Legislature(1993 - 1994)
02/10/1994 03:00 PM House HES
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
February 10, 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. Pete Kott
Rep. Harley Olberg
Rep. Bettye Davis
Rep. Irene Nicholia
MEMBERS ABSENT
Rep. Tom Brice
OTHER LEGISLATORS PRESENT
Rep. Fran Ulmer
Rep. Joe Sitton
COMMITTEE CALENDAR
*HB 344: "An Act relating to arrest of a person for illegal
possession, consumption, or control of alcohol;
and providing for an effective date."
HEARD AND HELD
*HB 332: "An Act establishing the Alaska Public Health
Commission."
HEARD AND HELD
(* First public hearing.)
WITNESS REGISTER
DON DAPCEVICH, Director
Chemical Dependency Services
City and Borough of Juneau
P.O. Box 021571
Juneau, Alaska 99802
Phone: (907) 586-2173
Position Statement: Testified in support of HB 344
JUANITA HENSLEY, Chief
Driver Services
Division of Motor Vehicles
Department of Public Safety
P.O. Box 20020
Juneau, Alaska 99802
Phone: (907) 465-2650
Position Statement: Testified in support of HB 344
MARGOT KNUTH
Assistant Attorney General
Criminal Division
Department of Law
P.O. Box 110300
Juneau, Alaska 99811-0300
Phone: (907) 465-3428
Position Statement: Testified in support of HB 344
DR. PETER NAKAMURA, Director
Division of Public health
P.O. Box 110610
Juneau, Alaska 99811-0610
Phone: (907) 465-3090
Position Statement: Testified in support of HB 332
DEBORAH SMITH, Executive Director
Alaska Mental Health Board
431 N. Franklin
Juneau, Alaska 99801
Phone: (907) 465-3071
Position Statement: Testified in support of HB 332
TERESA LYONS, Director
Alaska Nurses Association
P.O. Box 74119
Fairbanks, Alaska 99707
Phone: (907) 479-3667
Position Statement: Testified in support of HB 332
(Spoke via teleconference)
ELMER LINDSTROM
Special Assistant to Commissioner Lowe
Department of Health and Social Services
P.O. Box 110601
Juneau, Alaska 99811-0601
Phone: (907) 465-3030
Position Statement: Testified in support of HB 332
SHERRIE GOLL
Alaska Women's Lobby
P.O Box 22156
Juneau, Alaska 99802
Phone: (907) 463-6744
Position Statement: Testified in support of HB 332
HARLIN KNUDSON, President
Alaska Hospital and Nursing Home Association
319 Seward St.
Juneau, Alaska 99801
Phone: (907) 586-1790
Position Statement: Testified in support of HB 332
DENNY DEGROSS, Former President
Alaska Public Health Association
2348 Leander Cir.
Anchorage, Alaska 99515
Phone: (907) 344-8824
Position Statement: Testified in support of HB 332
PREVIOUS ACTION
BILL: HB 344
SHORT TITLE: ARREST OF MINORS FOR CONSUMING ALCOHOL
SPONSOR(S): REPRESENTATIVE(S) ULMER,Phillips,Porter
JRN-DATE JRN-PG ACTION
01/03/94 2014 (H) PREFILE RELEASED
01/10/94 2014 (H) READ THE FIRST TIME/REFERRAL(S)
01/10/94 2014 (H) HES, FINANCE
01/14/94 2061 (H) SPONSOR SUBSTITUTE
INTRODUCED-REFERRALS
01/14/94 2061 (H) HES, FINANCE
01/14/94 2083 (H) COSPONSOR(S): BROWN
01/24/94 2140 (H) COSPONSOR(S): BARNES,CARNEY,
FOSTER,
01/24/94 2140 (H) COSPONSOR(S): MACKIE, MULDER
02/10/94 (H) HES AT 03:00 PM CAPITOL 106
BILL: HB 332
SHORT TITLE: PUBLIC HEALTH COMMISSION ESTABLISHED
BILL VERSION: SSHB 332
SPONSOR(S): REPRESENTATIVE(S) SITTON,BRICE,NORDLUND,
Ulmer,Brown,Barnes,Carney,Foster,Mackie,Mulder
JRN-DATE JRN-PG ACTION
01/03/94 2014 (H) PREFILE RELEASED
01/10/94 2014 (H) READ THE FIRST TIME/REFERRAL(S)
01/10/94 2014 (H) HES, FINANCE
01/14/94 2061 (H) SPONSOR SUBSTITUTE
INTRODUCED-REFERRALS
01/14/94 2061 (H) HES, FINANCE
01/14/94 2083 (H) COSPONSOR(S): BROWN
01/24/94 2140 (H) COSPONSOR(S): BARNES,CARNEY,
FOSTER,
01/24/94 2140 (H) COSPONSOR(S): MACKIE, MULDER
02/10/94 (H) HES AT 03:00 PM CAPITOL 106
ACTION NARRATIVE
TAPE 94-14, SIDE A
Number 000
CHAIR BUNDE called the meeting to order at 3:04 p.m., noted
members present, and announced the calendar. The meeting
was teleconferenced from Seattle, Fairbanks and Anchorage.
