Legislature(1993 - 1994)

02/25/1993 03:00 PM House HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
           HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                         
                       STANDING COMMITTEE                                      
                        February 25, 1993                                      
                            3:00 p.m.                                          
  MEMBERS PRESENT                                                              
  Rep. Cynthia Toohey, Co-Chair                                                
  Rep. Con Bunde, Co-Chair                                                     
  Rep. Gary Davis, Vice Chair                                                  
  Rep. Al Vezey                                                                
  Rep. Pete Kott                                                               
  Rep. Harley Olberg                                                           
  Rep. Bettye Davis                                                            
  Rep. Irene Nicholia                                                          
  Rep. Tom Brice                                                               
  MEMBERS ABSENT                                                               
  COMMITTEE CALENDAR                                                           
  *HB 136:  "An Act relating to the offenses of driving while                  
            intoxicated and refusal to submit to a breath                      
            test; and providing for an effective date."                        
            HEARD AND HELD                                                     
  *HB 137:  "An Act authorizing special medical parole for                     
            terminally ill prisoners."                                         
            PASSED WITH INDIVIDUAL RECOMMENDATIONS                             
  HB 67:    "An Act relating to eligibility for and payments                   
            of public assistance; and providing for an                         
            effective date."                                                   
            NOT HEARD - HELD TO TIME CERTAIN                                   
  (* First public hearing.)                                                    
  WITNESS REGISTER                                                             
  LLOYD RUPP, Commissioner Designee                                            
  Department of Corrections                                                    
  P.O. Box 112000                                                              
  Juneau, Alaska 99811-2000                                                    
  (907) 465-3376                                                               
  Position Statement:  Supported HB 136, HB 137                                
  DANA LATOUR, Legislative Liaison                                             
  Department of Corrections                                                    
  P.O. Box 112000                                                              
  Juneau, Alaska 99811-2000                                                    
  Phone:  (907) 465-3454                                                       
  Position Statement:  Provided information on costs of HB 136                 
  JUANITA HENSLEY, Chief of Driver Services                                    
  Division of Motor Vehicles                                                   
  Department of Public Safety                                                  
  P.O. Box 20020                                                               
  Juneau, Alaska 99802                                                         
  Phone:  (907) 465-4335                                                       
  Position Statement:  Explained reasons for HB 136 amendments                 
  JAY DULANY, Director                                                         
  Division of Motor Vehicles                                                   
  Department of Public Safety                                                  
  5700 Tudor Road                                                              
  Anchorage, Alaska 99507                                                      
  Phone:  (907) 269-5559                                                       
  Position Statement:  Available to answer questions on HB 136                 
  LORN CAMPBELL, Administrator                                                 
  Highway Safety Planning Agency                                               
  Department of Public Safety                                                  
  P.O. Box 111200                                                              
  Juneau, Alaska 99811-1200                                                    
  Phone:  (907) 465-4374                                                       
  Position Statement:  Available to answer questions on HB 136                 
  MARGO WARING, Staff                                                          
  Alaska Mental Health Board                                                   
  431 N. Franklin St., Suite 101                                               
  Juneau, Alaska 99801-1121                                                    
  Phone:  (907) 465-3071                                                       
  Position Statement:  Supported HB 137                                        
  GEORGE DOZIER                                                                
  Aide to Rep. Pete Kott                                                       
  Alaska State Legislature                                                     
  State Capitol Building, Room 409                                             
  Juneau, Alaska 99801-1182                                                    
  Phone:  (907) 465-3777                                                       
  Position Statement:  Questioned release conditions in HB 137                 
  PREVIOUS ACTION                                                              
  BILL:  HB 136                                                                
  SPONSOR(S): REPRESENTATIVE(S) MULDER                                         
  TITLE: "An Act relating to the offenses of driving while                     
  intoxicated and refusal to submit to a breath test; and                      
  providing for an effective date."                                            
  JRN-DATE    JRN-PG                     ACTION                                
  02/05/93       238    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/05/93       238    (H)   HES, JUDICIARY, FINANCE                          
  02/25/93              (H)   HES AT 03:00 PM CAPITOL 106                      
  BILL:  HB 137                                                                
  SPONSOR(S): REPRESENTATIVE(S) MULDER                                         
  TITLE: "An Act authorizing special medical parole for                        
  terminally ill prisoners."                                                   
  JRN-DATE    JRN-PG                     ACTION                                
  02/05/93       238    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/05/93       238    (H)   HES, JUDICIARY, FINANCE                          
  02/25/93              (H)   HES AT 03:00 PM CAPITOL 106                      
  BILL:  HB  67                                                                
  SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR                                 
  TITLE: "An Act relating to eligibility for and payments of                   
  public assistance; and providing for an effective date."                     
