03/14/2014 08:00 AM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB214 | |
| HB134 | |
| HB250 | |
| HCR18 | |
| HCR19 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 134 | TELECONFERENCED | |
| += | HB 250 | TELECONFERENCED | |
| *+ | HCR 18 | TELECONFERENCED | |
| *+ | HCR 19 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 214 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 14, 2014
8:02 a.m.
MEMBERS PRESENT
Representative Pete Higgins, Chair
Representative Wes Keller, Vice Chair
Representative Benjamin Nageak
Representative Lance Pruitt
Representative Lora Reinbold
Representative Paul Seaton
Representative Geran Tarr
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 214
"An Act relating to mental health patient rights, notifications,
and grievance procedures."
- MOVED CSHB 214(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 134
"An Act requiring Medicaid payment for scheduled unit dose
prescription drug packaging and dispensing services for
specified recipients."
- MOVED CSHB 134(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 250
"An Act making an expression of apology, responsibility,
liability, sympathy, commiseration, compassion, or benevolence
by a health care provider inadmissible in a medical malpractice
case; requiring a health care provider to advise a patient or
the patient's legal representative to seek legal advice before
making an agreement with the patient to correct an unanticipated
outcome of medical treatment or care; and amending Rules 402,
407, 408, 409, and 801, Alaska Rules of Evidence."
- MOVED CSHB 250(HSS) OUT OF COMMITTEE
HOUSE CONCURRENT RESOLUTION NO. 18
Encouraging hospitals and birthing facilities in the state to
participate in the Baby- Friendly Hospital Initiative and to
support breastfeeding; and recognizing the benefits of
breastfeeding.
- MOVED HCR 18 OUT OF COMMITTEE
HOUSE CONCURRENT RESOLUTION NO. 19
Supporting Recover Alaska in its efforts to reduce the effects
of excessive alcohol consumption.
- MOVED CSHCR 19(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 214
SHORT TITLE: MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES
SPONSOR(s): REPRESENTATIVE(s) HIGGINS, TARR, GATTIS
01/21/14 (H) PREFILE RELEASED 1/10/14
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) HSS, JUD, FIN
02/18/14 (H) HSS AT 3:00 PM CAPITOL 106
02/18/14 (H) Heard & Held
02/18/14 (H) MINUTE(HSS)
02/25/14 (H) HSS AT 3:00 PM CAPITOL 106
02/25/14 (H) Heard & Held
02/25/14 (H) MINUTE(HSS)
03/11/14 (H) HSS AT 3:00 PM CAPITOL 106
03/11/14 (H) Heard & Held
03/11/14 (H) MINUTE(HSS)
03/13/14 (H) HSS AT 3:00 PM CAPITOL 106
03/13/14 (H) SCHEDULED BUT NOT HEARD
03/14/14 (H) HSS AT 8:00 AM CAPITOL 106
BILL: HB 134
SHORT TITLE: MEDICAID PAYMENT FOR MEDISET PRESCRIPTION
SPONSOR(s): REPRESENTATIVE(s) COSTELLO
02/20/13 (H) READ THE FIRST TIME - REFERRALS
02/20/13 (H) HSS, FIN
03/19/13 (H) HSS AT 3:00 PM CAPITOL 106
03/19/13 (H) Heard & Held
03/19/13 (H) MINUTE(HSS)
03/28/13 (H) HSS AT 3:00 PM CAPITOL 106
03/28/13 (H) Heard & Held
03/28/13 (H) MINUTE(HSS)
04/02/13 (H) HSS AT 3:00 PM CAPITOL 106
04/02/13 (H) Heard & Held
04/02/13 (H) MINUTE(HSS)
04/04/13 (H) HSS AT 3:00 PM CAPITOL 106
04/04/13 (H) Scheduled But Not Heard
04/06/13 (H) HSS AT 9:00 AM CAPITOL 106
04/06/13 (H) Heard & Held
04/06/13 (H) MINUTE(HSS)
04/08/13 (H) FIN AT 8:00 AM HOUSE FINANCE 519
04/08/13 (H) Scheduled But Not Heard
03/13/14 (H) HSS AT 3:00 PM CAPITOL 106
03/13/14 (H) SCHEDULED BUT NOT HEARD
03/14/14 (H) HSS AT 8:00 AM CAPITOL 106
BILL: HB 250
SHORT TITLE: MEDICAL MALPRACTICE ACTIONS
SPONSOR(s): REPRESENTATIVE(s) OLSON
01/21/14 (H) PREFILE RELEASED 1/17/14
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) HSS, JUD
02/27/14 (H) HSS AT 3:00 PM CAPITOL 106
02/27/14 (H) Heard & Held
02/27/14 (H) MINUTE(HSS)
03/13/14 (H) HSS AT 3:00 PM CAPITOL 106
03/13/14 (H) SCHEDULED BUT NOT HEARD
03/14/14 (H) HSS AT 8:00 AM CAPITOL 106
BILL: HCR 18
SHORT TITLE: BABY-FRIENDLY HOSPITAL INITIATIVE
SPONSOR(s): REPRESENTATIVE(s) HUGHES
02/19/14 (H) READ THE FIRST TIME - REFERRALS
02/19/14 (H) HSS
03/13/14 (H) HSS AT 3:00 PM CAPITOL 106
03/13/14 (H) SCHEDULED BUT NOT HEARD
03/14/14 (H) HSS AT 8:00 AM CAPITOL 106
BILL: HCR 19
SHORT TITLE: SUPPORTING EFFORTS OF RECOVER ALASKA
SPONSOR(s): REPRESENTATIVE(s) HERRON
02/21/14 (H) READ THE FIRST TIME - REFERRALS
02/21/14 (H) HSS
03/13/14 (H) HSS AT 3:00 PM CAPITOL 106
03/13/14 (H) SCHEDULED BUT NOT HEARD
03/14/14 (H) HSS AT 8:00 AM CAPITOL 106
WITNESS REGISTER
THOMAS STUDLER, Staff
Representative Pete Higgins
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the committee substitute and
answered questions for HB 214 on behalf of the bill sponsor,
Representation Higgins.
