
no objection, the confirmations of Christine R. Marasigan and James
H. Chase were advanced from the House Health, Education and Social
Services Standing Committee.
HB 270 - REQUIRED PREMARITAL COUNSELING
Number 0453
CHAIRMAN BUNDE announced the committee would next hear HB 270, "An
Act relating to premarital relationship counseling; amending
Rule 9(e)(7), Administrative Rules of Court." He asked
Representative Kemplen to introduce his bill.
Number 0478
REPRESENTATIVE KEMPLEN said HB 270 is an attempt to address one of
the fundamental problems of society in terms of broken families and
it provides an economic incentive for people contemplating holy
matrimony to engage in premarital counseling. He directed the
committee's attention to the background information in committee
packets; specifically, the study, "Predicting Marital Satisfaction
Using PREPARE: A Replication Study" showing a correlation between
premarital counseling and the success of the marriage. An excerpt
from Policy Review indicates that of the 100,000 couples per year
that complete PREPARE, a premarital inventory developed by Lutheran
psychologist David Olson, a questionnaire can predict with 85
percent accuracy who will divorce. It's a good indicator of
whether or not two people who are contemplating the marriage
commitment are compatible. It allows the couple to discuss key
issues and to determine how to address those key issues during
their relationship.
REPRESENTATIVE KEMPLEN explained HB 270 is fairly simple and it
establishes an incentive for marriage applicants in Alaska to
attend a minimum of four hours of relationship counseling. The
marriage license fee for couples attending the counseling is $25
and $300 for couples who have not met the minimum of four hours
counseling. He explained HB 270 does not mandate the counseling;
it provides an economic incentive for couples to participate in
relationship counseling prior to marriage.
Number 0701
CHAIRMAN BUNDE wondered if the $300 fee would discourage marriage
for people in lower income levels in some areas of the state.
REPRESENTATIVE KEMPLEN believes it would serve as an incentive for
couples to attend the premarital counseling.
CHAIRMAN BUNDE asked what the anticipated cost was for the
premarital counseling.
REPRESENTATIVE KEMPLEN said counseling done through a social worker
is anticipated to cost about $275, whereas if counseling is done
through a tribal elder or through a church, it would be easier and
less expensive.
Number 0755
REPRESENTATIVE GREEN confirmed, "So if I know a couple who decides
they don't want the counseling, their fee is $300 and they can go
ahead and do their thing. If they want to save some bucks and they
go to a minister who has sent off two boxtops and a $20 bill and
he's considered a minister by four people that go to his church,
does that negate the $275?"
Number 0890
REPRESENTATIVE KEMPLEN said it was a possibility based on the
definition of "counselor" in subsection (d) of HB 270.
Number 0830
REPRESENTATIVE GREEN expressed concern this may be kind of a
"limited entry to a license to steal" in that several years ago
ministers were declared nonprofit so they didn't have to pay the
tax rate, and suddenly everyone was sending away for certificates
declaring them to be a minister. His concern was that HB 270 would
set up a situation whereby these "ministers" would advertise their
services as a way for people to save $275.
Number 0890
REPRESENTATIVE KEMPLEN noted he had an amendment he would like to
introduce at some point.
Number 0920
REPRESENTATIVE TOM BRICE made a motion to adopt Amendment 1 which
reads:
Page 1, line 5, following (b)
Delete all through line 9
Insert "A surcharge of $275.00 shall apply to
the fee for all marriage license applications
unless the applicants submit acceptable
evidence of having received at least 4 hours
of relationship counseling. Acceptable
evidence of such counseling shall be a
certificate attesting under oath or
affirmation of the counselor and the parties
that the parties have completed at least 4
hours of relationship counseling in the six
months immediately preceding application for a
marriage license."
CHAIRMAN BUNDE objected for discussion purposes.
REPRESENTATIVE KEMPLEN explained the department had expressed
concern with getting locked into a $25 fee in statute and
Amendment 1 allows the flexibility to change the fee without having
to introduce legislation.
REPRESENTATIVE GREEN asked if it was Representative Kemplen's
intention that the remaining language in (b), as it exists, would
follow the language in Amendment 1.
REPRESENTATIVE KEMPLEN pointed out the language in (b) is replaced
by Amendment 1.
CHAIRMAN BUNDE removed his objection and asked if there was further
objection to Amendment 1. Hearing none, Amendment 1 was adopted.
CHAIRMAN BUNDE asked Al Zangri to come before the committee to
present his remarks at this time.
Number 1000
AL ZANGRI, Chief, Bureau of Vital Statistics, Department of Health
and Social Services, testified in support of HB 270 as amended. It
is the department's belief that some revenue can actually be
generated from this legislation and is attempting to find
additional studies and literature that discuss the effect of this
legislation. In response to Representative Green's question
regarding the impact and effectiveness of this legislation as
written, individuals will certainly be able to get around it;
however, in order for that to happen someone will have to commit
fraud certifying the 4 hours of counseling have been fulfilled. On
the other hand, he believed counseling sessions from a minister
would be of great help to individuals before making a commitment.
He pointed out that most of the ministers in Juneau require a
counseling session of at least a full day prior to performing a
marriage.
Number 1000
REPRESENTATIVE GREEN asked if the department has found in its
statistical review there are in fact, charlatans claiming to be
ministers.
MR. ZANGRI said he was certain those situations do exist, but the
department has no way of knowing how many exist because there is no
licensing provision.
CHAIRMAN BUNDE said, "I would guess there wouldn't be any financial
gain there if it was just somebody that wanted to fight the state
or the system, but if you can get free counseling or very
inexpensive counseling from a legitimate - I use the word (indisc.)
ministers ...."
REPRESENTATIVE GREEN said he was in favor of the counseling
session; he believed that too many people rush into marriage and
don't consider certain things.
CHAIRMAN BUNDE asked if there were further questions or additional
testimony on HB 270.
Number 1178
REPRESENTATIVE FRED DYSON asked if Representative Kemplen had had
any discussions with Representative Kelly regarding his covenant
marriage bill and how these two pieces of legislation might fit
together.