  JRN-DATE    JRN-PG                     ACTION                                
  01/15/93        86    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  01/15/93        86    (H)   HEALTH,EDUCATION & SS,                           
  01/15/93        86    (H)   -6 FNS (6-DHSS)  1/15/93                         
  01/15/93        86    (H)   GOVERNOR'S TRANSMITTAL LETTER                    
  ACTION NARRATIVE                                                             
  TAPE 93-24, SIDE A                                                           
  Number 000                                                                   
  CHAIR BUNDE called the meeting to order at 3:08 p.m. and                     
  noted members present.  He announced the calendar, noted                     
  that Anchorage was on-line via teleconference, and brought                   
  HB 136 to the table.                                                         
  HB 136:  DRUNK DRIVING AND BREATH TEST OFFENSES                              
  Number 030                                                                   
  REP. ELDON MULDER, PRIME SPONSOR OF HB 136, introduced                       
  himself and read his sponsor statement, which is on file in                  
  the committee room.  In summary, the statement said the bill                 
  is aimed at eliminating the backlog of 2,500 offenders                       
  waiting as long as a year before serving their mandatory 72                  
  hours of imprisonment for driving while intoxicated (DWI).                   
  Under the bill, offenders and those who refuse to submit to                  
  a breath test for alcohol must:  serve their 72-hour                         
  sentence in a Community Residential Center (CRC); pay the                    
  costs for such incarceration, if necessary through permanent                 
  fund dividend withholding; while incarcerated, perform 24                    
  hours of community service in a halfway house if available,                  
  or in an alternative facility designated by the Department                   
  of Corrections; and forfeit their vehicle upon third or                      
  subsequent offenses.  The intent of the bill is to curtail                   
  the number of DWIs by stiffening punishment, and to ease                     
  financial burdens on the Department of Corrections, he said.                 
  Number 084                                                                   
  REP. MULDER read through the sectional analysis of HB 136,                   
  noting the important provisions of the bill.                                 
  (Rep. B. Davis arrived at 3:13 p.m.  Rep. Brice arrived at                   
  3:14 p.m.)                                                                   
  Number 118                                                                   
  REP. MULDER asked the committee to consider amendments to                    
  the bill to create a working draft, instead of developing a                  
  committee substitute.  He presented a list of amendments to                  
  HB 136, and described them, numbered as described.                           
  Number 181                                                                   
  REP. G. DAVIS moved passage of the first amendment, changing                 
  the definition of half-way house to CRC.  Hearing no                         
  objection, Chair Bunde announced the AMENDMENT PASSED.                       
  REP. B. DAVIS moved passage of the second amendment,                         
  specifying that "appropriate facilities" under the bill are                  
  to be determined by the Department of Corrections.  Hearing                  
  no objection, Chair Bunde announced the AMENDMENT PASSED.                    
  REP. NICHOLIA moved passage of the third amendment, put                      
  forth as a cost-savings measure at the suggestion of the                     
  Department of Corrections, to extend the requirement for                     
  half-way house incarceration to second offenders, as well as                 
  to first offenders.  Hearing no objection, Chair Bunde                       
  announced the AMENDMENT PASSED.                                              
  REP. BRICE moved passage of the fourth amendment, to include                 
  provisions for limited driver's licenses, put forth at the                   
  suggestion at the Division of Motor Vehicles.  Hearing no                    
  objection, Chair Bunde announced the AMENDMENT PASSED.                       
  REP. G. DAVIS moved passage of the fifth amendment,                          
  eliminating Section 3 of the bill, relating to forfeiture of                 
  vehicles.  Hearing no objection, Chair Bunde announced the                   
  AMENDMENT PASSED.                                                            
  (Rep. Olberg arrived at 3:17 p.m.)                                           
  Number 191                                                                   
  CHAIR BUNDE asked for comment and questions about the first                  
  two amendments, and hearing none, turned to the third                        
  REP. NICHOLIA asked whether a person arrested for DWI in an                  
  area in which no half-way house was available would have to                  
  serve the sentence in a jail.                                                
  REP. MULDER answered yes, if no other appropriate facility                   
  was available, the sentence would have to be served in jail.                 
  Number 210                                                                   
  REP. NICHOLIA asked if the Department of Corrections had a                   
  list of appropriate facilities in rural areas.                               
  REP. MULDER said such a question might be better answered by                 
  the Commissioner of the Department of Corrections.                           
  Number 236                                                                   
  REP. KOTT asked if the committee could assume the first and                  
  third amendments replaced the term "half-way house" with                     
  "community residential center."                                              
  REP. MULDER said he felt he could not change terminology in                  
  mid-stream and so put forth those amendments to make the                     
  change in terminology clear in both sections.                                
  Number 256                                                                   
  REP. MULDER said the fourth amendment addresses the current                  
  ability of the court to allow those convicted for up to six                  
  drunken driving offenses to enjoy the use of a limited                       
  drivers license, allowing them to drive to and from work.                    