REPRESENTATIVE MIA COSTELLO
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 134 as the sponsor of the
bill.
CHARLES GUINCHARD, Staff
Representative Mia Costello
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during discussion of HB
134 for the bill sponsor, Representative Mia Costello.
MARGARET BRODIE, Director
Director's Office
Division of Health Care Services
Department of Health and Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HB 134.
ERIKA O'SULLIVAN, Staff
Representative Kurt Olson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 250 on behalf of the bill
sponsor, Representative Kurt Olson.
REPRESENTATIVE SHELLY HUGHES
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HCR 18 as the sponsor of the
resolution.
ALLISON CURRY
Regional Field Organizer
Planned Parenthood of the Great Northwest
Juneau, Alaska
POSITION STATEMENT: Testified in support of HCR 18.
REPRESENTATIVE BOB HERRON
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HCR 19 as the sponsor of the
resolution.
DIANE KAPLAN, President and CEO
Rasmuson Foundation
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HCR 19.
ELIZABETH RIPLEY, Executive Director
Mat-Su Health Foundation
Wasilla, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HCR 19.
JEFF JESSEE, Chief Executive Officer
Alaska Mental Health Trust Authority
Department of Revenue
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HCR 19.
WILLIAM STREUR, Commissioner
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified and answered questions during
discussion of HCR 19.
ACTION NARRATIVE
8:02:02 AM
CHAIR PETE HIGGINS called the House Health and Social Services
Standing Committee meeting back to order at 8:02 a.m.
Representatives Higgins, Seaton, Nageak, and Keller were present
at the call to order. Representatives Reinbold, Pruitt, and
Tarr arrived as the meeting was in progress.
[The House Health and Social Services Standing Committee had
recessed on March 13, 2014.]
HB 214-MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES
8:03:07 AM
CHAIR HIGGINS announced that the first order of business would
be HOUSE BILL NO. 214, "An Act relating to mental health patient
rights, notifications, and grievance procedures." [In front of
the committee was the proposed committee substitute (CS) for HB
214, labeled 28-LS0869\C, Mischel, 3/7/14, which had been
adopted as the working draft on March 11, 2014]
8:03:17 AM
REPRESENTATIVE KELLER moved to adopt the proposed committee
substitute (CS) for HB 214, labeled 28-LS0869\O, Mischel,
3/13/14, as the working draft. There being no objection, it was
so ordered. [Public testimony was closed at the March 11, 2014
committee meeting]
8:04:20 AM
THOMAS STUDLER, Staff, Representative Pete Higgins, Alaska State
Legislature, explained that Sections 1 and 2 of Version O were
unchanged from the previous version; however, Section 3 was
amended by adding, "has the right to add designated
representative employed and clearly identified by the evaluation
facility or unit or a designated treatment facility or unit to
act as a patient advocate and to assist in the filing of a
grievance under AS 47.30.847." He pointed out that [paragraph]
(14) was also amended, "has the right to select and individual
to act as a patient advocate and to assist in the filing of a
grievance under AS 47.30.847." Lastly, he noted that paragraphs
(15) and (16) were number changes. He reported that a patient
had the option of selecting their own advocate, or utilizing the
designated staff advocate at the facility. Directing attention
to page 5, line 17, which had been added after consultation with
DHSS, he read: "Nothing in this section applies to a facility
or unit or designated treatment facility that only provides
outpatient services." He stated that this had been an onerous
requirement on an outpatient service for filing grievances, as
the patient already had the option for leaving. He said that
Sections 4 and 5 were unchanged. He reported that Section 6 was
under discussion, although "it's not appropriate to discuss that
in this particular committee setting."
8:06:57 AM
MR. STUDLER, in reference to Section 6, remarked that, although
there had been resolution to the difference of opinion, he was
not yet ready to present it to the committee.
CHAIR HIGGINS offered his belief that the DHSS discussions for
the proposed bill were "pretty much vetted," and said that the
legal aspects were still to be worked out in the House Judiciary
Standing Committee.
8:07:58 AM
REPRESENTATIVE TARR opined that the legal opinion raised "a
pretty substantial issue that needed to be resolved," and she
asked if the information would accompany the proposed bill to
the House Judiciary Standing Committee.
CHAIR HIGGINS replied that, although there appeared to be
agreement for the proposed language, the House Judiciary
Standing Committee would "vet this a little bit further in that
area."
