Legislature(1993 - 1994)

03/07/1994 03:00 PM HES

Audio Topic
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
txt
                                                                               
           HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES                         
                       STANDING COMMITTEE                                      
                          March 7, 1994                                        
                            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. Harley Olberg                                                           
  Rep. Bettye Davis                                                            
  Rep. Irene Nicholia                                                          
  Rep. Tom Brice                                                               
                                                                               
  MEMBERS ABSENT                                                               
                                                                               
  Rep. Pete Kott                                                               
                                                                               
  OTHER LEGISLATORS PRESENT                                                    
                                                                               
  Rep. Gene Therriault                                                         
                                                                               
  COMMITTEE CALENDAR                                                           
                                                                               
  *HB 478:  "An Act relating to the authority of mobile                        
            intensive care paramedics and emergency medical                    
            technicians to pronounce death under certain                       
            circumstances."                                                    
                                                                               
            PASSED OUT OF COMMITTEE                                            
                                                                               
  HB 506:   "An Act relating to student loans; to sanctions                    
            for defaulting on a student loan, including denial                 
            of a state occupational license or disbursement of                 
            state money; and providing for an effective date."                 
                                                                               
            HEARD AND HELD                                                     
                                                                               
  *HB 354:  "An Act relating to identification required upon                   
            enrollment in a public school."                                    
                                                                               
            NOT HEARD - POSTPONED UNTIL TIME UNCERTAIN                         
                                                                               
  (* First public hearing.)                                                    
                                                                               
  WITNESS REGISTER                                                             
                                                                               
  STEVEN O'CONNOR, Assistant Chief                                             
  Central Emergency Services, Soldotna                                         
  231 S. Binkley St.                                                           
  Soldotna, Alaska 99669                                                       
  Phone:  (907) 262-4792                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  BILL KRIEGSMAN, Captain                                                      
  Emergency Medical Services                                                   
  Ketchikan Fire Department                                                    
  319 Main St.                                                                 
  Ketchikan, Alaska 99901                                                      
  Phone:  (907) 225-9616                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
  MARK JOHNSON, Chief                                                          
  Emergency Medical Services Section                                           
  Division of Public Health                                                    
  Department of Health and Social Services                                     
  P.O. Box H                                                                   
  Juneau, Alaska 99811-0616                                                    
  Phone:  (907) 465-3027                                                       
  Position statement:  Testified in support of HB 478                          
                                                                               
  THOMAS SWAN, Paramedic                                                       
  P.O. Box 83226                                                               
  Fairbanks, Alaska 99708                                                      
  Phone:  (907) 488-3327                                                       
  Position Statement:  Testified in support of 478                             
                       (spoke via teleconference)                              
                                                                               
  CRAIG LEWIS, President                                                       
  Alaska Emergency Medical Services Association                                
  1881 Marika St.                                                              
  Fairbanks, Alaska 99709                                                      
  Phone:  (907) 456-3978                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  THOMAS NAROW, Chief of Service                                               
  Interior Ambulance and Rescue Squad                                          
  370 Old Steese Hwy.                                                          
  Fairbanks, Alaska 99710                                                      
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  RONNI SULLIVAN, Executive Director                                           
  Southern Region Emergency Medical Services Council,                          
  Anchorage                                                                    
  6130 Tuttle Pl.                                                              
  Anchorage, Alaska 99507                                                      
  Phone:  (907) 562-6449                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  DAVID POTASHNICK, Assistant Chief                                            
  North Slope Fire Department                                                  
  P.O. Box 69                                                                  
  Barrow, Alaska 99723                                                         
  Phone:  (907) 852-0307                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  JASON ELSON, Batallion Chief/Training Officer                                
  Kenai Fire Department                                                        
  105 S. Willow                                                                
  Kenai, Alaska 99611-7745                                                     
  Phone:  (907) 283-7666                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  JOEY PAYTON, Emergency Medical Technician                                    
  Delta Rescue                                                                 
  P.O. Box 485                                                                 
  Delta Junction, Alaska 99737                                                 
  Phone:  (907) 895-4975                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  BRENT URSEL, Physician's Assistant                                           
  McGrath Health Center                                                        
  P.O. Box 10                                                                  
  McGrath, Alaska 99627                                                        
  Phone:  (907) 524-3299                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  JANET NORTH, Physician's Assistant                                           
  Galena Health Center                                                         
  P.O. Box 77                                                                  
  Galena, Alaska 99741                                                         
  Phone:  (907) 656-1366                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  GEORGE GILMORE, Physician's Assistant                                        
  Tenana Chiefs Conference                                                     
  P.O.Box 309                                                                  
  Ft. Yukon, Alaska 99740                                                      
  Phone:  (907) 662-2462                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  WENDY HLADICK, Physician's Assistant                                         
  Galena Health Center                                                         
  P.O. Box 74                                                                  
  Galena, Alaska 99741                                                         
  Phone:  (907) 656-1891                                                       
  Position Statement:  Testified in support of HB 478                          
                       (spoke via teleconference)                              
                                                                               
  JOE MCCORMICK, Executive Director                                            
  Alaska Commission on Postsecondary Education                                 
  3030 Vintage Blvd.                                                           
  Juneau, Alaska 99801-7109                                                    
  Phone:  (907) 465-6740                                                       
  Position Statement:  Answered questions on HB 506                            
                                                                               
  LYNNE SMITH, Committee Aid                                                   
  House Health and Social Services Committee                                   
  Alaska State Legislature                                                     
  State Capitol                                                                
  Juneau, Alaska 99801                                                         
  Phone:  (907) 465-6825                                                       
  Position Statement:  Answered questions pertaining to                        
                       Amendment 2 for HB 506                                  
                                                                               
  PAIGE ADAMS, Vice-President                                                  
  University of Alaska Southeast Student Council, Sitka                        
  6-B Lifesaver Dr.                                                            
  Sitka, Alaska 99835                                                          
  Phone:  (907) 966-2244                                                       
  Position Statement:  Testified in support of HB 506                          
                                                                               