  The Department of Motor Vehicles has said such a provision                   
  is costly, ineffective, and in violation of federal                          
  directives, Rep. Mulder said.                                                
  Number 271                                                                   
  REP. TOOHEY asked a clarifying question about the fourth                     
  REP. MULDER answered the question, saying the amendment                      
  would limit such licenses only to first offenders and would                  
  deny the limited license to those with subsequent offenses,                  
  he said.                                                                     
  CHAIR BUNDE said he did not wish to rush the amendments                      
  through the committee, especially as members had not seen                    
  them before the meeting.  He encouraged members to take                      
  their time and pose any questions they wished.                               
  REP. MULDER noted that, under the bill, those who refuse to                  
  take a breath test and are still convicted of drunken                        
  driving would not be eligible for a limited license.                         
  CHAIR BUNDE asked whether the fifth amendment merely deleted                 
  the option of confiscating the vehicle of a person convicted                 
  of DWI.                                                                      
  REP. MULDER said the court has the ability to confiscate a                   
  vehicle after the first offense.  He said that he had wanted                 
  to include strict sanctions to take away the vehicle of a                    
  person who committed multiple offenses and continued to                      
  drive drunk.  However, he encountered many statutory                         
  problems relating to ownership, liens and titles, and so                     
  decided to abandon the amendment as unnecessarily                            
  CHAIR BUNDE invited Department of Corrections Commissioner                   
  Rupp to testify, and asked him to limit his testimony to HB
  136, even though the commissioner was also planning to                       
  testify on HB 137 as well.                                                   
  Number 322                                                                   
  testified in Juneau in support of HB 136.  He expressed                      
  concern with the problem with drunken drivers and the delays                 
  of up to a year between sentencing and incarceration, which                  
  he said defeats the purpose of the law.  He also said that                   
  the state needs to assess whether those arrested for DWIs                    
  are functioning alcoholics who need treatment for their                      
  problem, while at the same time not excusing drunken                         
  behavior.  He supported the bill's effort to make people                     
  accountable for their actions and responsible for the costs                  
  incurred by their offenses.  Commissioner Rupp referred to                   
  the fiscal notes accompanying the bill and said the bill                     
  would collect as much revenue as it would cost after some                    
  initial expenses.  He said he had read news accounts of                      
  third-time offenders' involvement in fatal car accidents and                 
  called such situations intolerable.                                          
  Number 380                                                                   
  CHAIR BUNDE asked why, if the program would generate                         
  receipts equal to expenditures, there was no zero fiscal                     
  REP. MULDER answered that the fiscal notes displayed                         
  expenses in the top half of the page, and program receipts                   
  on the bottom side, and the two amounts balanced after the                   
  first year.                                                                  
  CHAIR BUNDE apologized for misreading the fiscal notes.                      
  Number 394                                                                   
  REP. BRICE asked about the assumption in the fiscal note                     
  that the state could collect only 60 percent of the charges                  
  levied under the bill, when the bill gave the state the                      
  ability to attach permanent fund dividends.                                  
  COMMISSIONER RUPP said that the department generally assumes                 
  it can collect 60 percent of the funds due it.  Also, he                     
  said, the department could not assume everyone arrested for                  
  DWI receives a permanent fund dividend.  He added that the                   
  state would eventually pay for itself.                                       
  Number 414                                                                   
  REP. BRICE said the fiscal notes were probably conservative                  
  estimates and the state would eventually bring in more money                 
  than the program cost.                                                       
  COMMISSIONER RUPP said he would be pleased with the extra                    
  money and could easily put the funds to good use within the                  
  REP. NICHOLIA noted that many people in Alaska do not                        
  receive permanent fund dividends because they owe for child                  
  care (support).                                                              
  Number 432                                                                   
  REP. G. DAVIS asked if the fiscal notes reflected the                        
  provisions for half-way house sentencing for second                          
  COMMISSIONER RUPP said extending the CRC provision to second                 
  offenders meant the department was looking at 20 days, which                 
  left more options.  He invited a staffer to testify with                     
  Number 444                                                                   
  CORRECTIONS, said 1,100 people were charged with a second                    
  DWI offense in 1992.  The offense carries a 30-day sentence,                 
  with a third of the sentence, or 10 days, subtracted for                     
  "good time."  Assuming 80 percent of those charged are                       
  convicted and serve their sentence, the second-offense CRC                   
  provision results in an additional 17,800 bed-days.  She                     
  said HB 136 addresses first-time offenses, of which there                    
  were 3,261 in 1992.  If each served a three-day sentence,                    
  that means 6,783 bed-days.  At $60 per day, a 20-day                         
  sentence would cost an offender $1,200, she said.                            