REPRESENTATIVE TARR expressed her concern that, as a sponsor to
the proposed bill, the provision had not yet been resolved when
it was passed from the House Health and Social Services Standing
Committee.
8:09:04 AM
MR. STUDLER explained that there had been discussions with the
assistant attorney general, and he offered his belief that a
resolution was forthcoming.
8:09:32 AM
REPRESENTATIVE KELLER moved to report CSHB 214, Version 28-
LS0869\O, Mischel, 3/13/14, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CSHB 214(HSS) was moved from the House Health and
Social Services Standing Committee.
8:10:03 AM
The committee took an at-ease from 8:10 a.m. to 8:12 a.m.
HB 134-MEDICAID PAYMENT FOR MEDISET PRESCRIPTION
8:12:16 AM
CHAIR HIGGINS announced that the next order of business would be
HOUSE BILL NO. 134, "An Act requiring Medicaid payment for
scheduled unit dose prescription drug packaging and dispensing
services for specified recipients." [In front of the committee
was the proposed committee substitute (CS) for HB 134, labeled
28-LS0303\R, Mischel, 4/1/13, which had been adopted as the
working draft on April 1, 2013]
8:12:22 AM
REPRESENTATIVE KELLER moved to adopt the proposed committee
substitute (CS) for HB 134, labeled 28-LS0303\T, Mischel,
2/27/14, as the working draft. There being no objection, it was
so ordered.
REPRESENTATIVE MIA COSTELLO, Alaska State Legislature, asked
that her staff present the proposed changes to the bill.
CHARLES GUINCHARD, Staff, Representative Mia Costello, Alaska
State Legislature, explained that the proposed CS had three
significant changes. In working with Department of Health and
Social Services, parts of the proposed bill had been re-arranged
to lower costs without changing any of the intent. The second
change was the deletion of any reference to DHSS paying for the
shipping costs of medication. He explained that the third major
change was for DHSS to adopt new regulations for pharmacy
reimbursement, which would be "right in line with what this bill
is asking." He pointed out that the fiscal note for the
proposed bill was zero. [Included in members' packets]
MR. GUINCHARD directed attention to the Sectional summary
provided by the Division of Legal and Research Services, dated
March 5, 2014. [Included in members' packets] Section 1
required Department of Health and Social Services to establish
an additional fee under the Medicaid program, to be paid to a
qualified pharmacy for dispensing services for prescriptions
that require medication compliance packaging into scheduled unit
doses for specified Medicaid recipients, and it described
specialized dispensary and delivery services which were covered.
Section 2 provided a contingent effective date, as any change to
a Medicaid program needed to be approved by the federal
government. Section 3 would establish the effective date.
8:17:14 AM
REPRESENTATIVE SEATON asked to confirm that it was no longer
necessary for 75 percent of the pharmacy's business to be
mediset.
MR. GUINCHARD replied that, although the 75 percent was in
regulation as a DHSS definition for pharmacies eligible to
receive reimbursement, it was not in statute. He directed
attention to the proposed bill, page 1, line 13, which defined
who was qualified to receive the dispensing fee. He pointed to
page 2, lines 3 - 12, which listed five criteria for
establishing a mediset. He stated that the bill determined that
a pharmacy capable of providing these five criteria was eligible
to receive the reimbursement.
8:19:19 AM
REPRESENTATIVE TARR directed attention to the fiscal note and
asked for clarification that the change from $750,000 to zero
had resulted from removal of the travel component. She asked if
the recipient was now responsible for this cost.
MR. GUINCHARD pointed to two significant changes in the proposed
bill which addressed the fiscal note. The first change was the
deletion of the transportation mandate to which she had
referred, although this was not responsible for the entire
reduction of the fiscal note. He stated that rearrangement of
the proposed bill was also responsible for a significant
reduction to the fiscal note. He noted that the criteria on
page 2, lines 3 - 12, in previous versions of the bill, had
created concern with DHSS that the proposed bill would require
establishment of separate fees for each of the criteria.
Reorganization of the proposed bill into Version T had now
clarified that only one fee would be established.
8:21:43 AM
MARGARET BRODIE, Director, Director's Office, Division of Health
Care Services, Department of Health and Social Services,
explained that removal of the transportation mandate had
eliminated the need for a survey to determine a new dispensing
fee, which had included delivery of the pharmaceuticals; hence,
the zero fiscal note. She said that the dispensing fee and the
mediset fee included delivery of the pharmaceuticals.
REPRESENTATIVE TARR asked to clarify that transportation was
still included.
MS. BRODIE stated that this was correct.
8:22:47 AM
CHAIR HIGGINS closed public testimony.
8:22:55 AM
REPRESENTATIVE KELLER moved to report CSHB 134, Version 28-
LS0303\T, Mischel, 2/27/14, out of committee with individual
recommendations and the accompanying zero fiscal note. There
being no objection, CSHB 134(HSS) was moved from the House
Health and Social Services Standing Committee.
8:23:49 AM
The committee took a brief at-ease from 8:23 a.m. to 8:25 a.m.