  DON WANIE, Director                                                          
  Division of Finance                                                          
  Department of Administration                                                 
  P.O. Box 110204                                                              
  Juneau, Alaska 99811                                                         
  Phone:  (907) 586-3603                                                       
  Position Statement:  Testified on HB 506                                     
                                                                               
                                                                               
  PREVIOUS ACTION                                                              
                                                                               
  BILL:  HB 478                                                                
  SHORT TITLE: EMT'S AUTHORITY TO PRONOUNCE DEATH                              
  SPONSOR(S): REPRESENTATIVE(S) THERRIAULT                                     
                                                                               
  JRN-DATE    JRN-PG                     ACTION                                
  02/14/94      2376    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/14/94      2376    (H)   HES, JUDICIARY                                   
  03/07/94              (H)   HES AT 03:00 PM CAPITOL 106                      
                                                                               
                                                                               
  BILL:  HB 506                                                                
  SHORT TITLE: STUDENT LOAN PROGRAM                                            
  SPONSOR(S): HEALTH, EDUCATION AND SOCIAL SERVICES BY REQUEST                 
                                                                               
  JRN-DATE    JRN-PG                     ACTION                                
  02/16/94      2416    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  02/16/94      2416    (H)   HES, L&C, FINANCE                                
  03/03/94              (H)   HES AT 03:00 PM CAPITOL 106                      
  03/03/94              (H)   MINUTE(HES)                                      
                                                                               
                                                                               
  BILL:  HB 354                                                                
  SHORT TITLE: I.D. REQUIRED TO ENROLL CHILD IN SCHOOL                         
  SPONSOR(S): HEALTH, EDUCATION AND SOCIAL SERVICES                            
                                                                               
  JRN-DATE    JRN-PG                     ACTION                                
  01/10/94      2020    (H)   READ THE FIRST TIME/REFERRAL(S)                  
  01/10/94      2020    (H)   HES, JUDICIARY                                   
  03/07/94              (H)   HES AT 03:00 PM CAPITOL 106                      
                                                                               
                                                                               
  ACTION NARRATIVE                                                             
                                                                               
  TAPE 94-38, SIDE A                                                           
  Number 000                                                                   
  CHAIR TOOHEY called the meeting to order at 3:07 p.m., noted                 
  members present and announced the calendar.  She then                        
  explained that HB 354 would be was postponed until a time                    
  uncertain.                                                                   
  CHAIR TOOHEY brought HB 478 to the table and indicated that                  
  Anchorage, Barrow, Delta Junction, Fairbanks, McGrath,                       
  Galena, Ketchikan, and Soldotna were on teleconference.                      
                                                                               
  HB 478 - EMTs AUTHORITY TO PRONOUNCE DEATH                                   
                                                                               
  Number 083                                                                   
                                                                               
  REP. GENE THERRIAULT, Prime Sponsor of HB 478, addressed his                 
  bill by reading from the sponsor statement.  He stated that                  
  HB 478 proposes to allow mobile intensive care paramedics                    
  and Emergency Medical Technicians (EMT) to determine and                     
  pronounce death under certain circumstances.  He indicated                   
  that certified paramedics and EMTs who are active members of                 
  a certified emergency medical service may make a                             
  determination and pronouncement of death if a physician is                   
  not immediately available upon determining that the person                   
  has suffered irreversible cessation of circulatory and                       
  respiratory functions.                                                       
                                                                               
  REP. THERRIAULT said currently when EMTs begin CPR they are                  
  required to continue resuscitation either until the person                   
  recovers or the EMT is relieved by either a medical facility                 
  or physician, or the responding parties become physically                    
  exhausted and are no longer able to continue, or their                       
  physical safety is seriously threatened, or a physician                      
  pronounces the person dead.                                                  
                                                                               
  REP. THERRIAULT indicated that many times emergency medical                  
  response members are required to continue unproductive                       
  resuscitation for several hours because physicians and                       
  medical facilities are not immediately available.                            
                                                                               
  REP. THERRIAULT stated that HB 478 would allow an emergency                  
  medical response member to declare death in situations where                 
  a physician is not available and would help emergency                        
  response teams respond to the emergency medical needs of                     
  Alaska.  He asked for questions from the committee.                          
                                                                               
  Number 174                                                                   
                                                                               
  CHAIR TOOHEY asked for teleconference testimony.  She also                   
  asked those testifying to limit their testimony to three                     
  minutes.                                                                     
                                                                               
  Number 176                                                                   
                                                                               
  STEVEN O'CONNOR, Assistant Chief, Central Emergency                          
  Services, Soldotna, testified via teleconference in support                  
  of HB 478.  He stated that he had concerns regarding page 2,                 
  line 19, of the bill.  He suggested that the line be deleted                 
  and recommended that the emergency medical technician should                 
  only provide information pertaining to the death to a                        
  physician who would actually sign the death certificate.  He                 
  also indicated that there are areas of the state that have                   
  Home No Code Death policies and was concerned that the                       
  legislation might conflict with that established protocol.                   
                                                                               
  Number 250                                                                   
                                                                               
  CHAIR TOOHEY said Mr. O'Connor's concern was understandable.                 
                                                                               
  Number 252                                                                   
                                                                               
  BILL KRIEGSMAN, Captain, Emergency Medical Service (EMS),                    
  Ketchikan Fire Department, testified via teleconference in                   
  support of HB 478.  He stated that he was in agreement with                  
  Steven O'Connor's suggestions.  He indicated that the term                   
  advanced cardiac life support techniques is referred to                      
  several times in the bill and suggested that the word                        
  cardiac be deleted.                                                          
                                                                               
  CHAIR TOOHEY asked Rep. Therriault if specific regulations                   
  would be brought up by the Department of Health and Social                   
  Services (DHSS) or the Department of Public Safety.  She                     
  asked what the guidelines would be for EMSs.                                 
                                                                               