He brought HB 344 to the table.
HB 344 - ARREST OF MINORS FOR CONSUMING ALCOHOL
Number 046
REP. FRAN ULMER, Prime Sponsor of HB 344,stated that HB 344
addressed the issue of the arrest of minors for consuming
alcohol. She said at the present time there are no laws to
allow police officers to arrest a minor for drinking unless
the minor has been seen consuming the alcoholic beverage by
the arresting officer. The minor cannot be arrested if an
officer suspects, by the behavior and physical signs, that a
minor has been drinking. She further stated that the
proposed legislation not only would allow police officers to
arrest minors whom they felt had been consuming alcohol, but
it would also set a moral tone in a community and would
perhaps prevent minors from getting into more trouble; i.e.,
prevent them from drinking and driving.
REP. ULMER stated that she was asked to introduce the
legislation by the Division of Chemical Dependency and the
Department of Social Services in Juneau, the mayor's Task
Force on Drug Abuse Among Juneau Youth, the Alaska
Association of School Boards, and the Alaska Peace Officers
Association.
Number 144
REP. VEZEY asked about the referral Rep. Ulmer had made to a
minor who has been drinking and then drives a car.
Number 157
REP. ULMER stated that when the minor is in the vehicle,
there would be a law that prohibits that act, and the
proposal would allow an officer to make an arrest before the
minor gets into a car.
Number 160
REP. VEZEY asked how a minor would be convicted under the
statute.
Number 199
REP. ULMER replied that it is against the law for minors to
consume alcohol.
Number 208
REP. VEZEY asked what evidence would be used to convict the
minor.
Number 216
REP. ULMER stated that she would let the law enforcement
people on teleconference answer.
Number 232
REP. VEZEY stated that Driving While Under the Influence
(DWI) statutes do not require a person to submit to a blood
alcohol test or breath test, although if the test is
refused, there would be forfeiture of license. He also
asked how other illegal substances would be handled under
the proposed legislation.
Number 265
REP. ULMER responded by saying that the proposal was
designed to address the inconsistency of having a law on the
books that says it is illegal for minors to consume alcohol,
but not allowing for arrest unless an officer actually sees
them in the act of consuming alcohol.
Number 297
(Rep. B. Davis arrived at 3:04 p.m. and Rep. Nicholia
arrived at 3:07 p.m.)
Number 305
REP. OLBERG asked if being drunk in public was against the
law.
Number 313
CHAIR BUNDE stated that in Anchorage it is not against the
law to be drunk in public.
Number 318
REP. KOTT wanted to correct for the record that Rep. Ulmer
had said that a police officer could arrest a minor based on
"probable cause" and that actually it would be "reasonable
cause."
Number 330
REP. ULMER agreed.
Number 349
DON DAPCEVICH, Director of Chemical Dependency Services for
the City and Borough of Juneau, testified in support of
HB 344. He stated that he had noticed that the rates for
arrests of minors consuming alcohol had gone down
significantly until May of 1993, and after that time there
were no arrests for a long period following. He then found
that the district attorney had sent a memo to all law
enforcement that said not to arrest minors for consuming
alcohol unless they are seen consuming. From that time, he
said he had been working with other city officials to draft
local legislation to fill the "gap" until the legislature
reconvened.