HB 250-MEDICAL MALPRACTICE ACTIONS
8:25:48 AM
CHAIR HIGGINS announced that the next order of business would be
HOUSE BILL NO. 250, "An Act making an expression of apology,
responsibility, liability, sympathy, commiseration, compassion,
or benevolence by a health care provider inadmissible in a
medical malpractice case; requiring a health care provider to
advise a patient or the patient's legal representative to seek
legal advice before making an agreement with the patient to
correct an unanticipated outcome of medical treatment or care;
and amending Rules 402, 407, 408, 409, and 801, Alaska Rules of
Evidence."
[In front of the committee was the proposed committee substitute
(CS) for HB 250, labeled 28-LS0967\O, Wallace, 2/10/14, which
had been adopted as the working draft on February 27, 2014]
8:26:15 AM
ERIKA O'SULLIVAN, Staff, Representative Kurt Olson, Alaska State
Legislature, explained that the proposed changes to the bill
were to clarify any ambiguity, and not to change the intent of
the bill or to favor any one group. She directed attention to
page 2, lines 20 and 22, and stated that "fault" would be
deleted in both lines. She stated that there was a precedent
for the language in this subsection (b) in 20 other states, and
she explained that the word "fault" did not necessarily mean
negligence or implied liability. She said that the word was
"oftentimes the right thing to do in the circumstances." She
reported that the change had been made to separate a reasonable
expression of sympathy during an explanation of occurrence from
an admission of negligence. She pointed to the change on page
3, line 7, which deleted "to" and inserted "in writing that the
patient or the patient's legal representative may." She
explained that this addition would remedy any problem of proof,
as everyone would be informed of their rights, and it would
ensure that the provision advised the patient of their legal
rights, as opposed to directing them to seek legal counsel. She
emphasized that this was for remedial measures, specifically for
offers to correct an unanticipated outcome.
8:29:51 AM
REPRESENTATIVE PRUITT moved to adopt proposed Amendment 1,
labeled 28-LS0967\O.1, Wallace, 3/8/14, which read:
Page 2, line 20:
Delete ", fault,"
Page 2, line 22:
Delete ", fault,"
Page 3, line 7:
Delete "to"
Insert "in writing that the patient or the
patient's legal representative may"
REPRESENTATIVE KELLER objected for discussion.
CHAIR HIGGINS clarified that discussion would be for proposed
Amendment 1, which Ms. O'Sullivan had just presented.
REPRESENTATIVE NAGEAK asked for clarification of the proposed
changes on page 3, line 7.
MS. O'SULLIVAN explained the change on page 3, line 7, which
deleted "to" and inserted "in writing that the patient or the
patient's legal representative may." She explained that this
addition would ensure that the provision was advising the
patient of their legal rights, as opposed to directing them to
seek legal counsel.
REPRESENTATIVE TARR asked to clarify that the sentence would end
with "seek legal advice."
MS. O'SULLIVAN expressed her agreement.
CHAIR HIGGINS reminded the committee that discussion was for the
proposed amendment.
8:33:07 AM
REPRESENTATIVE KELLER removed his objection. There being no
further objection, Amendment 1 was adopted.
8:34:10 AM
REPRESENTATIVE PRUITT asked for an explanation of the changes
from Version A to Version O.
MS. O'SULLIVAN paraphrased from HB250 Version A to Version O
Summary of Changes [Included in members' packets], which read:
On page 1, line 1 of the bill title, the word
'liability' was deleted. Under section 1(a) on page 1,
line 12 'liability' was deleted.
Under section 1(a), page 2, line 14, subsection (5)
was added to read: "evidence of a health care provider
requesting, demanding, inquiring, or directing another
to write-off, offer or promise to pay medical,
hospital, or similar expenses, in whole or in part,
following an unanticipated outcome of medical
treatment or care."
Under section 1, page 2, line 18, subsection (b) was
added to read: "If an expression of apology,
responsibility, sympathy, commiseration, compassion,
or benevolence made under (a)(1) of this section is
made in conjunction with an admission of liability,
fault, or negligence, only the expression of apology,
responsibility, sympathy, commiseration, compassion,
or benevolence is inadmissible, and the admission of
liability, fault, or negligence may be admissible as
evidence."
Under Section 2(1), section AS 09.55.545 on page 3,
line 6, 'liability' was deleted.
Under section 4, page 4, line 4, the CONDITIONAL
EFFECT was amended to include Sec. AS 09.55.545.
REPRESENTATIVE TARR stated that the key words were "expression"
versus "admission." She pointed out that it could require a
court case to call into question whether "responsibility" would
be used in a legal sense for liability.
REPRESENTATIVE KELLER stated that the intent of the proposed
bill was to reduce lawsuits, and he offered his belief that this
would successfully do this.
8:38:43 AM
CHAIR HIGGINS closed public testimony.
8:38:51 AM
REPRESENTATIVE KELLER moved to report CSHB 250, Version 28-
LS0967\O, Wallace, 2/10/14, as amended, out of committee with
individual recommendations and the accompanying fiscal notes.
There being no objection, CSHB 250(HSS) was moved from the House
Health and Social Services Standing Committee.
8:39:23 AM
The committee took an at-ease from 8:39 a.m. to 8:41 a.m.