  REP. THERRIAULT stated that there would be some regulatory                   
  "fleshing out" and he felt that statutes would not be able                   
  to address that level of detail.  He then said he had an                     
  amendment that would delete the language that requires the                   
  EMS provider to sign the death certificate and would change                  
  the language to require the EMS to provide information                       
  regarding the circumstances of death to the person who signs                 
  the death certificate.                                                       
                                                                               
  REP. BUNDE made a motion to adopt the amendment to HB 478.                   
                                                                               
  REP. VEZEY objected.                                                         
                                                                               
                                                                               
  (CHAIR TOOHEY stated for the record that Rep. Brice arrived                  
  at 3:10 p.m. and Rep. Nicholia arrived at 3:13 p.m.)                         
                                                                               
  REP. VEZEY asked if the amendment was numbered A.1                           
  (8-LS1678/A.1).  He was told by a number of members that it                  
  was.                                                                         
                                                                               
  REP. THERRIAULT said that the change would require the EMS                   
  to provide the information to the person who signs the death                 
  certificate.                                                                 
                                                                               
  REP. VEZEY said the amendment did not read well and asked                    
  for someone to read it in context.                                           
                                                                               
  Number 382                                                                   
                                                                               
  CHAIR TOOHEY read page 2, line 18, as amended:  "The                         
  paramedic or emergency medical technician shall provide to                   
  the person who signs the death certificate the... name of                    
  the deceased; presence of a contagious disease, if known;                    
  and..."                                                                      
                                                                               
  REP. VEZEY said it sounded like an incomplete sentence.                      
                                                                               
  REP. THERRIAULT further indicated that the words which must                  
  be include were deleted.   He said that it is an incomplete                  
  sentence that is completed with 1, 2, or 3.                                  
                                                                               
  REP. BRICE read the sentence again.                                          
                                                                               
  CHAIR TOOHEY asked if Rep. Vezey understood the question.                    
                                                                               
  REP. VEZEY said yes.  He then asserted that the physician                    
  would be held liable for the information provided by the EMS                 
  who hadn't signed anything.  He asked why it would be                        
  preferable not to have the paramedic sign.                                   
                                                                               
  CHAIR TOOHEY said the only information being provided was                    
  the name of the deceased, the presence of a contagious                       
  disease, if known, and the date and time.                                    
                                                                               
  REP. VEZEY indicated that the aforementioned information was                 
  very critical legal information with tremendous legal                        
  consequences.                                                                
                                                                               
  REP. THERRIAULT said it was his intention to have the EMS                    
  provider sign the death certificate, but indicated there is                  
  a system already in place through which that information is                  
  provided.                                                                    
                                                                               
  REP. OLBERG clarified that any death not attended by a                       
  physician would require a physician to sign a death                          
  certificate, even though the physician would be required to                  
  take a third party's word for it.  He also said it was his                   
  understanding that a death, not attended by a physician,                     
  would result in an autopsy.                                                  
                                                                               
  CHAIR TOOHEY agreed with Rep. Olberg.                                        
                                                                               
  REP. VEZEY said he was not comfortable with the amendment,                   
  but would listen to further testimony.                                       
                                                                               
  CHAIR TOOHEY asked Mark Johnson to address the question.                     
                                                                               
  Number 500                                                                   
                                                                               
  MARK JOHNSON, Chief, Emergency Medical Services Section,                     
  Division of Public Health, Department of Health and Social                   
  Services, testified in Juneau in support of HB 478.  He                      
  stated that there is a medical examiner system in place and                  
  also that the new State Medical Examiner, Dr. Probst, was                    
  opposed to the concept of EMS providers signing death                        
  certificates.  He maintained that the thrust of the bill is                  
  to enable EMS providers to pronounce death as to avoid                       
  extremely prolonged resuscitative efforts.  He also                          
  indicated that there were some administrative questions that                 
  he needed clarified.                                                         
                                                                               
  Number 541                                                                   
                                                                               
  REP. VEZEY asked if the amendment was still being debated.                   
                                                                               
  CHAIR TOOHEY said yes.  She called for a vote.                               
                                                                               
  REP. G. DAVIS asked that the vote be held until further                      
  testimony was heard, and said that Rep. Vezey's concerns and                 
  questions may be answered during that time.                                  
                                                                               
  CHAIR TOOHEY agreed.                                                         
                                                                               
  Number 576                                                                   
                                                                               
  THOMAS SWAN, Paramedic, testified via teleconference in                      
  support of HB 478.  He stated that the question of who would                 
  have the authority to pronounce a patient dead in the                        
  absence of a physician came up during a class that he was                    
  teaching last year.  He said he has been pursuing the issue                  
  ever since as there was no clear answer in state law.  He                    
  said the passage of HB 478 would ensure that proper medical                  
  procedures would be performed, that the EMS provider could                   
  pronounce the patient dead, and that the EMS provider would                  
  avoid any unnecessary exposure to a psychologically                          
  debilitating situation.  He also said that the measure would                 
  preserve resources that may be needed in another emergency.                  
                                                                               
  Number 640                                                                   
                                                                               
  CRAIG LEWIS, President, Alaska Emergency Medical                             
  Association, testified via teleconference in support of                      
  HB 478.  He stated that the aforementioned concerns should                   
  not stand in the way of the passage of the bill.  He felt                    
  the concerns could be addressed in regulation.  He urged the                 
  committee to support the legislation.                                        
                                                                               
  Number 670                                                                   
                                                                               
  THOMAS NAROW, Chief of Service, Interior Ambulance and                       
  Rescue Squad, testified via teleconference in support of                     
  HB 478.  He stated that the bill would help address                          
  situations where EMS providers are several hours away from a                 
  hospital.  He also indicated that the term advanced cardiac                  
  life support is overly specific and explained that the                       
  Interior Ambulance and Rescue Squad is licensed as an                        
  advanced life support agency in the state of Alaska.                         
                                                                               