MR. DAPCEVICH stated that there would still be a burden of
proof for prosecution and thought it would be in the same
manner that a DWI is proved. He felt it was important for
all citizens to send an unequivocal message to minors in the
state that drinking is illegal. He strongly urged the
committee to pass the legislation.
Number 455
JUANITA HENSLEY, Chief, Driver Services, Division of Motor
Vehicles, Department of Public Safety, testified in support
of HB 344. She stated that the court decision that made it
illegal to arrest a minor for consuming alcohol with
reasonable cause affected not only Southeast but also
Southcentral; i.e., Palmer.
MS. HENSLEY said that presently under current law an
individual between 18 and 20 years of age is cited and taken
to jail. If the person is under the age of 18, they are
taken into custody and cited, a parent or guardian is
called, and the case is referred to the Division of Family
and Youth Services (DFYS).
Number 542
REP. G. DAVIS said it was his understanding that the zero
fiscal notes indicated that the proposed legislation had
been common practice, but it had just been found to be
illegal to make an arrest, therefore no additional funds
would be needed.
Number 555
MS. HENSLEY agreed.
Number 569
CHAIR BUNDE asked if it was against the law for a minor to
be in possession of alcohol.
Number 571
MS. HENSLEY responded yes, but the courts in Southeast have
determined possession to mean that the officer has to
witness consumption, whereas before, "having consumed the
alcohol, your body is in possession."
Number 590
CHAIR BUNDE, for clarification, asked what other
municipalities were interpreting the law "in this manner?"
Number 601
MS. HENSLEY said, to her knowledge, Southeast, and
specifically Palmer, were interpreting the law in that way.
Number 614
CHAIR BUNDE asked if the Juneau city police and state
troopers were carrying out the present intent of the law.
Number 619
MS. HENSLEY responded yes.
Number 620
CHAIR BUNDE asked if it was just the troopers in the Mat-Su
valley that were not arresting minors for consuming alcohol.
Number 623
MS. HENSLEY said that the Palmer Police Department was not
making arrests either.
Number 629
REP. KOTT, in reference to Ms. Hensley's scenario of a minor
stumbling around extremely intoxicated, asked if under
current law could the minor be arrested.
Number 636
MS. HENSLEY said no.
Number 638
REP. KOTT said, "doesn't it also apply to adults...the
police also have their hands tied because of...we used to
have a law, I think, on the books."
Number 548
MS. HENSLEY said she could not answer that question, but
stated that individual municipalities may have "drunk in
public" laws.
Number 555
REP. KOTT asked for another example of reasonable cause.
Number 565
MS. HENSLEY related a scenario of a beach party where police
officers see kegs of beer but do not see an obviously
intoxicated minor with a beer in hand at that time.
Number 674
REP. TOOHEY asked if under the proposed legislation would a
blood alcohol or Breathalyzer test be done.
Number 682
MS. HENSLEY stated that a preliminary breath test and an
intoximilar 3000 test could be done, and also the smell of
alcohol or visual indications (bloodshot, watery eyes or
intoxicated behavior) would be sufficient.
Number 689
REP. TOOHEY asked if a blood test could be done without
parental permission.
Number 690
MS. HENSLEY said she could not answer the question.
Number 698
REP. TOOHEY stated that a Breathalyzer was sufficient.
Number 699
REP. VEZEY said, "forgive me for being confused, but it
appears that what we're doing here is proposing a statute
that says we can arrest people for breaking the law."
Number 724
MS. HENSLEY said that the courts have said that unless a
police officer sees a minor consuming alcohol, the current
statute would not apply.
Number 735
REP. VEZEY felt that the proposed legislation did not
address the problem.
Number 754
MS. HENSLEY said that the legislation would allow police
officers to enforce Title 4.16.050.
Number 760
REP. VEZEY, in reference to Mr. Hensley's reply, said that
it is not legal to enforce Title 4 at this time.
MS. HENSLEY agreed.