HCR 18-BABY-FRIENDLY HOSPITAL INITIATIVE
8:41:30 AM
CHAIR HIGGINS announced that the next order of business would be
HOUSE CONCURRENT RESOLUTION NO. 18, Encouraging hospitals and
birthing facilities in the state to participate in the Baby-
Friendly Hospital Initiative and to support breastfeeding; and
recognizing the benefits of breastfeeding.
8:42:13 AM
REPRESENTATIVE SHELLY HUGHES, Alaska State Legislature, reported
that one in nine women suffer from postpartum depression, 34
percent of teenagers were obese, and 120 women out of 100,000,
in Alaska, annually develop breast cancer. She declared that
these were all associated to the importance for breast feeding.
Breast feeding offered "an unmatched beginning for children,"
and could reduce sudden infant death syndrome, childhood
cancers, and diabetes. She stated that mothers who breast fed
were healthier, and that there was a savings for health care
costs. She relayed that scientists were in agreement that
breast milk was the very best way to nourish babies, could
reduce the occurrence of ear infection and diabetes in infants
by 40 percent, could reduce symptoms of postpartum depression by
50 percent, and could protect babies from some of the effects of
pollution. She declared that research had shown that exclusive
breast feeding would also naturally space pregnancies. She
reported that breast feeding could save $52 million annually in
Alaska. She read a short quote from a nurse manager at the
maternity outpatient clinic at Providence Alaska Medical Center:
"No public health campaign has a farther reaching, positive
affect on well-being and longevity." She pointed out that the
proposed resolution had a zero fiscal note, with no cost to the
families, as well. The resolution simply stated that the Alaska
State Legislature recognized the aforementioned benefits and
recommended that hospitals and birthing centers attain the baby
friendly designation by implementing the ten steps to a
successful breast feeding program. She declared that the
resolution had the support of many groups, including many
hospitals, the Alaska State Hospital and Nursing Home
Association (ASHNHA), the Academy of Nurses, and the Centers for
Disease Control and Prevention (CDC), as well as many other
national organizations.
8:46:46 AM
CHAIR HIGGINS asked for an explanation as to how the mechanics
for this resolution would work.
REPRESENTATIVE HUGHES replied that the hospitals all agreed that
"it's a good thing." She said that the proposed resolution
would be a motivator to be used as a public education tool.
CHAIR HIGGINS asked how the proposed resolution would get the
word out.
REPRESENTATIVE HUGHES said that, as a sponsor, she would get it
to the hospitals and birthing centers, although it did not
technically go to anyone.
REPRESENTATIVE HIGGINS asked if her office would distribute the
resolution.
REPRESENTATIVE HUGHES replied that her office would distribute
the resolution.
8:48:46 AM
REPRESENTATIVE TARR, reporting that she was a co-sponsor of the
proposed resolution, cited requirements for employers to provide
breaks for women to breast feed under the Affordable Care and
Patient Protection Act. She encouraged breast feeding and
making it easier for working mothers.
REPRESENTATIVE HUGHES shared an anecdote about a baby on the
floor of the House of Representatives. She noted that there was
also a reduction of child abuse, neglect, and domestic violence
associated with breast feeding.
CHAIR HIGGINS reported that the hospitals had encouraged breast
feeding for his five children.
REPRESENTATIVE HUGHES explained that hospitals would not offer
formula unless the mother could not breast feed, although
substance abuse mothers would not be encouraged to breast feed.
REPRESENTATIVE TARR shared that, as often the hospital stay was
brief, breast feeding had not yet initiated and required follow-
up to establish it successfully.
REPRESENTATIVE HUGHES emphasized that breast feeding was a
natural resource in the State of Alaska.
8:53:01 AM
CHAIR HIGGINS opened public testimony.
ALLISON CURRY, regional field organizer, Planned Parenthood of
the Great Northwest, said that breast feeding protected "both
infants and mothers from a host of chronic and acute diseases
and conditions." She offered that Planned Parenthood believed
nursing mothers needed to feel comfortable and supported in the
effort to provide for children. She recognized the need for
strong public policy "that safeguard nursing mothers' rights and
allow them to breast feed and express milk at their places of
work." She emphasized that health care providers should take
larger steps to encourage breast feeding by new mothers.
8:54:30 AM
CHAIR HIGGINS closed public testimony.
8:54:40 AM
REPRESENTATIVE KELLER moved to report HCR 18, Version 28-
LS0727\O, out of committee with individual recommendations and
the accompanying zero fiscal notes. There being no objection,
HCR 18 was moved from the House Health and Social Services
Standing Committee.
8:55:05 AM
The committee took an at-ease from 8:55 a.m. to 8:57 a.m.
HCR 19-SUPPORTING EFFORTS OF RECOVER ALASKA
8:57:03 AM
CHAIR HIGGINS announced that the final order of business would
be HOUSE CONCURRENT RESOLUTION NO. 19, Supporting Recover Alaska
in its efforts to reduce the effects of excessive alcohol
consumption.
8:57:18 AM
REPRESENTATIVE BOB HERRON, Alaska State Legislature, paraphrased
from the sponsor statement, which read:
Alaska is "The Great Land"-and we know our great land
takes first place on a number of lists. Year after
year, Alaska tops national state-by-state rankings for
domestic violence, sexual assault, certain serious
illness, and suicide rates. More than just shocking
numbers on paper, these "firsts" are loaded with real-
life stories of hardship and pain. A major factor in
the struggle? Excessive alcohol consumption.