  Number 713                                                                   
                                                                               
  RONNI SULLIVAN, Executive Director, Southern Region                          
  Emergency Medical Services Council, Anchorage, testified via                 
  teleconference in support of HB 478.  She stated that the                    
  issue has been a major concern of hers for several years.                    
  She explained the danger that EMSs face and sometimes put                    
  other people in when they continue emergency care on people                  
  that are not "viable" because CPR has been too prolonged or                  
  they were almost dead upon their arrival.  She further                       
  explained that her nightmare is that an ambulance would                      
  slide off a slippery road as it was rushing an obviously                     
  nonviable patient to the hospital and perhaps killing all                    
  those inside and maybe others on the road.  She said the                     
  bill would allow for the best patient care possible and                      
  would also remove a lot of the risk involved for the EMS                     
  providers.  She mentioned that the bill refers to paramedics                 
  as registered and indicated that they are, indeed, licensed.                 
                                                                               
  Number 758                                                                   
                                                                               
  DAVID POTASHNICK, Assistant Chief, North Slope Fire                          
  Department, testified via teleconference in support of                       
  HB 378.  He stated that it was his understanding that the                    
  proposal would require EMS providers to initiate care first                  
  and then determine whether the patient should be declared                    
  dead.  He felt there should be provisions for the initial                    
  withholding of care, especially in instances involving crime                 
  scenes.  He indicated that on page 1, lines 5-10, the                        
  inclusion of physician's assistants and registered nurses                    
  should be considered.  He explained that the aforementioned                  
  do provide care in pre-hospital settings.  He further                        
  indicated that on page 2, line 6, the term active member is                  
  unclear and questioned how it applied to the EMS providers.                  
                                                                               
  Number 808                                                                   
                                                                               
  JASON ELSON, Batallion Chief/Training Officer, Kenai Fire                    
  Department, testified via teleconference in support of                       
  HB 478.  He stated that he agreed with the amendment.  He                    
  also mentioned that an active member implies that the member                 
  is under current physician sponsorship and has a continuing                  
  medical education program.                                                   
                                                                               
  Number 820                                                                   
                                                                               
  JOEY PAYTON, Emergency Medical Technician, Delta Rescue,                     
  testified via teleconference in support of HB 478.  He                       
  stated that the 1990's have been dedicated to the research                   
  and development of quality treatment and equipment.  He said                 
  that he has, at times, had to work for up to three hours on                  
  nonviable patients.  He indicated that there is much                         
  emotional suffering endured by EMS providers that have to                    
  provide unnecessarily prolonged emergency treatment to a                     
  nonviable patient.  He further indicated that Dr. Jeffrey                    
  Mitchell has clearly documented the mental trauma endured by                 
  EMS providers from a prolonged resuscitation.  He maintained                 
  that the bill would give an EMS provider the ability to                      
  declare death, would reduce unnecessary trauma to providers,                 
  and would allow the "obviously deceased to remain dead with                  
  dignity."                                                                    
                                                                               
  Number 900                                                                   
                                                                               
  CHAIR TOOHEY asked if there was further teleconference                       
  testimony.                                                                   
                                                                               
  Number 905                                                                   
                                                                               
  BRENT URSEL, Physician's Assistant, McGrath Health Center,                   
  testified via teleconference in support of HB 478.  He                       
  stated that villages in rural areas do not have state                        
  troopers or physicians that can pronounce people dead.  He                   
  said that the EMTs and the health providers in the community                 
  are obligated to perform whatever life saving techniques are                 
  warranted, even when the case is obviously hopeless.  He                     
  felt the proposal would address some of the needs of rural                   
  villages and would take the pressure off EMTs and health                     
  providers in those situations.                                               
                                                                               
  Number 925                                                                   
                                                                               
  CHAIR TOOHEY said she agreed with Mr. Ursel and thanked him                  
  for his testimony.                                                           
                                                                               
  REP. BRICE asked Mr. Ursel if, as a physician's assistant                    
  (PA), he could pronounce a person dead or sign a death                       
  certificate.                                                                 
                                                                               
  MR. URSEL replied that he has been in touch with the local                   
  magistrate who informed him that he can pronounce people                     
  dead and sign death certificates.                                            
                                                                               
  Number 940                                                                   
                                                                               
  REP. G. DAVIS referred to the procedure of providing                         
  information to go along with a body to a physician who would                 
  then sign the death certificate and asked what his current                   
  procedure was in regards to the aforementioned procedure.                    
                                                                               
  MR. URSEL said that much of the information is provided to                   
  the coroner or state troopers.  He indicated that in a small                 
  village a state trooper can pronounce death and then those                   
  who were providing emergency care would give the information                 
  to the trooper.                                                              
                                                                               
  Number 973                                                                   
                                                                               
  CHAIR TOOHEY asked for testimony from Galena.                                
                                                                               
  Number 975                                                                   
                                                                               
  JANET NORTH, Physician's Assistant, Galena Health Center,                    
  testified via teleconference in support of HB 478.  She                      
  stated that PAs, nurse practitioners, and health aids are                    
  often the only EMS providers in rural communities.  She                      
  related an experience that happened over the weekend where a                 
  patient died after undergoing 40 minutes of CPR in the back                  
  of an ambulance.  She indicated that she was under the                       
  impression that only the coroner could declare a patient                     
  dead and that they spent five hours trying to find the                       
  coroner.  She asserted that the situation was distressing to                 
  the family of the deceased.  She felt the proposed                           
  legislation would make her job easier.                                       
                                                                               
  Number 995                                                                   
                                                                               
  CHAIR TOOHEY said she empathized with Ms. North's situation.                 
  She then asked for further testimony.                                        
                                                                               
  Number 997                                                                   
                                                                               
  GEORGE GILMORE, Physician's Assistant, Ft. Yukon, testified                  
  via teleconference in support of HB 478.  He asked if the                    
  proposal would allow EMTs to declare death at the scene.                     
                                                                               
  CHAIR TOOHEY indicated that after appropriate training EMTs                  
  will have that authority.                                                    
                                                                               