REPRESENTATIVE KEMPLEN said he has not had discussions with
Representative Kelly but he has reviewed Representative Kelly's
bill and he believes the two pieces of legislation actually
compliment each other. He added the only impact would be in terms
of the fiscal note; if Representative Kelly's legislation passes,
the fiscal note for HB 270 would be moot because the department's
computer system would need to be modified only once.
REPRESENTATIVE GREEN understood Representative Kelly's legislation
was voluntary, whereas HB 270 was compulsory.
Number 1244
MR. ZANGRI explained that in terms of the fiscal note, if both
pieces of legislation pass this session, the department would need
to change their forms and computer program only once.
CHAIRMAN BUNDE noted this was the first hearing for HB 270 and it
would be held in committee for further consideration.
SSHB 372 - LIMITS ON CONTRACEPTIVES TO MINORS
Number 1268
CHAIRMAN BUNDE announced the next bill to come before the committee
was HB 372, "An Act placing limits on prescribing and providing a
contraceptive drug or device to a minor." He requested that
Representative Dyson present his bill at this time.
Number 1330
REPRESENTATIVE DYSON said he had been contacted by the parents of
a teenage daughter who were outraged to find out their daughter had
been provided prescription contraception without the parent's
knowledge and without the prescriber doing an adequate job of
checking the child's and family's medical records and history.
Faced with the deadline of submitting personal bills, he had
drafted a bill that contained a provision requiring parental
consent; however, after the judge's decision striking down parental
consent on abortions, he surmised the parental consent provision
wouldn't withstand a court challenge, so he redrafted the
legislation so it now requires the medical prescriber to check the
patient's and family's medical history to avoid medical risk and to
notify the parents. He stated his belief that this will withstand
a court challenge.
REPRESENTATIVE DYSON said subsequent to that, he had been in
contact with U.S. Congressmen Istook and Manzullo and Congressman
Istook was outraged to find out that the 13-year-old daughter of
one of his constituents was taken to a local clinic by her 37-year-
old teacher and was given a shot of depoprovera. The whole
situation outraged the parents which has caused them to go forward
on the federal level with similar legislation. He also has been
talking with professionals in the medical field and has learned
there is a series of medical conditions for which some of the
prescription contraceptions are counter-indicated; in particular,
there are a number of things heart related and stroke related. He
said the committee would be hearing testimony from a parent whose
child had been put in significant danger as a result of the
prescription of a contraception without knowing the family's
significant risk for permanent heart damage. He offered to answer
any questions.
Number 1493
LISA TORKELSON, Legislative Assistant to Representative Fred Dyson,
Alaska State Legislature, clarified that it was the daughter of a
constituent of Representative Manzullo who was taken to the clinic
by her teacher.
CHAIRMAN BUNDE said, "It sounds like perhaps two issues here; one
of medical malpractice and the other of access to parent's control
- perhaps access."
REPRESENTATIVE DYSON pointed out HB 372 requires parental
notification, not parental control or consent. It's his
understanding that here in Alaska, very young girls are becoming
pregnant by males who are averaging 7 1/2 to 8 1/2 years older,
which from his perspective as a father, speaks of exploitative
relationships. He commented the entire system of statutory rape
laws is set up on the inordinate amount of pressure males, in
particular, can put on young women to exploit them. The goal is to
do the best, under existing law and court interpretations, to make
sure the medical risk is minimized and the parents are in the
information loop regarding their children.
Number 1575
REPRESENTATIVE PORTER said, "Just so the record is not ambiguous on
the point that the behavior described by the sponsor reminds me of
felonious criminal behavior, which it is, so ...."
CHAIRMAN BUNDE commented 13 and 7 1/2 certainly should be statutory
rape.
REPRESENTATIVE DYSON interjected, "Which is not often prosecuted in
our jurisdiction."
CHAIRMAN BUNDE announced he would begin taking public testimony at
this time. He asked Cynthia Brooke to present her comments.
Number 1600
CYNTHIA BROOKE, M.D., Representative, American College of
Obstetricians and Gynecologists (ACOG), testified via
teleconference from Anchorage. She explained that ACOG is a
national organization of Board Certified OB/GYN physicians which is
a specialty dealing with women's health. Many local ACOG
physicians are concerned about recent bills which they feel will
have a negative impact on Alaskan women. ACOG is especially
concerned by Representative Dyson's bill, SSHB 372. She said
contraceptives save lives. A healthy nonsmoking female who carries
a pregnancy to full term is six times more likely to die than if
she used oral contraceptives. And this is just the beginning of
the story. Oral contraceptives alone save this country millions of
health care dollars every year. Some people feel this figure is
conservative and may extend into the billions of dollars. It does
this by preventing about 130,000 hospitalizations annually. This
includes hospitalization for women with breast disease, ovarian
cysts, anemia, pelvic inflammatory disease and other sexually
transmitted diseases, ectopic pregnancy, rheumatoid arthritis, and
uterine and ovarian cancer. In addition to the prevention of death
and severe illness from unwanted pregnancies, oral contraceptives
also have a profound beneficial effect on many diseases in women,
including a 50 percent reduction in uterine and ovarian cancer.
DR. BROOKE continued that SSHB 372 as amended, would now require
parental notification of oral contraceptives for minors. The ACOG
believes that teenagers will not want to go to physicians to
request contraceptives if their parents will be notified.
Teenagers frequently will not admit sexual activity to their
parents, the result would be decreased access to teenagers of
contraceptives and sexually transmitted disease counseling. In
light of the medical benefits of oral contraceptives, it seems this
bill would discriminate on the basis of age; minors would not have
access to the same health care benefits that older women enjoy.
Beyond this, the logic of this bill is not apparent in light of
current knowledge regarding teenage pregnancy. Multiple studies
have shown that teenage sexual activity is not affected by
availability of contraception. Rather, the most successful
deterrent to teenage sexual activity is parental openness to
discussion of sexual issues with their teenagers.