  COMMISSIONER RUPP said that cost did not seem unreasonable                   
  given the permanent fund dividend and other assets that                      
  people would have.  He said he felt the key was to say that                  
  people are responsible for the costs the state bears.                        
  Number 458                                                                   
  REP. KOTT asked if the term "imprisonment" should be used                    
  instead of "detention" when referring to a stay at a half-                   
  way house.                                                                   
  COMMISSIONER RUPP answered that the term "half-way house"                    
  had been replaced in favor of "community residential center                  
  (CRC)," a more expressive and appropriate term.  He added                    
  that some areas speak of community corrections, or community                 
  imprisonment, or house arrest.                                               
  REP. KOTT asked if AS 28.35.03 also included other motorized                 
  vehicles, such as snowmobiles.                                               
  COMMISSIONER RUPP responded affirmatively.                                   
  Number 475                                                                   
  REP. KOTT asked what type of facility in rural Alaska might                  
  be deemed an "appropriate facility" by the Department of                     
  COMMISSIONER RUPP said giving the department latitude would                  
  be appropriate.  He noted the department would consider a                    
  community's resources for possible CRCs, including such                      
  facilities as a hotel, which would mean the prisoner would                   
  have to pay the cost of incarceration in a hotel.  In other                  
  places, the department might deem an armory or other                         
  community facility an "appropriate facility."  It is                         
  important to make sure a place of confinement was                            
  appropriate and safe, to address liability issues, he said.                  
  If the bill did not provide for CRC, requirements for                        
  imprisonment in jail might mitigate (sic) against it, he                     
  said.  He stated he wanted to let the community respond to                   
  what it had.                                                                 
  REP. KOTT said he would hate to tell constituents that a                     
  drunk driving conviction netted a person a three-day stay in                 
  Juneau's Westmark hotel.                                                     
  Number 475                                                                   
  COMMISSIONER RUPP said he was once sentenced in traffic                      
  court to a traffic school, which took place overnight in a                   
  hotel and which cost some participants both the cost of the                  
  traffic school and the costs of a night's lodgings at a                      
  hotel.  He said it was a method that had been tried with                     
  Number 500                                                                   
  REP. BRICE asked what would happen if a first-time DWI                       
  offender was indigent and had their permanent fund dividend                  
  (PFD) already attached.                                                      
  COMMISSIONER RUPP said he would not mind attaching PFDs for                  
  future years.  He also said offenders could borrow money                     
  from friends or relatives, credit cards or any method of                     
  payment to make sure that a person was held accountable for                  
  the cost to society of his actions.                                          
  REP. BRICE said his major concern was not to see children                    
  neglected to pay costs of imprisonment.                                      
  Number 515                                                                   
  CHAIR BUNDE announced that, in light of the length of                        
  discussion on HB 136, the committee was not likely to bring                  
  HB 67, Eligibility for Public Assistance, to the table that                  
  day.  He said the committee would hold HB 67 over until the                  
  following week.                                                              
  Number 522                                                                   
  REP. NICHOLIA asked if the Department of Corrections knew                    
  how the cost of incarceration in a CRC would compare to the                  
  cost of incarceration in a jail.                                             
  COMMISSIONER RUPP answered yes, and noted that such costs                    
  vary by region.  He said the cost for jails range from a low                 
  of $68 to a high of almost $140 per day, for an average of                   
  about $100 per day.  The costs for CRCs range from a low of                  
  $38 per day to a high of almost $70 per day, he said.                        
  REP. NICHOLIA asked whether a person in an area without a                    
  CRC would have to serve their sentence in jail and incur the                 
  higher cost.                                                                 
  COMMISSIONER RUPP answered yes.  But he added that most                      
  communities are open to the idea of CRCs.  He added that the                 
  department would be willing to contract with for- or non-                    
  profit corporations to provide the service.  A church or a                   
  community association could provide the CRC service, as long                 
  as they met the core criteria for the state's core program.                  
  He said the state should make allowances for regional                        
  variations in CRC conditions or programs, especially to make                 
  allowances for Native issues.                                                
  (Rep. Olberg departed at approximately 3:45 p.m.)                            