  MR. GILMORE stated that he heartily endorsed the intent of                   
  HB 478.  He explained that in the rural area he is in there                  
  has been no one who is certified to pronounce death.  He                     
  said the issue has caused many problems and referred to the                  
  disposition of the deceased and the hardship endured by the                  
  family.                                                                      
                                                                               
  Number 045                                                                   
                                                                               
  CHAIR TOOHEY asked for further testimony.                                    
                                                                               
  Number 047                                                                   
                                                                               
  WENDY HLADICK, Physician's Assistant, Galena Health Center,                  
  testified via teleconference in support of HB 478.  She                      
  stated her belief that if a coroner with no medical                          
  background can pronounce death, certainly an EMS provider,                   
  who is highly trained in emergency care, could also declare                  
  death.                                                                       
                                                                               
  Number 064                                                                   
                                                                               
  CHAIR TOOHEY asked if there was further teleconference                       
  testimony.  There was none.                                                  
                                                                               
  REP. BUNDE made a motion to adopt the proposed amendment.                    
                                                                               
  CHAIR TOOHEY asked Rep. Vezey if his objection still stands.                 
                                                                               
  REP. VEZEY said no, and withdrew his objection.                              
                                                                               
  CHAIR TOOHEY, hearing no objections, stated that the                         
  amendment was so moved.  She asked if there were any further                 
  amendments or questions.                                                     
                                                                               
  Number 090                                                                   
                                                                               
  REP. BRICE indicated that he would move to pass the bill                     
  out, unless Rep. Kott had an amendment to make.                              
                                                                               
  REP. KOTT stated that he had a letter of intent that he                      
  would like to have accompany the passage of HB 478 to the                    
  next committee of referral.  He felt the letter of intent                    
  would be better addressed in the next committee.                             
                                                                               
  REP. BUNDE stated that HB 478 as amended had a zero fiscal                   
  note and asked if the letter of intent would have any fiscal                 
  impact.                                                                      
                                                                               
  REP. KOTT responded no, but asked that perhaps a member of                   
  the department should address the question.                                  
                                                                               
  Number 100                                                                   
                                                                               
  MR. JOHNSON stated it was his understanding that there would                 
  be no additional fiscal note added as a result of the                        
  accompanying letter of intent.                                               
                                                                               
  Number 116                                                                   
                                                                               
  REP. BRICE made a motion to pass HB 478 as amended out of                    
  committee.                                                                   
                                                                               
  REP. B. DAVIS asked what the focus of the letter of intent                   
  was.                                                                         
                                                                               
  REP. KOTT stated that the letter of intent would require                     
  additional training for all EMS providers as to recognize                    
  the signs of death, and would also require that there be                     
  extensive notification to all emergency medical services                     
  providers and agencies as soon as possible after the bill                    
  becomes law.                                                                 
                                                                               
  TAPE 94-38, SIDE B                                                           
  Number 000                                                                   
                                                                               
  CHAIR TOOHEY asked if the EMS providers have to be trained.                  
                                                                               
  MR. JOHNSON answered yes and said a notice would be sent to                  
  all the emergency medical services and medical directors in                  
  the state informing them of the new law.  Then it would be                   
  the responsibility of the directors to ensure that the EMS                   
  providers under their sponsorship are appropriately trained.                 
  He said the DHSS would probably send guidelines as to how                    
  the training should be done.                                                 
                                                                               
  REP. G. DAVIS indicated that the letter from the Alaska                      
  State Medical Association recommends that the word or be                     
  changed to and on page 3, line 2, of the bill.  He asked Mr.                 
  Johnson to respond to the suggestion.                                        
                                                                               
  MR. JOHNSON said he felt the change would be going further                   
  than necessary.  He said he preferred the language as                        
  written.                                                                     
                                                                               
  Number 086                                                                   
                                                                               
  REP. BUNDE asked that there be a technical change to                         
  substitute the word licensed for the word registered.                        
                                                                               
  REP. THERRIAULT said he was unsure as to whether the term                    
  should be licensed or registered.                                            
                                                                               
  MR. JOHNSON explained that the regulations for paramedics                    
  uses the word license.  He also indicated that the words                     
  licensed and registered are "almost interchangeable words in                 
  our state."  He said the word licensed is used on the                        
  certificate given to paramedics in the state.                                
                                                                               
  REP. THERRIAULT said that he would agree with any language                   
  that the legal department suggests.                                          
                                                                               
  Number 133                                                                   
                                                                               
  CHAIR TOOHEY asked if the second item was addressed in the                   
  letter of intent.                                                            
                                                                               
  REP. KOTT said yes.                                                          
                                                                               
  CHAIR TOOHEY asked the pleasure of the committee.                            
                                                                               
  REP. BUNDE made a motion to pass HB 478 as amended out of                    
  committee with individual recommendations and accompanying                   
  fiscal note.                                                                 
                                                                               
  CHAIR TOOHEY asked if there were any objections.                             
                                                                               
  Number 154                                                                   
                                                                               
  REP. VEZEY objected.  He referred to page 2, lines 29-31,                    
  and said he found it incredulous that EMS providers would be                 
  expected to perform life saving measures under those                         
  circumstances.  He asked if there was a valid reason the                     
  line was in the bill.                                                        
                                                                               
  MR. JOHNSON agreed with Rep. Vezey, but felt it doesn't hurt                 
  to have the language included.  However, he said that some                   
  of the conditions listed leave room for judgement.                           
                                                                               
  REP. VEZEY said, "what brought it out of my mind is the                      
  Alaska State Medical Association was advocating changing the                 
  word or after (the) semicolon to and.  And, I would                          
  interpret that coming after the semicolon that it applied to                 
  all the previous subsections, which I think would just be                    
  ludicrous."                                                                  
                                                                               
  REP. VEZEY further commented that perhaps it would be better                 
  to delete the entire sentence on page 2, lines 18-22.  He                    
  asked if there was more information that goes on the death                   
  certificate than is listed on those lines.                                   
                                                                               
  MR. JOHNSON said there is additional information that                        
  pertains to the cause of death.  He felt it would be best to                 
  have those already trained in signing death certificates to                  
  continue doing so.                                                           
                                                                               