REP. OLBERG explained that any misdemeanor arrest must be
observed, and what the courts have determined is that a
police officer must actually see the minor consuming.
Number 789
MS. HENSLEY pointed out that HB 344 would allow the police
to make a warrantless arrest, explaining that under current
law an officer would have to obtain a warrant to arrest a
minor for consuming alcohol.
REP. G. DAVIS said that the authority was given to arrest a
minor for reasonable cause under existing law.
CHAIR BUNDE asked if the thrust of the proposed legislation
was to change from probable cause to reasonable cause.
Number 850
MARGOT KNUTH, Assistant Attorney General, Criminal Division,
Department of Law, testified in support of HB 344. She
responded to Chair Bunde's question by stating the thrust of
the problem as being that there is a court ruling that says
a warrantless arrest is not allowed of a minor consuming
alcohol. She stated that the court ruling would more than
likely spread to Anchorage and Fairbanks. She said the
problem could be approached two ways. First, the minor
consuming offense could be changed to say that possession of
alcohol includes possession by consumption, or the
warrantless arrest statute could be changed. She stated
that the Department of Law did not like the idea of an
officer having to walk away from an obviously intoxicated
minor under current law.
Number 902
CHAIR BUNDE closed public testimony and stated that it was
not his intention to move the bill out of committee.
Number 920
REP. VEZEY stated that he was not in opposition to the bill,
but he felt that further legal research should be done.
Number 930
REP. KOTT asked what requirement would there be under the
proposed legislation that would allow the Department of Law
to require a Breathalyzer or blood test from a violator, and
subsequently what would happen if the arrested minor
refused.
Number 942
MS. KNUTH stated that the department did not have the
authority to require those tests unless the minor was
driving. She further stated that she would make herself
available to legislators and their staff to answer questions
before HB 344 comes up for hearing again.
CHAIR BUNDE thanked Ms. Knuth for her testimony.
Number 979
REP. NICHOLIA made a motion to move the HB 344 out of
committee to Judiciary where the legal problems could be
better addressed.
Number 983
CHAIR BUNDE stated again that it was not his intention to
move the bill out of committee. He then brought HB 332 to
the table.
HB 332 - PUBLIC HEALTH COMMISSION
Number 996
(See Attachment 1 for prepared statement from Rep. Sitton.)
REP. JOE SITTON, Prime Sponsor of HB 332, stated that the
bill establishes a public health commission that would
develop a comprehensive public health plan for Alaska. He
said that the plan must be established regardless of other
health care reform measures because no plan is going to
succeed in the area of cost containment unless public health
and prevention are the cornerstones of the plan. He said
the legislation would define what public health is and what
the priorities should be. He said without the definition,
prioritizing would be impossible and funding would be
haphazard.
REP. SITTON explained that the legislation would require the
compilation of comprehensive statewide data that would help
to prioritize resources. He said a comprehensive
information system is an integral part of health care
reform. He said a central data base on all Alaskan children
and on patterns of Alaskans' usage of resources was needed.
He asserted that substance abuse was Alaska's number one
health problem. Rep. Sitton continued on to list
percentages of alcohol related problems in Alaska. He
stated that there are few indicators of the nature and
prevalence of alcohol and drug usage among youth. He said,
as stated in Healthy Alaskans 2000, that "without a
continuing mechanism to track changes in the behavior of
youth, there will be no way of measuring progress toward
reducing the use of alcohol and other drugs among youth."
REP. SITTON further stated that a comprehensive public
health plan can reduce health care costs by focusing on how
to finance medical treatment and health care delivery
systems. He also said it was necessary to focus on the
underlying factors which contribute to rising medical
expenditures. He parenthetically stated that last year the
total cost for health care for the 500,000 people in Alaska
was over $1.3 billion.
REP. SITTON referred to the 1993 U.S. Public Health Service
report that indicated dramatic health gains which could be
obtained if resources were applied to public health
services.
TAPE 94-14, SIDE B
Number 000
REP. SITTON stated there would be a fiscal impact in
developing a comprehensive public health plan, but stressed
that prevention was far more cost-effective than treatment.