DR. BROOKE stated a recent USA Today article summarized studies
from the Center for Disease Control which showed a link between
teenagers who delay their first sexual encounter beyond 20 years of
age with educational level of their parents. Whether or not a
teenager will have intercourse is determined by an internal moral
compass which is most profoundly influenced by his or her parents,
personal goals and sense of self-esteem. Teenage pregnancy in this
country costs $37 billion annually. This is because teenage
mothers are significantly less likely to receive a high school
diploma, adolescent fathers finish fewer years of schooling and
earn less income annually by age 27, children of adolescents are
more likely to have health and cognitive disadvantages and to be
neglected or abused, the daughters of adolescents are more likely
to become adolescent mothers themselves, and the sons of
adolescents are more likely to be incarcerated. She concluded on
the basis of this information, the position of ACOG is that
limiting access of contraceptives to teenagers would increase
health care costs significantly and would have a negative impact on
everyone.
Number 1780
CHAIRMAN BUNDE noted that Representative Dyson had mentioned cases
of young women being prescribed birth control without a full
knowledge of their medical history. He asked Dr. Brooke if that
was standard medical practice.
DR. BROOKE responded it is not a standard medical practice and in
her experience, she is not aware of any instances where that has
happened. People coming into her office to receive contraceptives
are given a full history physical, but she can't speak to what
happens in other places.
CHAIRMAN BUNDE inquired if a doctor were to prescribe
contraceptives to a 14-year-old girl, would the doctor be totally
dependent on the minor for the medical history or would the doctor
have to request a more detailed medical history from the parents.
DR. BROOKE said the doctor would be dependent on the minor in terms
of the medical history. Overall, teenagers are better off on oral
contraceptives than off them; women are at decreased risk for
diseases in general on oral contraceptives than off them.
Number 1860
REPRESENTATIVE GREEN referred to Dr. Brooke's remarks that the
availability of contraceptives doesn't necessarily have any effect
on promiscuity of teens and asked if Dr. Brooke had discussed with
her peers that HB 372 would deter teens from perhaps seeking
contraceptives that might otherwise prevent pregnancies or does it
work in reverse.
DR. BROOKE stated in her opinion the requirement for parental
permission would deter teenagers from getting contraception.
CHAIRMAN BUNDE thanked Dr. Brooke for her comments and asked Jane
Conard to present her testimony at this time.
Number 1895
JANE CONARD testified via teleconference from Bethel on behalf of
her teenagers and as a registered nurse. She said her concern with
HB 372 is multiple and she highly applauds Dr. Brooke. The
problems with a pregnant teen with a heart condition are much worse
than a teen not pregnant with a heart condition. She has discussed
sex and the ramifications with her two daughters and son and her
daughters have received counseling at a family planning clinic.
She discussed the various services her daughters received at the
clinic. She thought there were other resources available to
address some of the concerns that have been expressed rather than
changing the possibility of teenagers being able to get access to
control their reproductive lives, especially responsible teenagers
who have plans for the future. Just because a teenager is under
the age of 18 doesn't mean they're incapable of making some good
decisions in their lives. While she may not be pleased with all
the decisions her teenagers have made, she is pleased that they
haven't become pregnant. Speaking as a mother, she believes that
reproductive rights for both sexes are important and considering
that teenage years are the age of experimentation with many things
other than sex, she is hopeful her discussions with her children
have impacted their decisions and also that the resources are
available for them to seek and receive the proper medical
intervention needed to make responsible decisions.
REPRESENTATIVE DYSON agreed that some children under 18 years of
age are capable of making adult decisions. He asked Ms. Conard at
what age did she think children were not capable of making of adult
decisions - 13?
MS. CONARD responded, "I think if a sexually active 13-year-old
came in and told me that they were having sex and were afraid of
getting pregnant, they can't find their mother most of the time,
live with their aunt or other people around the state, they don't
have a guardian, then I think that child needs first to know that
some parts of her body should be private - but as you have so
rightly said, sometimes these people are preyed upon - I would
think that to allow her to become pregnant would be a gross
misjustice to her as well as the fact that she's being exploited.
As a mother and as a nurse, I would also encourage her and empower
her to control parts of her life so that she wouldn't get pregnant
and then I would encourage and try to do other intervention so that
if she's being preyed upon, that that could be rectified as soon as
possible. So, I don't care if it's 10, 11, 5 or 2 - if a child is
being abused, it needs to be addressed. But if they're at an age
where they can't control anything, where they are being preyed
upon, then I think they must have some resource to not add more of
a burden on their young lives with an unwanted pregnancy."
REPRESENTATIVE DYSON inquired if there were other medical
interventions other than contraception and he assumed, abortion,
that Ms. Conard felt that parents should be cut out of the loop.
MS. CONARD responded that reproductive information or prevention of
reproduction should be information that's available to anyone. She
would feel very bad if her daughter chose to terminate a pregnancy,
but she would also feel bad if her daughter was forced to have a
pregnancy with complications and died. She stated her belief that
it is incumbent upon parents to be responsible and talk to their
children even though she knows it doesn't happen all that often.
CHAIRMAN BUNDE thanked Ms. Conard for her remarks and asked
Jennifer Schmidt to testify at this time.
Number 2125
JENNIFER SCHMIDT testified via teleconference from Fairbanks. As
a parent and nurse of 27 years, she urged the committee to oppose
SSHB 372. She said it's important to prevent unintended pregnancy
in every way possible - through education of teens and parents,
encouraging communication within a family but not legislating it,
and providing preventative contraceptive methods when requested.
She said the local public health clinic provides almost 400
pregnancy tests each year of which a number are young women 19
years of age, but 80 percent of these tests are negative. She said
it is unconscionable and in her mind, poor practice, to only
provide information and encourage family communication and then let
these young girls leave without a more reliable method of birth
control. She stated many women with sexually transmitted diseases
(STD) are identified when they come to the clinic not for sexually
transmitted disease exams, but because they have already had sex
and want a reliable method of birth control. These young people
may not come in for a STD exam or for birth control if they knew
their parents would be notified, but if they hadn't come in for the
birth control method, they might suffer from pelvic inflammatory
disease or future infertility. It is the practice for the staff at
public health centers to encourage young people to communicate with
their parents. In terms of medical background, people coming to
the public health clinic complete a 3-page health history form and
it's surprising how much information these young people have
regarding their family's health history. It is incumbent upon the
parents to inform their children of health risks in the family so
that information can be transmitted to the health care provider
regardless of age. She concluded that we do need to encourage
communication within families, but legislating it is not the best
way. She urged the committee to oppose this legislation.