  Number 257                                                                   
                                                                               
  CHAIR TOOHEY asked if Rep. Vezey's objections still stands.                  
                                                                               
  REP. VEZEY withdrew his objection.                                           
                                                                               
  REP. KOTT objected and asked that the maker of the motion to                 
  pass HB 478 as amended out of committee amend the motion to                  
  include the letter of intent.                                                
                                                                               
  REP. BUNDE said that it was his intent to make that the next                 
  motion.  He felt it should be done in two steps.                             
                                                                               
  REP. KOTT withdrew his objection.                                            
                                                                               
  Number 283                                                                   
                                                                               
  CHAIR TOOHEY called for the vote to pass HB 478 as amended                   
  out of committee with accompanying fiscal note.                              
  Representatives Bunde, G. Davis, Vezey, Kott, B. Davis,                      
  Nicholia, Brice and Toohey voted Yea.  There were no Nay                     
  votes.                                                                       
                                                                               
  REP. BUNDE made a motion to include the accompanying letter                  
  of intent with HB 478 as amended.                                            
                                                                               
  CHAIR TOOHEY, hearing no objections, said that HB 478 as                     
  amended was so moved.  She then brought HB 506 to the table.                 
  HB 506 - STUDENT LOAN PROGRAM                                                
                                                                               
  Number 348                                                                   
                                                                               
  JOE MCCORMICK, Executive Director, Alaska Commission on                      
  Postsecondary Education (ACPE), introduced himself and began                 
  his testimony on HB 506.                                                     
                                                                               
  CHAIR TOOHEY indicated that she was turning the gavel over                   
  to Rep. Bunde.  Rep. Bunde presided over the remainder of                    
  the meeting.                                                                 
                                                                               
  CHAIR BUNDE explained that there were two proposed                           
  amendments and indicated that amendment A.2 (8-LS1752/A.2),                  
  submitted by Rep. Brice, would be referred to as Amendment                   
  1.  He then asked Mr. McCormick how the amendment related to                 
  his suggested amendments.                                                    
                                                                               
  Number 400                                                                   
                                                                               
  MR. MCCORMICK stated that the amendment would pertain to the                 
  variable interest rate that the ACPE has recommended.  He                    
  said, in good conscience, he could not support the amendment                 
  with a 15% cap.  He maintained that to put a cap on the                      
  variable rate would defeat the purpose of having a variable                  
  rate.                                                                        
                                                                               
  REP. BRICE made a motion to move Amendment 1.                                
                                                                               
  REP. TOOHEY objected.                                                        
                                                                               
  CHAIR BUNDE maintained that if a student wants to take                       
  advantage of low rates they "have to gamble on the high                      
  rates."  He said he did not support the amendment.                           
                                                                               
  REP. BRICE agreed with Chair Bunde and indicated that was                    
  the reason he suggested a cap at such a high rate.  He felt                  
  a cap at 15% would reach a certain level of compromise.  He                  
  said his concern was if rates go above 20% that students                     
  would not be able to afford to go to school.                                 
                                                                               
  Number 470                                                                   
                                                                               
  REP. VEZEY stated that the interest rate on a loan is not                    
  variable over the life of that loan, and the person knows                    
  that rate to be set for the life of the loan.  He said if                    
  the cap is at 15% and the prime rate is 20%, the funds for                   
  the student loan program will be depleted quite rapidly.                     
                                                                               
  CHAIR BUNDE said the loan program would be shut down at that                 
  point.  He further stated, "Each year is a new loan.  Each                   
  year could be a different interest rate."                                    
                                                                               
  REP. BRICE said, "Which is the precise reasoning for having                  
  a cap at 15%."  He said the cap would prevent a person from                  
  being locked in at 20%.  He acknowledged the provisions for                  
  refinancing but indicated that it's in the state's best                      
  interest not to have the rate "blossom."  He felt anything                   
  over 15% would be a disincentive for students.                               
                                                                               
  Number 538                                                                   
                                                                               
  REP. TOOHEY asked Mr. McCormick if there would be any time                   
  in his career when he would advise an 18 year old,                           
  unemployed student to take a loan at 20%.                                    
                                                                               
  MR. MCCORMICK said there has never been a time, to date,                     
  that he has done that.  He explained that if a student is                    
  highly motivated in pursuing an education, the rate of                       
  interest is not a consideration.                                             
                                                                               
  Number 545                                                                   
                                                                               
  REP. TOOHEY asked if Mr. McCormick would ever stop a student                 
  from taking a loan out at 20%.                                               
                                                                               
  MR. MCCORMICK replied that he would caution the student as                   
  to the income to debt ratio that would be incurred, but he                   
  would not prevent the student from making that decision.  He                 
  further indicated that it is the student's choice as a                       
  consumer.                                                                    
                                                                               
  Number 579                                                                   
                                                                               
  CHAIR BUNDE pointed out that if the cost of money is higher                  
  than the interest that the students pay, the student loan                    
  program will be phased out.  He asked for further discussion                 
  on the amendment.                                                            
                                                                               
  REP. KOTT asked if there was a section on the permanent fund                 
  dividend form that would allow the student to pay for                        
  education "at today's rates."                                                
                                                                               
  CHAIR BUNDE said it was his understanding that the section                   
  is designed for parents and further explained that it takes                  
  quite some time to build up funds.  He then called for a                     
  vote to adopt Amendment 1.  Representatives B. Davis,                        
  Nicholia, and Brice voted Yea, and Representatives Bunde G.                  
  Davis, Vezey, Kott, and Toohey voted Nay.  Chair Bunde                       
  announced that Amendment 1 failed.  He brought Amendment 2                   
  (8-LS1752/A.1) to the table.                                                 
                                                                               