He said that $240 million would be saved annually by
preventing 3% of coronary by-pass operations. He said
hospital costs for low birth rate babies could range between
$30,000 and $70,000 and perhaps five to ten times that for
long-term care, and prevention would have cost approximately
$700. He further stated that lifetime expenditures of over
$354,000 for an infant with congenital rubella syndrome
would be preventable with immunization. He said $10 million
would be saved annually by preventing the outbreak of only
two communicable diseases. Also, he explained that
prevention of one new HIV infection for every five person
identified as HIV positive would save $15 to $25 for every
$1 spent in counseling, testing, referral and partner
notification and counseling. He continued on to say that
the estimated cost of water fluoridation for on individual's
lifetime equals or is less than the cost for treatment of
one cavity.
REP. SITTON told the committee that a choice needs to be
made. He felt money should be spent on prevention to save
costs in the long-term and to save lives or be prepared for
ever escalating costs of treatment.
REP. SITTON stated that what he was proposing to do was to
establish a limited lifetime commission that would last six
years and subsequently be able to report its recommendations
to the legislature. He stressed that there were Alaskans
dying needlessly because there is no comprehensive public
health policy.
Number 165
REP. TOOHEY referred to the 59% of children under the age of
two who are not immunized and asked if immunization was not
available to them.
Number 180
DR. PETER NAKAMURA, Director, Division of Public Health,
Department of Health and Social Services (DHSS), answered
that the statistics indicate children who were not fully
immunized for their age.
Number 190
CHAIR BUNDE interjected that children are not allowed into
the school system unless they are fully immunized.
Number 196
DR. NAKAMURA responded by saying that many diseases affect
children before school age. He stressed the importance of
immunizing at the appropriate age.
Number 240
REP. KOTT asked why the commission would have ten members
versus a less "unwieldy" number.
Number 250
REP. SITTON said that the decision for ten members was
projected from the scope of the work involved.
Number 269
REP. KOTT said if HB 332 were to become law, the earliest
effective date would be implemented sometime in August. He
felt that with the requirement for the commission to report
to the legislature, January 1, 1995, was too optimistic.
Number 300
REP. SITTON said the date was for the initial assessment of
the plan. He further stated that he was open for any
suggested amendments.
REP. KOTT suggested that whoever drafted the DHSS fiscal
note consider that the plan would not be implemented until
August, and that it would not be a full year of travel and
personal expenses therefore, indicating a possible decrease
in the fiscal note.
REP. SITTON said that the fiscal note would be worked on
further. He urged the committee to take the long view and
said he was convinced that millions of dollars could be
saved. He said he felt his proposal was the least expensive
of all other proposed bills.
Number 363
CHAIR BUNDE said he was not optimistic that money would be
saved because people continue to do unhealthy things knowing
that it is unhealthy. He felt that the people of Alaska are
not ill-informed and that Rep. Sitton was trying to "lead a
horse to water."
Number 392
REP. SITTON said that a person's behavior does not shield
them from some public health threats. He said that a very
health conscious, responsible person could get on a plane
and contract Tuberculosis (T.B.) from someone who was not
identified with having T.B. and was not being tracked by the
state. He said that innocent bystanders are able to
contract T.B. for which there is no cure.
Number 427
CHAIR BUNDE asked how Rep. Sitton thought his proposal would
"mesh" with Governor Hickel's proposal.
Number 441
REP. SITTON said "the bill in the Senate...first had a vague
reference to public health." He said that the Senate had
looked at HB 332 and incorporated it into SB 270/HB 414.
Number 480
CHAIR BUNDE asked how Rep. Sitton's proposal related to
SB 270/HB 414.
Number 485
REP. SITTON said the Senate has shown an interest in public
health. He stressed that as long as the "function" was
carried out that he did not care whose bill it was.
Number 497
CHAIR BUNDE asked for teleconference testimony.
Number 534
DEBORAH SMITH, Executive Director, Alaska Mental Health
Board, testified in support of HB 332. She said it was very
important that public health issues be coordinated around
the state. She suggested an additional provision under
Section 3 requesting that the Alaska Mental Health Board be
added to the list that the commission would consult with.
She said frequently public health views an individual "from
the neck down and we want to make sure the whole individual
is considered in that plan."