Recover Alaska is a public-private partnership
initiative formed by a dynamic group of concerned
Alaska business, government, and independent leaders.
Together, members share expertise in the criminal
justice and health care systems, community
development, and other fields touching on the causes
and consequences of excessive alcohol consumption.
Working with diverse stakeholders, Recover Alaska
pursues a variety of strategies to effect long-term
change. Strategies include (but are by no means
limited to):
Implementation of a comprehensive statewide
communication and advocacy plan to educate the public
about the negative impacts of excessive alcohol
consumption on individuals, families, communities, and
the state as a whole;
Development of a one-stop-shop for Alaskans to
access accurate information, as well as prevention and
treatment referral services; and
A sincere review of laws governing the sale and
distribution of alcohol in the state.
Recover Alaska is not anti-alcohol, anti-self
determination, or anti-business. Rather, in the
course of seeking to reduce the occurrence and the
aftermath of excessive consumption, Recover Alaska
supports healthier communities and brighter futures
for all Alaskans.
9:02:08 AM
CHAIR HIGGINS asked how this resolution would be distributed.
REPRESENTATIVE HERRON explained that the goal of the proposed
resolution was for recognition by the Alaska State Legislature
that there was excessive alcohol consumption in Alaska, and that
the legislature would strive, in conjunction with Department of
Health and Social Services (DHSS), to address the problem.
9:03:32 AM
CHAIR HIGGINS asked if this proposed resolution would go to the
governor, as it was important for the governor to understand
this request for help with this problem.
REPRESENTATIVE HERRON expressed his agreement, and deferred to
Commissioner Streur.
REPRESENTATIVE NAGEAK expressed his agreement that it was a big
problem and that it was necessary to continue working with
organizations to encourage young people.
REPRESENTATIVE HERRON said that the resolution recognized the
people working with Recover Alaska that want a change for
excessive consumption.
REPRESENTATIVE TARR expressed her appreciation for the
resolution.
9:08:09 AM
[A short video was presented]
9:11:29 AM
DIANE KAPLAN, President and CEO, Rasmuson Foundation, commented
on a letter previously received from Governor Parnell,
explaining his veto that half of the alcohol tax be used for
alcohol programs. He had stated that he would reconsider this
decision if he was persuaded that there were impactful programs
in place, and he had urged that Recover Alaska look at
innovative ways to address the issue. She relayed that Rasmuson
Foundation had convened a broad based, high level group of
policy makers about four years earlier to discuss the issue of
excessive alcohol use. She listed some of the programs with
alcohol related problems that Rasmuson Foundation had supported,
and she pointed out the necessity for Rasmuson Foundation to
work toward the core of the problem. She shared that this was a
joint initiative including participation by Rasmuson Foundation,
the Alaska Mental Health Trust Authority, Department of Health
and Social Services, and the Mat-Su Health Foundation, as well
as members of the judiciary, health providers, and other non-
profits.
9:13:28 AM
ELIZABETH RIPLEY, Executive Director, Mat-Su Health Foundation,
reported that surveys completed during the last year throughout
Alaska had revealed that alcohol and substance abuse was the
"top issue listed by Alaskans as detrimental to their health."
She acknowledged that its impact had drained resources and that,
although many organizations were addressing the issue, the
effect had plateaued and many providers, funders, families, and
individuals were frustrated. She emphasized that, as this hurt
the schools, the communities, the employers, and the State of
Alaska, it affected all Alaskans. She declared that it was such
a complex issue that many organizations stayed away for fear of
not making any impact. She remarked that discussion regarding
the economic impacts of alcohol often focused on the hospitality
industry, although alcohol was not an ordinary commodity and it
had "a terrible social cost" which needed to be acknowledged and
addressed. She stated that the monetary impact to the Alaska
economy was almost $1.2 billion annually. She explained that
the group would focus on the systems and the leadership to
better align efforts and partners. She noted that the Mat-Su
community had also ranked alcohol and substance abuse as the
number one issue, and that the top five health issues in the
community were all related to behavioral health. She said that
the board of directors of the Mat-Su Health Foundation had
selected behavioral health and child trauma as the areas to
focus its funding. She said that $5 million was annually
allocated to raise the health status of people in the Borough.
She pointed out that alignment throughout Alaska by Recover
Alaska to the behavioral health investment efforts for time,
expertise, and money would "really make a bigger dent in this
issue."
9:17:37 AM
JEFF JESSEE, Chief Executive Officer, Alaska Mental Health Trust
Authority, Department of Revenue, expressed his agreement for
the alignment of efforts across a variety of partners, as this
was critical for advancement of solutions to these problems. He
declared that this was the best opportunity he had seen, in his
34 years working in this field, to actually make some progress.
He pointed out that Rasmuson Foundation was leading Recover
Alaska, the Alaska Mental Health Trust Authority had identified
alcohol and substance abuse as one its new focus areas, and
Senator Pete Kelly had coordinated a group with the goal to end
fetal alcohol spectrum disorder (FASD) in Alaska. He noted that
the Mat-Su Health Foundation was also leading a local effort to
deal with this issue, and other wellness coalitions and tribal
partners had dedicated their efforts to change some social norms
and reduce the negative impacts of excessive consumption.