CHAIRMAN BUNDE thanked Ms. Schmidt for her testimony and asked
Nancy Rollins to present her remarks at this time.
Number 2221
NANCY ROLLINS testified via teleconference from Kenai in opposition
to SSHB 372. She is the parent of two teenagers and works for an
organization that provides contraceptive methods and exams to
teens without parental consent. She stated it is critical to
prevent teen pregnancy and access to prescription contraception is
a very important part of the whole picture of prevention of teen
pregnancy. She pointed out that teens don't need adult permission
or parental consent to have sex and most parents who would be
outraged with their children being able to obtain contraception,
would also be outraged to know their children were having sex.
It's much safer to take birth control pills than it is to become
pregnant and most health care providers providing prescription
contraception do so after taking a complete medical history and
giving good counseling to young people about the different methods
of contraception, including not having sex at all.
TAPE 98-35, SIDE B
Number 0007
MS. ROLLINS continued that many teens talk to their parents before
coming into a clinic and oftentimes, they will inform and involve
their parents after having the exam and receiving the
contraceptives. She urged the committee to oppose SSHB 372 for
personal and public health reasons.
Number 0068
CHAIRMAN BUNDE asked if it is a possibility that encouraging oral
contraception will also encourage unsafe sex resulting in more
young women becoming susceptible to STDs.
MS. ROLLINS said the organization for which she works also
provides, encourages and teaches anyone who is at risk of a
sexually transmitted disease to use condoms with every active
intercourse. She noted there are conflicting studies about whether
or not people using oral contraceptives also use condoms.
CHAIRMAN BUNDE thanked Ms. Rollins for testifying and asked Angela
Moehring to testify.
Number 0235
ANGELA MOEHRING testified via teleconference from Mat-Su on behalf
of teenagers in the Mat-Su area. She expressed amazement that this
discussion was even taking place when sex education is being taught
in middle schools. Children should know about the various forms of
contraceptives and not be afraid to talk with their parents or
other adults. She is of the opinion that most teenagers don't
announce to their parents they are having sex.
CHAIRMAN BUNDE asked Jo Campbell to come before the committee to
present her testimony.
Number 0320
JO CAMPBELL testified she is the mother of a 14-year-old daughter
and an educator. She said the testimony relating to the medical
aspect of birth control sounds great; but her concern generates
from finding birth control pills in her 14-year-old daughter's coat
pocket. Her daughter has been educated since birth regarding the
family's history of congenital heart disease; however, she was
taken to the clinic by one of the junior high school nurses and
given birth control pills. Ms. Campbell was unsure why her
daughter had been feeling ill, but after discovering the birth
control pills, she understood the reason. She said her daughter is
not the exception. She has worked with at risk kids for 30 years
and the availability of birth control pills does not help these
children; parental concern and adult guidance is what helps these
kids. Taking the adult guidance away from the birth control issue
will only lead to trouble. Every week she works with 15 teenage
girls, the oldest is 20 years of age with two children, and she
doesn't believe the availability of birth control pills prevents
these kids from having babies. Also, the general feeling amongst
these teenagers is that birth control pills will protect them from
getting pregnant, but the fact is it does not protect them from
getting sexually transmitted diseases and a teenage girl and
teenage boy who thinks she's perfectly safe to have sex will not
use a condom. Her contraceptive choice for her children or any
other child would be foam and a condom, which will protect them
from a number of things. She believes that availability of oral
contraceptives will lead to an increase in venereal diseases. She
said she is really confused because her kids can't rent skis on
their own, she, in her job, cannot give a child an aspirin, her
kids can't get their ears pierced before the age of 18 without
parental consent, but yet they can get oral contraceptives and get
an abortion without her knowing about it.
MS. CAMPBELL said the school nurses have indicated they provide
follow-up with these kids, but most children need verbal
instruction again and again; generally the paper work given to a
child is thrown out without even reading about the maintenance
information that's necessary with birth control pills. Birth
control pills are high maintenance, requiring regular visits to the
doctor and follow-up examinations and most kids will not do that.
Her concern is that her daughter was not given a choice to call
home at the time she was given the birth control pills; not one
adult ever asked if she wished to call her mother. She believes
that at some point parents should be allowed to make life choices
for their children.
Number 0664
REPRESENTATIVE DYSON asked how long it would be before Ms. Campbell
would know if her daughter's heart was damaged by the birth control
pills.
MS. CAMPBELL responded the family's congenital heart disease shows
up at different times, depending on a number of things. Her
daughter may not even have it, but her older daughter has it, she
does and her grandmother has it. She explained, "It could show up
when she's 20. So, if she took birth control pills from now until
she's 20, her body thinks she's pregnant. What happens is your
body thinks it's pregnant all this time, then when you go into
labor, that's when you croak - it's a heart, blood thing."
Number 0720
REPRESENTATIVE DYSON said that existing state law says under
examination and treatment of minors, that the provider of medical
or dental services shall counsel the minor, keeping in mind not
only the valid interest of the minor, but the valid interest of
parent or guardian and the family unit as best the provider
presumes them. He asked Ms. Campbell if that was the current
practice as she understands it?
MS. CAMPBELL said no, based on her involvement with teenagers in
the course of her job, she doesn't believe these children are being
counseled and second, how many 14-year-old children know their
family's medical history or would even bother to fill out the
questionnaire properly.
REPRESENTATIVE DYSON asked Ms. Campbell if she had any knowledge of
children being counseled about the valid interests of the parents
or guardians.
MS. CAMPBELL responded no, most children do as they are told by
adults and in these cases where the future consequences are
uncertain, they need to have an adult whether it be a parent, a
relative, a teacher or whomever, involved in this big decision.