CHAIR BUNDE asked for testimony from Fairbanks.
Number 583
TERESA LYONS, Director, Alaska Nurses Association, testified
in support of HB 332. She stated that the mission of the
Alaska Nurses Association is to work for the improvement of
high health standards and the availability of health care
services for all people. She wanted to address health care
reform issues. She stated that a universal health care
program should be available and accessible in regards to
insurance. She said there must be access to not only
universal insurance, but also to health care provisions.
She explained that there was a difference between public
health services and cadillac health care coverage available
to most Alaskans and Americans. She asserted that cadillac
coverage is coverage for catastrophic care. Public health
services are founded on prevention services and result in
savings.
MS. LYONS stated that for $1 spent on prevention of
premature births, $10 is saved for neonatal care. She felt
that health care coverage should be a basic human privilege
for every American and that primary health care and
preventative services could be a strong tool for social
intervention.
Number 706
CHAIR BUNDE referred to Mr. Aaron Katz, on-line from Seattle
for testimony. Mr. Katz informed Chair Bunde that he was
not prepared for testimony but would be happy to answer any
questions on public health issues.
Number 717
CHAIR BUNDE continued with testimony in Juneau.
Number 725
ELMER LINDSTROM, Special Assistant, Department of Health and
Social Services, testified in support of HB 332. He stated
that SB 270/HB 414 was drafted with a provision that would
allow for the creation of subcommittees under the health
authority, which he felt implied a public health role.
Number 766
CHAIR BUNDE thanked Mr. Lindstrom for his testimony and
stated that it was a concern to the committee as to how "we
mesh services, particularly in challenging budgetary times."
Number 783
SHERRIE GOLL, Alaska Women's Lobby, testified in support of
HB 332. She felt it was important to create a commission to
focus on the health care issue. She stated that "the
"incredibly high cost of health care is of great concern to
women and families; and in fact, is the underlying problem
that we're trying to address with other legislation to
reform our welfare system and our system of torts."
MS. GOLL asserted that the issue is the cost of health care
and the purpose of public health service delivery is to
promote healthy people. She felt that in the long-term
society would save considerable amounts of money by
promoting prevention. She said that, as women, they were
concerned about communicable and preventable diseases and
immunization, citing that China, Bulgaria and Hungary are
more successful than the United States for fully immunizing
children. She said that woman in Alaska face a higher risk
of homicide than women nationwide. She explained that for
every 1000 births in Alaska 60 are teen births compared to
four of every 1000 births in Japan. She further stated that
teen mothers are less likely to get prenatal care, resulting
in more low birth weight babies. She said a total of 5% of
all Alaskan babies are low birth weight babies. She also
mentioned that, as a nation, our infant mortality rate was
higher than South Korea and Singapore. She continued on to
say that substance abuse, mental health, and environmental
health problems abound in Alaska.
MS. GOLL stated that a strong and comprehensive health care
system will help to control the overall cost of medical
care. She said, although preventive care does cost
something, it costs less than the "actual treatment." She
urged the committee not to delay in the process of
developing a public health plan for the state.
Number 867
CHAIR BUNDE asked for further testimony.
Number 874
HARLIN KNUDSON, President, Alaska Hospital and Nursing
Association, testified in support of HB 332. He said the
foremost reason he supports the legislation is that there is
a need to support public health systems. He urged the
committee to keep public health issues in the forefront.
He noted that Section 4 of HB 332 is duplicated in SB 284.
Number 931
REP. TOOHEY stated that Mr. Knudson made the third reference
to the Senate bill and asked if it was SB 270 (Senator
Duncan's bill).
MR. KNUDSON said "no, this is the workgroup bill. This is
the compromise bill."
Number 938
MR. KNUDSON stated that he hoped the legislation will
address the issue of health reform and cited that Section 4
would be a "charge" to whatever commission is created.
Number 958
DENNY DEGROSS, Former President, Alaska Public Health
Association, testified in support of HB 332. He agreed with
Rep. Toohey that America has the greatest health care system
in the world, but America also has the poorest health. He
felt that it was due to the lack of understanding between
the medical care system and public health care. He
explained that services are provided to an individual
through doctor, hospital, or clinic care as opposed to the
care that is provided as protection for large populations.