  REP. NICHOLIA asked which rural communities the department                   
  contacted concerning the CRC programs.                                       
  COMMISSIONER RUPP said the department would not talk about                   
  contracting for CRCs until the legislature had its say on                    
  HB 136.  But, he said, he had spoken with a representative                   
  of Saxman who was interested in doing a culture-relevant                     
  program in that area.  Commissioner Rupp also noted that he                  
  had spoken with representatives of "two other areas that                     
  were associations," as well as with representatives from the                 
  Alaska Federation of Natives.  He said the department's                      
  intent, if HB 136 were to pass, would be to sit down with                    
  people in various areas to see what types of facilities                      
  would make sense as CRCs.  He said the department would                      
  promulgate its basic uniform requirements for certification,                 
  then talk with representatives from different areas to see                   
  how they might want to add to those basic requirements, then                 
  entertain proposals.                                                         
  Number 574                                                                   
  testified from Anchorage on HB 136.  She addressed the                       
  bill's fourth amendment, to include provisions for limited                   
  driver's licenses.  She said the division asked Rep. Mulder                  
  to include the amendment for two reasons.  The first reason                  
  was that the existing 1990 statutes regarding limited                        
  licenses, allowing such licenses to be granted to those                      
  charged with their second to sixth drunken driving offenses,                 
  are extremely burdensome to the division and to the court                    
  system.  She said there was no method included to allow the                  
  division to keep track of the limited license.  Given                        
  Alaskans' transience of residence and employment, the                        
  existing statutes create a large burden of paperwork and                     
  recordkeeping on the division and on the license-holder's                    
  employers, Ms. Hensley said.                                                 
  (Rep. Brice departed at 3:50 p.m.)                                           
  (Rep. Brice returned at 3:52 p.m.)                                           
  MS. HENSLEY said the second reason the division sought Rep.                  
  Mulder's fourth amendment was that granting limited licenses                 
  under the statutes was a large factor and disqualified the                   
  state from receiving about $200,000 in annual alcohol                        
  education grants given by the National Highway Safety                        
  Traffic Administration and administered by the Division of                   
  Public Safety's planning agency.  The grant requirements                     
  specify that a qualifying state must meet five of six                        
  qualifications, she said.  The state does not comply with                    
  requirements for limited licenses, for minimum age drinking                  
  prevention programs, or for sobriety checkpoints.                            
  TAPE 93-24, SIDE B                                                           
  Number 000                                                                   
  THE DEPARTMENT OF PUBLIC SAFETY, testified from Anchorage,                   
  making himself available to answer questions on HB 136.                      
  (Rep. Olberg returned at 3:54 p.m.)                                          
  AGENCY, IN THE DEPARTMENT OF PUBLIC SAFETY, testified via                    
  teleconference in Juneau, making himself available to answer                 
  questions on HB 136.                                                         
  REP. G. DAVIS noted the absence of a fiscal note from the                    
  Division of Motor Vehicles on the bill, and asked whether                    
  the bill would not require more work for the division.                       
  MR. DULANY answered that the bill would actually help the                    
  division.  He said that when amendments were passed in 1990,                 
  the division was unable to place a fiscal note and obtain                    
  funding to do the work called for by the amendments.  He                     
  said HB 136 would help the division's operations in the                      
  driver services area.                                                        
  Number 039                                                                   
  REP. NICHOLIA asked whether the Department of Corrections                    
  would work with tribal courts in villages, as most                           
  nonprofits do not have programs in all villages.                             
  COMMISSIONER RUPP answered yes.                                              
  Number 050                                                                   
  CHAIR BUNDE closed public testimony on HB 136 and asked the                  
  will of the committee.                                                       
  REP. BRICE moved passage of HB 136 with individual                           
  recommendations, with amendments and fiscal notes attached.                  
  Number 070                                                                   
  REP. VEZEY expressed concern about the number of amendments                  
  to the bill and said he would like to see a full list of the                 
  amendments so that the bill could be read in one document.                   
  He also expressed concern about the fiscal note.  He said if                 
  the Department of Corrections wanted to come back later and                  
  ask for more money to administer the program, he would be                    
  encouraged to refuse.  He said the bill was supposed to                      
  reduce the cost of enforcing compliance, and if it did not                   
  achieve that end, the legislature should try a different                     
  REP. G. DAVIS expressed agreement with Rep. Vezey on the                     
  number of amendments and said the fiscal impact of the third                 
  amendment was not included in the fiscal note, which would                   
  be updated and included.                                                     
  REP. BRICE said he would be willing to withdraw his motion                   
  to pass the bill from the committee if it were the will of                   
  the committee.                                                               
  CHAIR BUNDE said he would be willing to have a vote on the                   
  REP. B. DAVIS objected to the motion.                                        
  CHAIR BUNDE said he understood the will of the committee to                  
  have a clean copy of HB 136, plus a revised fiscal note to                   
  allow for the impact of including second offenses.  Chair                    
  Bunde closed discussion of HB 136 and announced his                          
  intention to turn the chair over to Rep. Toohey and to have                  
  the discussion turn to HB 137.                                               
  REP. NICHOLIA asked whether the committee would be able to                   
  discuss HB 136 when the bill returned to the table with a                    
  clean copy.                                                                  
  CHAIR BUNDE said yes, the committee would be able to                         
  continue discussing the bill until it was ready to vote.                     