CHAIRMAN BUNDE thanked Ms. Campbell for her testimony and asked
Patricia Mark to testify at this time.
Number 0930
PATRICIA MARK, representative, Anchorage American Civil Liberties
Union (ACLU), testified via teleconference from Anchorage. For
clarification she asked if the 13-year-old who received birth
control had given the doctor an incorrect medical history or if the
doctor didn't ask for one at all.
CHAIRMAN BUNDE responded the doctor didn't ask in this case.
MS. MARK said the ACLU believes the passage of SSHB 372 would be a
bad policy decision. She said the Alaska Constitution
unequivocally protects the privacy rights of its citizens,
including minors. No decision is more private than the decision of
whether and when to bear a child. If a teenager has to notify her
parents, she will very likely be discouraged from using the birth
control. The ACLU believes this legislation will increase the
number of teen pregnancies which will in effect increase the number
of abortions, which is a much more dangerous procedure. She said
that one-third of teen pregnancies end in abortion and there is no
reason to increase the number of abortions performed in the state.
She said "Section 1(a)(3) says that a minor child who is the parent
of a child can give consent to medical services for the minor
child. That kind of seems illogical - why once you become a parent
can you give consent for your child - I mean, you're not in any
better control of knowing your medical history." It appeared to
her this legislation was thrown together in haste and suggested
taking some additional time to draft a better bill.
Number 1056
CHAIRMAN BUNDE asked where in existing law does it state "under
examination and treatment of minors that the provider of medical or
dental services shall counsel the minor, keeping in mind not only
the valid interest of the minor, but the valid interest of parent
or guardian and the family unit as best the provider presumes
them."
REPRESENTATIVE DYSON responded AS 25.20.025.
CHAIRMAN BUNDE asked,"I would really be interested in a reaction
from the ACLU or anyone in the legal profession about how that's
addressed when we have, in this case I suppose, school nurses
escorting teenagers to get birth control, if the doctor does not
contact the parent, is the doctor in violation of Alaska Statute?"
CHAIRMAN BUNDE next asked Cynthia Moehring to present her remarks.
Number 1120
CYNTHIA MOEHRING testified via teleconference from Mat-Su. She has
a nine-month-old daughter and doesn't think teenagers should have
to get a court order to get birth control bills. She said in this
day and age, a young woman is expected to have sex by 16 years of
age and the last thing anyone wants is unwanted pregnancies and in
order to avoid that, young women should be able to get birth
control if that's what they want to do.
CHAIRMAN BUNDE clarified this legislation does not address a court
order, it requires that a parent be notified if contraceptive drugs
or devices are prescribed. Teenagers would still be allowed to use
all nonprescription forms of birth control if they so choose.
Number 1224
KAREN PEARSON, Health Programs Manager, Division of Public Health,
Department of Health and Social Services, testified it is the
department's belief the best thing is for very young women to not
be sexually active; but addressing the fact this bill deals with
contraceptive access, she would direct her comments accordingly.
She said the information at the top of the handout came from the
1995 Youth Behavioral Risk Factor Survey which was a survey done
with 6,000 young men and women in Alaska. The survey shows that
out of 3,866 young women ages 15-17, only 669 were using
contraceptives, no young women under 15 years of age indicated use
of oral contraceptives, 60 percent of the young women who said they
were sexually active indicated the use of a condom. The results of
the survey reveal a couple of things: there are a great number of
sexually active young women who are not using an oral
contraceptive.
CHAIRMAN BUNDE clarified for the individuals on teleconference
there are 13,422 young women ages 15-17 years of age in the state
of which 5,956 have been sexually active, 3,866 are currently
sexually active, so only about 25 percent of young women between
the ages of 15-17 are sexually active.
MS. PEARSON said the department was pleased that no young women
under the age of 15 said they were using an oral contraceptive.
She said one of the disconcerting things to the department was that
according to the Bureau of Vital Statistics, between 1980 and 1995
the number of births to young women under 18 grew from 280 to 415,
representing a 67 percent increase over a 15 year period.
Simultaneously, the births to 18- 19-year-old women held even and
births to 20-29 years olds dropped significantly. This indicates
that something is happening with the 16- and 17-year-old young
women and efforts need to be made in the area if information and
education to prevent that dramatic increase in births to this age
group. She remarked there are significant physical risks
associated with a pregnancy for a young woman. One significant
thing which has not been addressed is that babies born to very
young women and a very young partner, are at very high risk for
abuse and neglect because the parents do not have the maturity to
nurture and care for these children.
REPRESENTATIVE DYSON asked what is the age difference between the
young girls who get pregnant and their male partners.
MS. PEARSON said the staff of the Bureau of Vital Statistics had
just compiled that information and she would forward a copy to
Representative Dyson. Basically, the statistics show that of young
mothers age 13, one father was 1-4 years older, one father was 5-9
years older; in the 14-year-old mother category, 12 fathers were 1-
4 years older, one father was 5-9 years older, one father was 10-19
years older, and one father was more than 20 years older; in the
15-years-old moms category, 4 fathers were the same age, 52
fathers were 1-4 years older, 22 fathers were 5-9 years older, 6
fathers were 10-19 years older, and 1 father was more than 20 years
older.
REPRESENTATIVE DYSON asked why are some contraceptive method
prescription and others aren't?
MS. PEARSON thought it had to do with the potential medical
benefits; the risks and benefit ratio. Using a condom for
instance, basically poses no health risk but any kind of medicinal
pharmaceutical requires a dispensing authority.
REPRESENTATIVE DYSON said in other words the reason that some
devices and methods are prescription is because there's a medical
risk from utilizing it. He noted that Ms. Pearson opposed this
legislation and asked if she was opposed to the section requiring
that a prescriber should make good faith effort to get the medical
history.
MS. PEARSON replied, "What we believe is that good medical practice
says that any prescriber, whether prescribing a contraceptive or
any pharmaceutical, will always make good faith effort to get all
the history and information to make a good diagnosis."
REPRESENTATIVE DYSON reiterated his question of whether she was
opposed to putting the requirement into law.