He mentioned the various systems of cultural, state, and
military systems that provide health care.
MR. DEGROSS offered the metaphor that "we are on a $2
billion truck careening down a hill...and we've got all
these groups in the front seat and everyone is trying to
stay away from the steering wheel. We have nobody in charge
of this 18 wheeler."
MR. DEGROSS asserted that health care cost is now $2 billion
and is projected to be approximately $6 billion by the year
2003. He said the state desperately needs to get health
care reform under control. He said that "someone has to
know what the whole picture looks like, and we have nobody
who has that capacity."
MR. DEGROSS said the legislation would cause all those
involved to discuss and develop the core functions of state
government in regards to public health care.
TAPE 94-15, SIDE A
Number 000
CHAIR BUNDE stated that we would be gathering information
that the state is already aware of and then disseminating it
to people who would continue to engage in self-destructive
habits. He said if a successful goal could be achieved, he
would not be opposed to the legislation, but he felt people
would not take personal responsibility to protect themselves
regardless of the information and resources provided by the
state.
Number 065
REP. SITTON said that he agreed with most of what Chair
Bunde had expressed. He said it was his feeling that there
is a lot of information and resources in the state, but much
of it is not utilized because of organizational problems.
He further explained that 25% of people with "full blown"
AIDS contracted the disease between the ages of ten and 19.
He asserted that a ten year old child did not have the
acumen to protect him/herself from such diseases. Rep.
Sitton mentioned again the threat of contracting T.B. as an
innocent bystander.
Number 167
CHAIR BUNDE contended that if a commission was in place, he
still could not protect himself against T.B.
Number 171
REP. SITTON said, "well, I don't know that."
Number 179
CHAIR BUNDE reiterated that he agreed on the goals of the
legislation, but he felt there would be difficulty making
the public comply with what the state asks them to do.
Number 190
REP. TOOHEY said that at the very least the legislation
makes the state aware of the importance of health care
issues. She felt that a commission would be destructive and
redundant and urged everyone in the room to attend every
meeting held that pertains to public health care.
Number 231
REP. SITTON said that he was prepared to propose amendments
on Governor Hickel's bill.
Number 238
DR. NAKAMURA told the committee that public health is the
state of health of the public and is also a system that will
assure that the gains that have been made will be retained.
He felt that a public health improvement plan was needed for
the state that would identify all core functions and
essential services that have to be in place to preserve
health gains. He said the proposal was an infrastructure
for a health care system that must be developed. He said
the Clinton administration health care reform plan uses the
words simplicity, security, savings, quality, and
responsibility. Dr. Nakamura referred to the definitions of
these terms in the hand out titled "President Clinton's
Health Care Reform Plan: Health Security act of 1993."
(See Attachment 2.)
DR. NAKAMURA reiterated that there is a definitely defined
service and process to health care. He thanked the
committee.
Number 428
REP. B. DAVIS stated that many bills are addressing the
issue of public health. She said that money will not be
saved in the short-term but will be in the long-term. She
stressed cost containment. She felt there must be other
components along with the commission to deal with public
health. She also stated that she had valuable knowledge and
input to help craft a successful bill. She stressed that
changes had to be made regardless of what is decided in
Washington, D.C.
Number 555
CHAIR BUNDE said he agreed with Rep. B. Davis and said, "if
we want something done right, we ought to do it ourselves."
He thanked Rep. Sitton for his efforts.
Number 595
REP. SITTON commented that he wanted specific provisions and
said he did not care who's legislation it was in.
Number 609
REP. G. DAVIS referred to the fiscal notes and then to the
words in constitution provided in the bill files and said,
"...the legislature shall provide for the promotion and
protection of public health." He felt the sentence was
vague and perhaps needed work. He said public health was
the core of health and social services and it was given very
little recognition in regards to a $600 million state
budget. He further stated that prevention was the core
issue that needed to be addressed to save catastrophic care
costs in the future.
Number 669
CHAIR BUNDE, seeing no further business before the
committee, ADJOURNED the meeting at 4:45 p.m.
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