  Chair Bunde announced he would have to leave the meeting at                  
  4:30 p.m. for another commitment, at which time he would                     
  turn the chair over to Rep. Toohey.  He noted the                            
  teleconferenced portion of the meeting was completed.  He                    
  brought HB 137 to the table.                                                 
  (Rep. Kott departed at approximately 4:00 p.m.)                              
  HB 137:  PAROLE FOR TERMINALLY ILL PRISONERS                                 
  COMMISSIONER RUPP testified in Juneau on HB 137.  He said                    
  the bill responds to a recommendation from the Alaska                        
  Sentencing Commission concerning special medical parole for                  
  terminally ill prisoners.  He said the bill was prompted, at                 
  least in part, by concerns over HIV-positive prisoners.  He                  
  said prisoners are dying in record numbers and the                           
  significant amounts of medical attention required of AIDS                    
  cases meant large medical expenses for dying prisoners.                      
  Commissioner Rupp said he believed the intention of Rep.                     
  Mulder, the sponsor, was to seek payment for such medical                    
  expenses not by the state, but by third parties, such as the                 
  federal government's Medicare or Medicaid programs.  The                     
  state can furlough terminally ill prisoners, but retains                     
  responsibility for their medical treatment, he said.  There                  
  are now eight to 10 prisoners who would qualify for terminal                 
  parole under HB 137, and medical expenses for one of those                   
  prisoners has already exceeded $500,000.  The commissioner                   
  said he had attended a conference of state prison                            
  commissioners at which they shared ideas on how to fight                     
  increasing health care costs, costs fueled in large part by                  
  AIDS and HIV.                                                                
  COMMISSIONER RUPP said he would like to see the provisions                   
  for parole in HB 137 expanded to include prisoners suffering                 
  from chronic debilitating conditions, saying that prisoners                  
  whose condition confined them to bed could be better cared                   
  for in different facilities.  He noted that the Department                   
  of Corrections did not have specialists in the care of the                   
  terminally ill on staff, nor did it have the funding or                      
  inclination to add them.  The department therefore provides                  
  a patchwork of care for terminally ill prisoners that is not                 
  up to the standard of care provided by specialists in the                    
  area, and which therefore serves as another reason for the                   
  department's support of HB 137, he said.                                     
  Number 193                                                                   
  COMMISSIONER RUPP said the bill would result in parole of                    
  some prisoners who would not otherwise be paroled, but there                 
  is no assurance such prisoners would be granted general                      
  parole, which is granted only at the discretion and                          
  independent authority of the Parole Board.  The commissioner                 
  said he had asked the executive director of the Parole                       
  Board, Richard Collum, to be available to answer questions.                  
  He reminded the committee members that the Parole Board does                 
  not work for the Department of Corrections.                                  
  Number 216                                                                   
  REP. TOOHEY asked whether terminally ill prisoners now are                   
  sent to a specific facility.                                                 
  Number 228                                                                   
  COMMISSIONER RUPP answered no, that the department did not                   
  have a specified facility or staff to deal with terminally                   
  ill prisoners.  He said the department provides most care                    
  for such prisoners through contracted services.  He added                    
  that the department is also responsible for the medical care                 
  of the prisoners it holds in jails, which can cause more                     
  problems than the population of terminally ill prisoners                     
  held in prisons.  Current law holds the department                           
  responsible even if a prisoner is being held before trial,                   
  he said.  In some cases, Commissioner Rupp said, people                      
  needing serious medical attention have committed offenses                    
  with the deliberate aim of being placed in jail and being                    
  provided medical care, though a third-party might have paid                  
  the medical costs had the person remained free.  He called                   
  that practice a travesty perpetrated upon the Alaska public.                 
  He concluded by saying the points he had raised showed why                   
  the Department of Corrections supported HB 137.                              
  Number 246                                                                   
  CHAIR BUNDE, on behalf of Rep. G. Davis, asked how much it                   
  cost the department to care for a terminally ill prisoner,                   
  compared to the cost Medicare or other third-party payer.                    
  COMMISSIONER RUPP estimated that, as the department                          
  contracts for such services, the cost would be approximately                 
  the same for each.                                                           
  CHAIR BUNDE asked whether the department anticipated saving                  
  money by moving prisoners needing intensive medical care out                 
  of the prisons into other public facilities where Medicaid                   
  could pay for the care.                                                      
  COMMISSIONER RUPP answered that if the prisoners were moved                  
  to a state-funded system, then the state would continue to                   
  bear some expense.  He added that it was likely that the                     
  state would pay less money because other health care                         
  facilities might have better contracts and be able to                        
  provide service at lower costs.                                              
  Number 269                                                                   
  REP. TOOHEY asked whether the prisons treat sick prisoners                   
  inside prisons or in hospitals.                                              
  COMMISSIONER RUPP said the prisons rely on the advice of the                 
  institution's attending physician whether to treat a                         
  prisoner inside the prison dispensary or at a facility                       
  outside the prison.  The prison bears the cost of either                     
  choice, Commissioner Rupp said.  He said treatment at an                     
  outside hospital costs more in part due to the necessity of                  
  sending guards along with prisoners.                                         
  Number 282                                                                   
  REP. NICHOLIA asked, "What if an individual contracted AIDS                  
  in the jail because it was beyond their control?"                            