9:19:30 AM
MS. KAPLAN reported that none of the partners were willing to
simply meet and "contribute to a report that's gonna sit on
someone's shelf for the next 20 years." She emphasized that
there was a lot of drinking in Alaska, with very few
consequences, so it was necessary to change the social norms.
She pointed to the tobacco cessation program in the early 1990s
as an example. She shared that change in alcohol consumption
had already started, noting that not there were not too many
three martini lunches anymore. She stated that people now
routinely used seat belts, which was another major social change
in the community. She expressed her belief that this change
could also be accomplished with excessive alcohol consumption.
She pointed out that it was very uncommon to see noticeably
pregnant women drinking in public, as this behavior was subject
to social pressure. She stressed the necessity to have public
and private partners working together, which was the basis for
Recover Alaska. This would be a long term project, noting that
the tobacco cessation effort had taken 20 years, with the first
impacts noticed after 3 years, and acknowledging that the
alcohol program would also take this long. She stated that
private entities made good partners, as they had patient
capital. She reported that Rasmuson Foundation had taken the
lead for the organization of the Recover Alaska efforts. She
said that Rasmuson was actively involved in a review of Title 4,
the state alcohol rules, and this review was chaired by an
officer of the Cabaret, Hotel, Restaurant, & Retailers
Association (CHARR). She reported that these 60 active members
were looking at every aspect of the alcohol laws, with a goal
for proposed legislation by 2015 to reduce the amount of
excessive drinking in Alaska. She stated that there would be a
social norms campaign focused on youth, sharing that kids like
to be normal and commenting that cool kids don't drink, so other
kids will want to be like them. She noted that most kids think
every other kid was drinking. She discussed partnerships to
review adverse childhood experiences, including neglect caused
by alcohol. The outcomes in later life of this neglect were an
increased prevalence of obesity, suicide, and other health
conditions, and happiness would be impacted. She stated the
need of a resource in Alaska for people who need help, and
declared that Rasmuson would pilot a one-stop-shop for guided
help to find the available resources.
CHAIR HIGGINS asked about the United Way 211 system.
MS. KAPLAN replied that this system offered no better resources,
as no one kept a list of the available programs, available beds,
assessments, in-patient care, and what insurance was accepted.
She reported that Rasmuson Foundation would pilot this program
in two communities.
9:25:54 AM
REPRESENTATIVE REINBOLD commented on the wide spread use of
alcohol on college campuses, and asked how the program would be
implemented.
9:26:54 AM
MS. KAPLAN replied that they were currently working to define
the impact messaging, and she offered an example of the tobacco
alliance messages to teenagers. She said that the Mat-Su
partnership was working with professional media companies to try
out different messages on focus groups of teenagers. She
emphasized that kids would be defining the messages.
9:28:00 AM
REPRESENTATIVE REINBOLD suggested reaching out to the youth
leaders.
9:28:23 AM
REPRESENTATIVE KELLER stated that he had "very little faith in
legislation making the level of changes by itself." He
expressed his support for the partnership described by Mr.
Jessee, as there were "some really tough questions that have to
be brought forward," and he offered FASD as an example.
9:29:39 AM
MR. JESSEE, referencing the aforementioned legislation, said
that the Alcohol Beverage Control (ABC) Board was reviewing the
Title IV alcohol beverage control statutory framework, which he
declared to be a "hodge-podge of additions over time." He
stated that enforcement was inconsistent, and the ABC board had
convened a number of committees to review topics which included
local options, underage drinking, and licensing. He shared that
he was the chair of the licensing committee, that 70 percent of
his committee members were from the [alcohol] industry, and that
the goal was to find common areas of agreement for a public
health oriented approach to alcohol regulation without
negatively impacting the legitimate business interests. He
spoke about the committee review of underage drinking and the
subsequent criminal records for offenders. He explained that
the onerous consequences discouraged police officers from
writing citations. He suggested lowering the criminality of the
offense to be more consistent with law enforcement. He
suggested that legislation for a follow-up to the registration
of kegs found at underage drinking parties could be part of the
solution.
CHAIR HIGGINS offered his belief that a problem which groups
fall into was to think "their mousetrap is better than everybody
else's mousetrap." He declared that there was not any
coordination among the many good groups. He opined that any
group receiving state funding or grants should be required to
have a conference for coordination of efforts. He suggested to
team up with United Way 211 to make that site "the best it could
possibly be, 'cause they're already doin' it." He stated a need
for coordinated efforts.
REPRESENTATIVE REINBOLD suggested that youth community service
should be an aspect of sentencing for underage drinking.
MS. KAPLAN, in response to Chair Higgins, said that the plan for
the one-stop-shop was for the United Way 211 to be the entryway
into services. This would be supported by a person acting as a
guide to actual services, as currently there was just a list
without any support or follow up help. She noted that United
Way was also a key member of Recover Alaska.
REPRESENTATIVE TARR asked if this effort was regional or
statewide, and how it would identify those who need help to best
meet their needs.