  MR. MCCORMICK stated that the amendment would require a                      
  change to the promissory note and said administratively the                  
  change is not necessary.  He said that persons within the                    
  Division of Finance who were present would testify and offer                 
  language that would change Sections 9 and 10.  He said he                    
  would support those changes as a friendly amendment to the                   
  bill as to allow for the kind of leverage needed prior to                    
  the disbursements of warrants.  He said, "If I read this                     
  right, that says... the disbursement is due under terms of a                 
  written contract with that person... which would mean I                      
  would have to print in my promissory note that I had the                     
  authority to do this.  I just don't feel that's necessary."                  
  He further stated that it is the psychology of the provision                 
  that is the focus.  He said students will stop and think                     
  about putting a higher priority on their student loan                        
  payment.  He stated that he is opposed to the amendment.                     
                                                                               
  CHAIR BUNDE asked if there was anyone present to speak in                    
  favor of the amendment.  He then indicated that the                          
  amendment came from the ACPE.                                                
                                                                               
  MR. MCCORMICK said he offered a friendly amendment to amend                  
  Section 9, which would authorize the Department of                           
  Administration to withhold warrants from contractors.  He                    
  was unsure if the amendment would accomplish that.  He                       
  indicated that page 6, line 30, was under Section 10.                        
                                                                               
  Number 716                                                                   
                                                                               
  CHAIR BUNDE asked Lynne Smith where the amendment originated                 
  from.                                                                        
                                                                               
  LYNNE SMITH, Committee Aid, House HESS Committee, explained                  
  that the amendment came from Dianne Behrends from the ACPE.                  
                                                                               
  CHAIR BUNDE stated that he withdrew his motion to adopt the                  
  amendment.  He said if the amendment is needed, it could be                  
  addressed in a future committee.  He then asked for further                  
  questions or testimony.                                                      
                                                                               
  Number 741                                                                   
                                                                               
  PAIGE ADAMS, Vice-President, University of Alaska Southeast                  
  Student Council, Sitka, testified in Juneau in support of                    
  HB 506.  She stated that she did not think the role of the                   
  ACPE to be one of a financial advisor to students.  She felt                 
  that students are old enough to figure that out for                          
  themselves.  She asserted that if the interest rate was to                   
  remain at 8%, the availability of loans would decrease for                   
  future students.  She said, personally, she did not want to                  
  pay higher interest rates, but she felt that any loan is                     
  better than no loan.                                                         
                                                                               
  Number 780                                                                   
                                                                               
  REP. BRICE, as the only legislator on the committee with an                  
  outstanding loan, related how the interest rates just                        
  continue to stack up.  He said he hoped Ms. Adams will have                  
  a job a year after she graduates to make loan payments.                      
                                                                               
  MS. ADAMS said that her permanent fund dividend is paying                    
  for her schooling.  She said after four hours of debate, the                 
  council decided that going with a variable rate would ensure                 
  the program's future.                                                        
                                                                               
  Number 815                                                                   
                                                                               
  REP. TOOHEY said Ms. Adam's attitude was very responsible.                   
                                                                               
  CHAIR BUNDE asked Don Wanie to testify.                                      
                                                                               
  Number 818                                                                   
                                                                               
  DON WANIE, Director, Division of Finance, Department of                      
  Administration (DOA), testified on HB 506.  He stated that                   
  the division runs the state's payroll and accounting                         
  systems.  He further stated that the division would be                       
  paying employees who may have wage assignments and vendors                   
  who may have garnishments.  He said the legislation would                    
  affect both areas.  He indicated that Section 6, subsection                  
  C, may affect garnishments that the division already has in                  
  place.  He said the student loan garnishment would take                      
  precedence, and the division would have to suspend the other                 
  garnishment.  He questioned the wisdom of the requirement.                   
                                                                               
  MR. WANIE addressed Sections 9 and 10.                                       
                                                                               
  TAPE 94-39, SIDE A                                                           
  Number 000                                                                   
                                                                               
  MR. WANIE stated that Section 10 would cause circumstances                   
  whereby the division could receive a notification by way of                  
  a computer file from ACPE saying that certain people are in                  
  default on their student loans.  He said the division would                  
  then do a computer match against the vendor file and                         
  subsequently deny payments to vendors.  He said the division                 
  has not in the past held payments to vendors without some                    
  type of court document.  Although he did note that the                       
  Department of Law indicated that it would be permissible.                    
  He felt there was more than one way to address the problem                   
  and referred to the document he passed out titled "Comments                  
  on HB 506."  (See Attachment 1)                                              
                                                                               
  MR. WANIE said that, as written, the bill charges the DOA                    
  with the responsibility of performing the computer file                      
  matches and subsequent research to make absolutely certain                   
  that payments are withheld from the correct person.  He said                 
  the ACPE would develop a subsection that would pass files to                 
  the division, which would have a subsection that would look                  
  into vendor files.  On a day to day basis payments to                        
  vendors would be scrutinized to avoid payments being made to                 
  vendors who are delinquent in their loan payments.  He said                  
  the responsibility would then lie with the DOA to catch                      
  those people.                                                                
                                                                               
  MR. WANIE suggested that language be included in Title 14                    
  that would have the same effect as current language, but it                  
  would place responsibility for research and identification                   
  with the ACPE.  The ACPE would then notify the DOA of the                    
  specific persons from whom payments should be withheld.  He                  
  said the DOA currently has a mechanism in place, both in the                 
  payroll and vendor payment system, whereby if the DOA                        
  receives a court order that requests payments be held from a                 
  particular employee or vendor the payments are, indeed,                      
  withheld.  He suggested that the language in Section 10 be                   
  placed in Title 14 and that the ACPE do the necessary                        
  researching and documentation before the DOA processes them                  
  through their existing mechanism.                                            
                                                                               
  MR. WANIE stated that under language already in Title 9, the                 
  ACPE can get a court order to direct withholding of payments                 
  from a vendor.  He reiterated that there is already a                        
  mechanism in place that would allow the ACPE to obtain a                     
  court order.                                                                 
                                                                               
  Number 190                                                                   
                                                                               
  REP. OLBERG asked Mr. Wanie to define the term vendor.                       
                                                                               