  COMMISSIONER RUPP answered that he would have to consider                    
  the methods by which inmates contract AIDS, and such people                  
  are more often participants rather than victims in such                      
  circumstances.  Nevertheless, the Department of Corrections                  
  would be liable for the medical care of prisoners, he said.                  
  REP. NICHOLIA said she raised the question because there are                 
  some instances in which inmates who contract AIDS while                      
  imprisoned are unwilling victims.                                            
  Number 300                                                                   
  COMMISSIONER RUPP said he would be concerned about the                       
  quality of care available for inmates.  He said the                          
  department does not have the facilities or trained personnel                 
  to provide as good of care for terminally ill patients as                    
  the Alaska Psychiatric Institute, the Alaska Native health                   
  care system, or other services.  He said he believed people                  
  deserve to die with dignity, and that there was not much                     
  dignity dying in a jail cell of terminal AIDS.                               
  Number 310                                                                   
  REP. VEZEY asked who sets the standards for care of                          
  terminally ill people.                                                       
  COMMISSIONER RUPP answered that the department has a                         
  physician, a medical officer, on staff who would remain in                   
  consultation with whatever medical authority was present at                  
  any of the department's 14 facilities.  The initial standard                 
  of care would be established by the care-giver at the                        
  facility, with discussion with the departmental medical                      
  officer.  The commissioner also mentioned that there is a                    
  four-member medical board which meets routinely to review                    
  cases for appropriateness of treatment, and which has                        
  ultimate decision-making authority on maintaining                            
  appropriate medical treatment.  The board is primarily there                 
  to consider the cost of care and make sure that only                         
  appropriate care is provided.  He said it would also                         
  consider whether and when to move prisoners from one                         
  facility to another for medical reasons.  He said moving                     
  prisoners also entails a cost, which will be even higher                     
  given the requirements to comply with the Americans with                     
  Disabilities Act (ADA).                                                      
  Number 335                                                                   
  REP. VEZEY asked whether ADA addressed illnesses.                            
  COMMISSIONER RUPP answered no, the concern with ADA was that                 
  it required the department to make allowances for inmates                    
  with disabilities.  He said that upgrading all the state's                   
  prison facilities to meet ADA standards would be                             
  prohibitively expensive, prompting them instead to upgrade                   
  one or two at a time, then move prisoners with special needs                 
  to those facilities.  He commented that ADA was informally                   
  known as a "full employment act for attorneys."                              
  Number 353                                                                   
  REP. VEZEY said, "Staying on the same line of questioning, I                 
  was wondering how you were tying the ADA into health care,                   
  but.  What is, to kind of approach the question from a                       
  different angle, what's to prevent you from prescribing a                    
  terminally ill patient two aspirin and sending them back to                  
  their jail cell?  I mean, half a million dollars in medical                  
  expenses on terminally ill patients is a rather difficult                    
  sum of money to imagine.  I know it can be done."                            
  Number 375                                                                   
  COMMISSIONER RUPP said he might want to refer the question                   
  to Dr. Townsend, but said that doctors must provide care                     
  according to medical standards, as a condition of their                      
  medical licenses.  He said such standards, which include                     
  medical review, would help guide the standard of care.  He                   
  said he could not imagine giving a terminally ill patient                    
  two aspirin and sending him back to his cell to die.  He                     
  repeated that such questions might be better left to his                     
  medical officer to answer.                                                   
  REP. OLBERG asked a clarifying question, namely, whether                     
  state prisoners were guaranteed full medical benefits while                  
  the public at large was not.                                                 
  COMMISSIONER RUPP answered that this was true, though                        
  ironic.  He said court decisions, including Russ v. State,                   
  and Estelle v. Gambel, require the state to assume                           
  responsibility for the medical condition of those it                         
  Number 390                                                                   
  testified in Juneau in support of HB 137.  She said the                      
  board's executive committee was concerned about several                      
  cases in which prisoners suffering from Alzheimer's disease                  
  and other organic dementias, and therefore people of concern                 
  to the board, could have been better served had they been                    
  paroled to more appropriate facilities.  Such parole would                   
  allow the families of such people to help select what                        
  facility to which the prisoner could be paroled.  The board                  
  felt the demented should be released from prison when in the                 
  terminal stages of their illness, when continued                             
  incarceration would neither benefit them nor serve to                        
  protect the public.  She said the issue was one of humane                    
  CHAIR BUNDE closed public testimony and asked the will of                    
  the committee.                                                               
  REP. VEZEY moved passage of HB 137 from the committee with                   
  individual recommendations.                                                  
  Number 422                                                                   
  REP. B. DAVIS asked about Commissioner Rupp's earlier                        
  statement that he would like to see the bill's provisions                    
  extend to prisoners with chronic, debilitating diseases.                     