MS. PEARSON said she believed it was in existing law which
Representative Dyson had previously read.
REPRESENTATIVE DYSON said, "It absolutely doesn't say that. What
it says in that passage is that they're supposed to counsel the
child relationship to the family values and family interest. It
doesn't talk about the medical stuff and I want to know why all of
you who are in this business are objecting to putting good medical
practice into the law."
MS. PEARSON deferred that to Dr. Nakamura because she's not a
prescriber, but she thought it was in medical practice.
REPRESENTATIVE DYSON said, "Then it seems to me that all good
medical practitioners would say - that's what good professionals do
- putting it into law loses nothing and all that you all really are
objecting to is the idea that parents might know what's going on
with their kids and that knowledge might preclude the kids going
and getting a prescription device which by definition has some
danger and by definition gives them no protection against almost
all the STDs."
MS. CAMPBELL interjected the birth control pills given to her
daughter were not prescription; they were a sample and not
prescribed by a doctor.
CHAIRMAN BUNDE indicated he would continue with public testimony
and asked Robin Smith to present her remarks at this time.
Number 1660
ROBIN SMITH testified via teleconference from Anchorage. She said
according to the American College of Obstetricians and
Gynecologists in 1994 an estimated 910,600 U.S. teenagers between
the ages of 15-19 became pregnant resulting in 505,000 live births,
276,000 abortions and 128,000 fetal losses. That same year nearly
29,000 women under the age of 15 also became pregnant. A
comparison of these statistics with other industrialized countries
indicates the U.S. teen pregnancy rate is twice as high as in
England, Wales and Canada and more than nine times as high as in
the Netherlands and Japan. She said SSHB 372 would punish medical
professionals who are trying to provide teens with health care
which is obviously needed. This legislation simply does not make
sense. Multiple studies have shown that teenage sexual activity is
not affected by the availability of contraception. She said, "Just
today a mother of two teenage boys told me that her son's 19-year-
old friend had impregnated a younger women. His father and future
grandfather of the baby has indicated that this is none of his
son's concern and it is all her problem." Surely, rather than
punishing physicians who provide oral contraceptive, which is the
most effective contraceptive against pregnancy, perhaps the father
of this teenage boy should be punished for not being responsible
and for allowing his teenage son to have sex. Teens will have sex
and eliminating access to the most effective form of birth control,
even simply by parental notification, will not prevent teens from
having sex. Birth control prevents unintended pregnancies and it
prevents abortion. Doctor/patient privacy also allows for the
treatment of sexually transmitted diseases. She said certainly we
want and encourage our children to seek help rather than to hide
their problem. Teenage pregnancy hurts everyone; young women are
less likely to continue their education, children of teen mothers
are more likely to be abused, neglected and not to attain their
full potential, and these children are more likely to become teen
parents and to continue the destructive cycle. She urged the
committee to fund sex education programs, family planning clinics
and parenting classes, which will better serve communities than
this legislation.
CHAIRMAN BUNDE noted the committee is in agreement with a number of
the areas addressed by Ms. Smith; certainly the committee does not
support teen pregnancy, and certainly wants these young women to
have the ability to grow up without the burden of an unwanted
pregnancy. One of the challenges he's hearing is the other dangers
of having sex.
MS. SMITH said her concern is that kids will have sex with or
without birth control and if a teen goes to a physician or other
health professional to get birth control and finds out that her
parents have been notified, that word will get spread amongst the
peer groups and none of the kids will go to get birth control to
prevent the pregnancies. Instead, they'll continue to have sex at
a far greater risk.
CHAIRMAN BUNDE agreed that teenagers will have sex no matter what,
he agreed that withholding birth control will not keep teenagers
from having sex, but the birth control pill is not the only form of
birth control.
MS. SMITH noted that according to a summary on past surveys of
teenage pregnancies, one of the biggest things is that boys don't
like to use birth control and condoms are the only form of birth
control for boys.
REPRESENTATIVE DYSON agreed that most of the social problems with
very young girls are a result of very irresponsible males.
CHAIRMAN BUNDE asked Andrea Ellenson to present her comments at
this time.
Number 1950
ANDREA ELLENSON testified via teleconference from Mat-Su. She
said, "You were just talking about how not having birth control
available would not make a teenager quit having sex, but then again
before that you were talking about 12-year-olds and 13-year-olds
having sex and how many 12-year-olds know how to put on a condom?
That's just going to spread AIDS more and it's just going to make
more teenagers pregnant and yet oral contraceptives do not stop
sexually transmitted diseases but it does stop the pregnancies - or
at least helps to. And not having that available will make it a
bigger epidemic in the Valley than it is right now."
CHAIRMAN BUNDE thanked Ms. Ellenson for her testimony and asked Dr.
Nakamura to come before the committee and present his remarks.
Number 1990
PETER NAKAMURA, M.D., MPH, Director, Division of Public Health,
Department of Health and Social Services, said one of his
responsibilities as the Director of the Public Health Division is
to review and help direct health policy to make sure that when
issues are brought up that can affect health, less harm and more
good is done. And in reviewing SSHB 372, there is no question the
intent of the bill is positive; to involve parents with their
children. However, in looking at the wording and the way in which
the bill is proposed causes him significant concern. He said, "It
first says that the provider must obtain records of the client and
family. That poses a significant barrier. Yes, it's nice to have
as much information as possible, but to try to get the medical
records of the client and family is a very major task. You have to
get individual consent from each of the adult members of that
family in order to obtain their medical records. Very often it's
not the same provider that the child encounters that provides the
medical care to the other parents. So that provides a significant
barrier. To do that, you have to inform the parents, which
automatically goes against the reason why the child doesn't consult
the parent in the first place. They hope to have their medical
encounter in confidence. This ruins that opportunity. Giving a
written notice to the parent that the minor has requested
contraceptives even is more intrusive and again puts the child in
confrontation with the parent if they so choose to proceed with
their care. The odds are that knowing this, they will not even
encounter the physician and as mentioned before, probably the most
significant thing to us is that if this child that is sexually
active doesn't have an encounter with the provider, they're not
going to get the medical consultation and information that's so
critical to this child. Not only getting the information about the
risks of pregnancies, but the risks of sexually transmitted
diseases and the long-term chronic effects related to it. So,
probably to us in the health field, it's very critical to have this
child come in and make the encounter with the health provider."