  MR. WANIE referred to the list from the Suggested Amendments                 
  to HB 506 that was handed out at the previous meeting.  He                   
  said the ACPE suggested amending Section 9 so that only                      
  disbursement of payments for goods and services provided by                  
  an individual contractor would be withheld.  He said the DOA                 
  would not want to withhold welfare payments, longevity bonus                 
  payments, and other payments that are generated by the state                 
  system.  He felt that the ACPE was focusing on payments for                  
  goods and services provided to the state.                                    
                                                                               
  Number 233                                                                   
                                                                               
  REP. OLBERG asked if a person could be found under an                        
  assumed name.                                                                
                                                                               
  MR. WANIE responded no.  He said the DOA can identify those                  
  people who provide goods and services to the state if they                   
  use a social security number (SSN) rather than an employer                   
  identification number.  If they use an employer                              
  identification number as a sole proprietor, or if they are                   
  incorporated and use an identification number, the DOA                       
  cannot find them.  He said the only matches that can be made                 
  are with SSNs.                                                               
                                                                               
  Number 278                                                                   
                                                                               
  CHAIR BUNDE referred to Mr. Wanie's suggestions regarding                    
  Sections 9 and 10 and asked Mr. McCormick if he felt Item 2,                 
  as indicated in Comments on HB 506, would be a feasible                      
  option for the ACPE.                                                         
                                                                               
  MR. MCCORMICK said it would be doable without considerable                   
  additional expense.  He said a computer tape match system                    
  could be developed to match SSNs.  He further explained that                 
  the previously withdrawn amendment that related to page 6,                   
  line 30, would reference the contractor not the borrower.                    
  He indicated that he was mistaken in his earlier opposition                  
  to that amendment and clarified that he now supported it.                    
                                                                               
  Number 360                                                                   
                                                                               
  CHAIR BUNDE asked for further clarification regarding                        
  contractor and borrower.                                                     
                                                                               
  MR. MCCORMICK stated that under Section 10, subsection B,                    
  the amendment would change the line to read, "The Department                 
  of Administration may not disburse money to a person under                   
  (a) of this section if..."  He said the person would have a                  
  contract with the DOA.                                                       
                                                                               
  CHAIR BUNDE stated that Mr. McCormick's response clarified                   
  the issue for him.                                                           
                                                                               
  REP. VEZEY asked if the ACPE endorsed the amendment.                         
                                                                               
  MR. MCCORMICK said yes.                                                      
                                                                               
  CHAIR BUNDE asked if there was further discussion on                         
  Amendment 2.  He then asked for any objections.   Hearing                    
  none, Chair Bunde, stated that Amendment 2 was adopted.                      
                                                                               
  Number 416                                                                   
                                                                               
  REP. VEZEY asked that his amendment be discussed at the next                 
  meeting of the HESS Committee.                                               
                                                                               
  CHAIR BUNDE asked Rep. Vezey to hand out his amendment and                   
  indicated that he wanted to be sure that Mr. McCormick could                 
  review it.                                                                   
                                                                               
  REP. VEZEY made a motion to adopt Amendment 3.                               
                                                                               
  CHAIR BUNDE asked Rep. Vezey to speak to his amendment.                      
                                                                               
  REP. VEZEY stated there are several statutes that require                    
  the employer to continue to withhold payments until further                  
  order of the court.  He indicated that those orders can                      
  stand in perpetuity and it is an unreasonable burden on an                   
  employer to keep track of an employee's garnishments if the                  
  employee has returned to the company after several years.                    
  He suggested that after the word court on page 5, line 9,                    
  the phrase "or until the employment of the obligee is                        
  terminated" should be added.  He then said it would be the                   
  responsibility of the obligor to notify the employer to                      
  resume garnishing the wages of the obligee.                                  
                                                                               
  Number 483                                                                   
                                                                               
  CHAIR BUNDE asked for further discussion.                                    
                                                                               
  REP. BRICE related a scenario of an employee who has an                      
  outstanding student loan that is in default and quits his                    
  job.                                                                         
                                                                               
  CHAIR BUNDE interjected and said that Rep. Brice was missing                 
  a step and added that the student has a loan in default, has                 
  been put into collections, and his wages are being                           
  garnished.                                                                   
                                                                               
  REP. VEZEY interjected that conflict arises when the                         
  employee goes back to work for the employer after five years                 
  and the court order is still in effect.  He stated that                      
  state agencies have "gone after" employers and have made                     
  them liable, after the rehire, for all pay periods that they                 
  did not garnish wages.                                                       
                                                                               
  REP. BRICE said, "whether or not he's working or not."                       
                                                                               
  REP. VEZEY said no, and further stated that the employer has                 
  to honor that court order no matter how old it is.  They                     
  have to keep all their personnel records active to avoid                     
  possible penalties.                                                          
                                                                               
  CHAIR BUNDE reiterated the same scenario and further added                   
  that the employer is expected to remember that the employee                  
  had his wages garnished five years previously.  He indicated                 
  that Rep. Vezey's amendment would require the ACPE to notify                 
  the employer.                                                                
                                                                               
  Number 544                                                                   
                                                                               
  REP. BRICE asked if Mr. McCormick would have access to the                   
  Department of Labor.                                                         
                                                                               
  CHAIR BUNDE indicated that Mr. McCormick has access to skip                  
  tracers that would track the student for those five years.                   
                                                                               
  MR. MCCORMICK said the amendment would shift the                             
  responsibility of tracking to the ACPE.  He said he did not                  
  object to the amendment.                                                     
                                                                               
  CHAIR BUNDE asked if there were any objections to the                        
  amendment.  Hearing none, Chair Bunde stated that Amendment                  
  3 was adopted.  He then indicated that several committee                     
  members had another meeting to attend and asked that all                     
  interested parties attend the meeting the next day to finish                 
  discussing HB 506.                                                           
                                                                               
  Seeing no further business before the committee, CHAIR BUNDE                 
  ADJOURNED the meeting at 4:25 p.m.                                           

Document Name Date/Time Subjects