  She said that such a provision would require a specific                      
  definition of that condition.                                                
  COMMISSIONER RUPP said his medical people could have a                       
  definition drawn up quickly.                                                 
  Number 436                                                                   
  MS. LATOUR said she had asked Mike Stark, an attorney with                   
  the Department of Law's criminal division, whom she said has                 
  worked frequently with the Department of Corrections,                        
  whether a definition of terminally ill" had to be included                   
  in HB 137.  She said Mr. Stark had answered no, the                          
  Department of Corrections had the authority through                          
  regulation to have its medical team determine a definition                   
  of terminally ill and to decide what chronic and                             
  debilitating illnesses would be.  She said that while the                    
  department could set those guidelines, it would still be up                  
  to the Parole Board to determine whether a prisoner would                    
  win parole.                                                                  
  REP. B. DAVIS said that while she appreciated Ms. LaTour's                   
  answer, she would have to have more than one person's answer                 
  before she was satisfied.                                                    
  Number 446                                                                   
  COMMISSIONER RUPP offered to have his medical people come up                 
  with a statement for inclusion in the bill.                                  
  Number 450                                                                   
  GEORGE DOZIER, AIDE TO REP. PETE KOTT, testified on behalf                   
  of Rep. Kott.  Mr. Dozier said he wanted to express concern                  
  over the lack of specific statutory standards and criteria                   
  for conditions of release.  While it is important to be                      
  fiscally responsible, as was one goal of the bill, it is                     
  also important to protect the public health and safety, he                   
  CHAIR BUNDE said there was a motion on the floor to move                     
  HB 137 from the committee.                                                   
  REP. BRICE interrupted to say there was a motion to amend                    
  the bill.                                                                    
  CHAIR BUNDE said he had not heard such a motion, but would                   
  entertain such a motion if offered.                                          
  Number 464                                                                   
  REP. VEZEY said he was satisfied with the term "terminal                     
  illness," but he had reservations about "debilitating                        
  illness."  He said it was too broad a term, encompassing too                 
  much, and would require specific a definition.  Many                         
  illnesses, such as arthritis, are debilitating, he said.  He                 
  expressed comfort with the term "terminal illness" and with                  
  the delegation to either the medical board or the Parole                     
  Board to define the term.                                                    
  Number 475                                                                   
  REP. TOOHEY expressed agreement with Rep. Kott's position on                 
  the question of "debilitating illness."  A terminally ill                    
  person is not a danger to society and is debilitated to the                  
  point of inability to walk and probable inability to                         
  function without assistance.  She said the committee could                   
  leave that discretion to the Corrections Department's                        
  medical (board).                                                             
  COMMISSIONER RUPP said that prisons are getting more                         
  geriatric prisoners, defined as inmates who are 55 years old                 
  and older.  He said the growth of the age class of prisoners                 
  susceptible to Alzheimer's disease prompted concern over the                 
  disease relative to HB 137.  He said prison authorities are                  
  concerned about how to deal with prisoners suffering from                    
  Alzheimer's disease and from mental illnesses.  He said he                   
  has 700 mentally ill prisoners in his prison system, 350 of                  
  them acutely and chronically mentally ill.  Some of them are                 
  approaching the condition in which they are not terminally                   
  ill, but might be considered debilitated.                                    
  Number 497                                                                   
  REP. OLBERG asked whether the bill just provides the                         
  opportunity of parole to those who would not be eligible any                 
  other way.  That is, a prisoner not eligible for parole, but                 
  terminally ill, becomes eligible for parole under the bill,                  
  he said.  He shared the concern with over-broadening the                     
  bill to include debilitating diseases.                                       
  Number 505                                                                   
  CHAIR BUNDE said he would oppose HB 137 if it were broadened                 
  to include prisoners suffering from Alzheimer's disease.  It                 
  would be a shame to have such people in prison, but it would                 
  be even worse to have them on the street, he said.                           
  Number 510                                                                   
  CHAIR BUNDE repeated the motion to pass HB 137 from the                      
  committee with individual recommendations and without                        
  amendment to include debilitating illness.  Hearing no                       
  objection to the motion, he declared the bill passed with                    
  individual recommendations.                                                  
  CHAIR BUNDE announced that the committee would hear HB 67                    
  the following Tuesday, March 2, 1993.  The meeting was                       
  ADJOURNED at 4:30 p.m.                                                       

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