REPRESENTATIVE DYSON asked if Dr. Nakamura could suggest language
that would be less rigorous, but would still place in law that the
medical provider must do their best to get the significant medical
history of the child to ensure that child's life is not being put
at risk.
DR. NAKAMURA replied that good medical practice dictates that a
medical provider already makes all efforts possible to get as much
information about that patient. He added, "If you put any kind of
language or requirements in there that dictates a procedure that
will break the confidentiality, and you cannot get this information
without breaking this confidentiality, then you provide the kind of
barrier that would keep this child from coming in for care."
REPRESENTATIVE DYSON said, "So another medical practitioner that
jumped my bones about this a couple of months ago, said children
are going to die because they are prescribed these devices without
it. He said they're dying now and he said that's the way it's got
to be because we would rather protect the confidentiality and make
sure the kids get these devices and avoid the risk of pregnancy and
abortion, but they're going to die. And that's just the medical
risk of dealing with this client population."
DR. NAKAMURA responded that was pretty extreme. A child will have
a greater likelihood of dying if she gets pregnant than she will
from taking any contraceptive device.
REPRESENTATIVE DYSON said that's correct, but for the few for whom
these devices and prescriptions are counter-indicated, the risk is
significant and Dr. Nakamura's position is that those children
should be subjected to that risk out of ignorance rather than be
rigorous about getting the information.
DR. NAKAMURA said, "Rigorous about getting the information, I
totally agree with and I think you'll find any provider that will
be rigorous in trying to get as much information. But relative to
the risks even to any individual person, the risks from taking
contraceptive medications against the risk of medical complications
from pregnancy is much higher on the side of pregnancy - for any
individual."
REPRESENTATIVE DYSON said that may be true, but what Dr. Nakamura
was arguing for is medical ignorance. If there's a chance to get
that information to protect that population in jeopardy, Dr.
Nakamura is arguing in favor of not going after that information.
DR. NAKAMURA said, "See, I don't know how you can get that
information and compromise this child's health risks by increasing
the risk to pregnancy than by providing the service."
Number 2240
DR. NAKAMURA said the five-day waiting period is another
significant barrier. He remarked it's quite an intimidating
procedure for most children to make the choice to come in to see a
physician, much less to come in to see a physician about a service
that is not the most comfortable to discuss with someone the child
is not that familiar with. To make the child come back five days
later to receive the service originally sought, will almost
maximize the reality that the child will never come back for that
second visit. The consequences of failing to get the contraceptive
services ....
TAPE 98-36, SIDE A
Number 0005
DR. NAKAMURA .... and share the information the child is either
interested in becoming sexually active or is active, the majority
of children have a significant degree even with the best of
parents, but there are a number of parents who do not have the
ability to communicate and provide the support necessary, which is
evidenced by the 15,000 reports of child abuse and neglect every
year in Alaska. If a child is forced to encounter that parent for
advice and consultation or even to have that parent notified, it
raises the risk to that child of additional violence or
confrontation. A law mandating the notification would create that
situation. In conclusion, he recognized the positive intent of the
legislation, but from a public health perspective it's more
counter-productive than a benefit.
Number 0200
REPRESENTATIVE DYSON said, "Dr. Nakamura, just like you wish that
all the parents were ideal, I wish all the medical practitioners
were. Certainly, the information I have is anecdotal, but it
doesn't seem to me that the medical practitioners are doing the job
of being rigorous about exploring the medical risks and I have yet
to find - and I hope I'm very wrong - that the dispensers have sat
down and complied with the law and counseled the child about not
only their best interests, but their family values and the valid
interests of the parents. How can we - you particularly from your
responsibility - encourage that and check up on it and find out if
it's happening?"
DR. NAKAMURA said, "I don't have the answer to that, but I can make
a very positive statement that you'll find that those health care
providers who take the time to deal with this very difficult
subject are some of the best providers out there. They take the
time to deal with this very difficult issue and have the
information that can be made available to that child - whether the
child hears it or not, is a question. But I have a great deal of
confidence in them and in the health care profession, I'm not just
saying physicians, but those individuals who deal with this very
difficult problem."
CHAIRMAN BUNDE asked who can write a prescription for oral
contraception?
DR. NAKAMURA replied a physician, a nurse practitioner or physician
assistants working under the direction of a physician. He pointed
out that the language in SSHB 372 goes beyond oral contraception;
it relates to any medical device.
CHAIRMAN BUNDE thanked Dr. Nakamura for his remarks and asked Lana
Henley to present her comments.
Number 0310
LANA HENLEY testified via teleconference from Mat-Su and agreed
with Dr. Nakamura's remarks. Her work at the Services for Young
Pregnant Teens brings her in daily contact with teen pregnancies.
She doesn't believe that teens are more promiscuous today than when
she was a teen; both she and her husband had sexual opportunities
as teens, but the services available today were not available at
that time. Today's generation is more educated and is more open
about sex education. She thinks of herself as a good parent to her
teenage daughter and teenage son, but she remembers being deathly
afraid of her parents when she was growing up even though she knew
she could talk with them and if her children have that same fear of
talking to her, she wants them to talk to someone, whether it be a
doctor, counselor, nurse or whomever. Taking services away from
teens is not the answer; there is a need for more counselors in
schools and people who are more educated.
CHAIRMAN BUNDE thanked Ms. Henley for her comments. He asked Ron
Kreher to come forward to testify at this time.