MR. JESSEE acknowledged that the group was stealing this idea
from the Tobacco quit line. He declared that the important part
of the one-stop-shop was for someone to help decide what would
be the most effective treatment program, and then check back
with the individual for any follow up support. He declared that
this was a fundamental difference from the 211 referral. He
opined that more information for improvement would be
forthcoming as the system and the services were being utilized.
9:37:43 AM
MS. KAPLAN directed attention to the partnership strategy with
media to raise public awareness. She mentioned the series on
FASD in the Anchorage Daily News (ADN), and reported that
Rasmuson Foundation was funding a full time reporter and part
time photographer at ADN for 18 months to report on alcohol
issues. Referring to the FASD series in ADN, she stated that 50
percent of pregnancies in Alaska were unplanned. She noted that
most women were not thinking about ceasing alcohol consumption
until pregnancy was a reality, and not just a possibility. She
stated that the cost of an FASD child to the family, to the
state, and to the child itself, was enormous.
9:39:42 AM
CHAIR HIGGINS requested project directors: "please do not be
politically correct." He suggested telling the truth.
REPRESENTATIVE KELLER said that he was excited about the program
and the quality of the organizations aligning to address the
problem. He pointed to the "depth of the political ramification
and the visceral reactions that are tied to this issue that you
have to deal with."
REPRESENTATIVE REINBOLD mentioned that both Mark Hamilton and
Senator (Pete) Kelly were passionately working on eradication of
FASD. She referred to a recently formed Medicaid taskforce. She
offered her belief that this was an important opportunity to
address the issue and reduce the DHSS budget. She suggested
that the Friday night church programs, Recovery Alaska, were
amazing and impressive.
MS. RIPLEY, in response to Representative Reinbold, listed the
medical sector, the education sector, and the business sector as
all identifying alcohol and substance abuse as the number one
issue.
REPRESENTATIVE TARR, pointing to the earlier discussion for
social norms surrounding alcohol abuse, suggested that there be
more empathy and less judgment toward alcohol abuse.
REPRESENTATIVE NAGEAK stated that it was our job to share the
messaging with those who were struggling.
REPRESENTATIVE PRUITT acknowledged that this was a monumental
task and he suggested that adults had to be targeted in the
message, as well as kids. He declared that the public norm had
to also be viewed, and he offered an anecdote regarding alcohol
consumption at public functions. He asked that the program
message be expanded beyond kids, declaring that we all had to
keep ourselves, our colleagues, and our friends from excessive
alcohol consumption.
MR. JESSEE offered several anecdotes regarding the atmosphere of
social norms that needed to change.
CHAIR HIGGINS shared an anecdote.
9:49:37 AM
WILLIAM STREUR, Commissioner, Office of the Commissioner,
Department of Health and Social Services (DHSS), stated "this is
a good thing. What we're doing with this is something that is,
I think, going to get us off of dead center." He shared that
there had been these same challenges for 40 years, and that it
was financially evident that this could not continue in the same
way. He pointed to the negative effects of alcohol and the
amount of money spent on alcohol problems among the divisions in
Department of Health and Social Services. He declared that a
common theme among many departments in the state were the
results from mis-use of alcohol and drugs. He declared the need
for a partnership with "our tribes, with our municipalities,
with our villages, and with our private partners." He expressed
his support for the Recover Alaska group.
9:52:35 AM
REPRESENTATIVE HERRON offered two insights he had gained after
this presentation, one insight was that this was not a project,
as it had no end date, and the second insight was that all 60
legislators had to be involved and supportive. He expressed his
appreciation for Senator Kelly "carrying that banner" for FASD;
however, FASD and not drinking when you were pregnant had been
in the statutes for 25 years. He declared that the proposed
resolution not only recognized Recover Alaska, but it declared
the need for help from everyone.
9:54:48 AM
CHAIR HIGGINS opined that there would be substantial savings
through Recover Alaska, if its efforts could be coordinated with
other groups. He declared that it was a necessity for all the
stakeholders to communicate. He emphasized that jobs were
necessary as it gave value to people's lives.
9:56:05 AM
REPRESENTATIVE KELLER suggested that the final paragraph of the
sponsor statement be phrased more positively to state that
Recover Alaska was willing to take on issues.
CHAIR HIGGINS asked about an earlier reference for a change to
the wording order in the title of the resolution.
REPRESENTATIVE HERRON explained his request for a minor, though
significant, change in the title to now read: "Supporting
Recover Alaska in its efforts to reduce excessive alcohol
consumption and the effects."
9:58:04 AM
REPRESENTATIVE PRUITT suggested a conceptual amendment for the
title to read: "Supporting Recover Alaska in its efforts to
reduce excessive alcohol consumption and its effects."
There being no objection, Conceptual Amendment 1 was adopted.
9:58:36 AM
REPRESENTATIVE KELLER moved to report HCR 19, Version 28-
LS1475\A, as amended, out of committee with individual
recommendations and the accompanying zero fiscal notes. There
being no objection, CSHCR 19(HSS) was reported from the House
Health and Social Services Standing Committee.
9:59:17 AM
The committee took a brief at-ease.
9:59:43 AM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 9:59 a.m.
| Document Name | Date/Time | Subjects |
|---|