Number 0550
RON KREHER, Program Policy Analyst, Division of Public Assistance,
Department of Health and Social Services, said much of the
testimony has alluded to many of the medical as well as the social
concerns regarding this legislation. His comments would be
somewhat more prosaic; i.e., the potential impact this legislation
would have on public assistance programs with respect to increasing
the number of minor parents receiving public assistance. The
division believes this legislation is likely to increase the number
of minor parents through teen pregnancies. When the federal
government adopted the welfare reform law, quite a bit of research
was devoted to the impacts of teen pregnancies and it is known that
women under the age of 17 who have children are much more likely to
become dependent on public assistance and the costs associated with
providing services to minor parents is up to 30 percent higher than
adults who have children. Also, it is known that children of teen
parents, especially those born out of wedlock, are three times more
likely to become public assistance recipients than the average
population. He said the division believes there will be
significant fiscal impacts as a result of this legislation which is
indicated on the division's fiscal note.
Number 0655
REPRESENTATIVE PORTER asked how the division had determined that
123 pregnancies would result if this legislation were to pass.
MS. PEARSON said, "We took the information that we found basically
- part of it's in the original bill analysis, but the figures I
gave you for the number of young women who are using oral
contraceptives, which was 669, the research says that about 41
percent of young women say that if they had to involve their
parents they would not seek contraceptives. So we took that 41
percent - brought that down, that's 274 and then the research also
says that sexually active women not using a contraceptive, 90 out
of 100 will be pregnant at the end of one year. So we took the 90
percent of the 274; that gave us 246 and if we were just going to
go straight across, we would say 246 are going to get pregnant and
at that point we no longer had any research, we just made an
arbitrary and capricious decision that half of those young women
would find some other alternative that would work for them - a less
reliable, you know, foam or something like that - and so that's how
we came up with the number 123. Everything can be backed by
research to the 246, but when we said half of that, that was just
our best guess of what would likely happen."
CHAIRMAN BUNDE asked Becca Brown to come forward to present her
comments at this time.
Number 0780
BECCA BROWN testified on behalf of herself and supported much of
the testimony that had already been presented. She agrees that
SSHB 372 is well-intentioned and that it is intended to benefit
teenagers and their parents and to promote good communication among
families. However, in the end she thinks it's illogical and there
are probably more effective ways to this end of helping teenagers
and their families. First, she thinks this legislation presupposes
that access to birth control figures into an adolescent's decision
to engage in sexual activity. Many studies support her own
observations that teenage sexual activity is not affected by the
availability of contraception and if it's not available - oh, well,
they'll do without and come what may. She has read the most
successful deterrent to teenage sexual activity is parental
openness to discussion of sexual issues with their teenagers.
Unfortunately, she couldn't think of a way to mandate parental
openness. Also, she thinks this legislation presupposes that all
parents are sensitive, supportive and open-minded and she
personally, knows that is not the case. Two years ago she worked
in a program in Juneau for at risk ninth graders and attended, as
a volunteer, several Alaskan Teen Institutes. She has worked with
a lot of teens who do not even have one parent, much less two,
living with them who could be considered fully functioning, stable,
sober adults, so she doesn't think the parent is always the best
person to provide counseling. She agrees that teenagers should get
counseling from a responsible adult and she hoped that health care
practitioners could help fill that void when the parent is not in
a position to provide good counsel. She said many of the students
she worked with years ago were abused both physically and/or
sexually by their families and in her opinion, it's unreasonable to
deny these teenagers, many of whom are sexually active, access to
birth control because they're afraid or unwilling to talk to their
parents, who may be abusive. As an aside, three of the girls she
taught are now mothers and her concern is that many of them were
not sober while pregnant. She said unintended pregnancy accounts
for over three-fourths of all pregnancies among unwed teenagers.
She pointed out some of the consequences of unintended pregnancies
are increased abortions, dangerous delays in prenatal care and
later on, increases in child abuse and neglect. The consequences
for teenager mothers are less of a likelihood to finish high school
or college and they are more likely to be poor and on welfare
public assistance. She stated her belief that anything done to
prevent unintended pregnancies will improve the lives of teenagers
and hopefully, their offspring who will come later. Teenagers
should be encouraged to delay the start of sexual activity and for
those who are sexually active, to promote and encourage the use of
birth control.
MS. BROWN said another issue is that focus is being placed on some
anecdotal evidence about health care practitioners who obviously
did not live up to their responsibilities, but it was her belief
there were existing laws which cover that issue. It seems
illogical to her that promoting access to the pill will increase
sexually transmitted disease because most health care
practitioners, when prescribing the pill, provide a lot of
information on sexually transmitted diseases and require a pap
smear which is important for sexually active women in preventing
and early detection of cancer.
MS. BROWN said in conclusion parents don't have to give their
signature of approval when their child has sex, don't have to sign
for their child to receive prenatal care once they are pregnant,
nor do they have to sign for their child to get invasive procedures
such as amniocentesis or to get a Caesarian section. Why then
should the parent have to sign for their child to get birth
control?
Number 1120
REPRESENTATIVE GREEN inquired if there had been a significant
number of males in attendance at the youth counseling sessions Ms.
Brown had attended.
MS. BROWN replied it's about 50/50. The counseling sessions she's
been involved with in Juneau are run through the National Council
on Alcoholism.
REPRESENTATIVE GREEN said there had been previous testimony that
sometimes males are not responsive or receptive to the use of
condoms and he wondered if there was any difference in the use
thereof in the number of males who had attended the counseling
sessions as opposed to those who haven't gone through some type of
counseling or education program.
MS. BROWN said she didn't have any hard statistics, but she
certainly hopes so.
Number 1188
CHAIRMAN BUNDE thanked Ms. Brown for her testimony. He noted that
HB 420 and HJR 58 would be heard at a later meeting.
Number 1200
MR. KREHER noted that as part of the federal welfare reform law,
states that manage to reduce out-of-wedlock pregnancies by a
significant portion without increasing abortions are eligible for
(indisc.) bonus from the federal government. The state of Alaska
has a relatively good chance in the third or fourth year of this
process to be eligible for this bonus. The possibility that out-
of-wedlock pregnancies might actually increase if this legislation
passed could hamper the state's ability to qualify.
CHAIRMAN BUNDE thanked everyone for their participation.
ADJOURNMENT
CHAIRMAN BUNDE adjourned the House Health, Education and Social
Services Standing Committee at 5:02 p.m.
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