Legislature(1997 - 1998)
04/25/1997 01:06 PM JUD
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
HOUSE JUDICIARY STANDING COMMITTEE April 25, 1997 1:06 p.m. MEMBERS PRESENT Representative Joe Green, Chairman Representative Con Bunde, Vice Chairman Representative Brian Porter Representative Norman Rokeberg Representative Jeannette James Representative Ethan Berkowitz MEMBERS ABSENT Representative Eric Croft COMMITTEE CALENDAR SENATE BILL NO. 106 "An Act relating to the bond required of a notary public." - MOVED OUT OF COMMITTEE CS FOR SENATE BILL NO. 112(JUD) "An Act relating to marriage licenses; and transferring responsibility for marriage licensing from judicial officers to the state registrar of vital statistics." - MOVED OUT OF COMMITTEE CS FOR SPONSOR SUBSTITUTE FOR SENATE BILL NO. 38(JUD) "An Act relating to anatomical gifts, living wills, and do not resuscitate orders." - MOVED HCS CSSSSB 38(JUD) OUT OF COMMITTEE CS FOR SENATE BILL NO. 3(JUD) "An Act authorizing prosecution and trial in the district court of municipal curfew violations, and providing for punishment of minors upon conviction for violation of a curfew ordinance." - HEARD AND HELD HOUSE BILL NO. 234 "An Act relating to assistance for abortions under the general relief program; and relating to financial responsibility for the costs of abortions." - HEARD AND HELD HOUSE BILL NO. 245 "An Act relating to minimum sentences for assault in the fourth degree that is a crime involving domestic violence; providing that a prisoner may not contact the victim of the offense when provided access to a telephone or otherwise immediately after an arrest; and amending Rule 5(b), Alaska Rules of Criminal Procedure." - BILL CANCELLED (* First public hearing) PREVIOUS ACTION BILL: SB 106 SHORT TITLE: NOTARY PUBLIC BOND SPONSOR(S): JUDICIARY BY REQUEST JRN-DATE JRN-PG ACTION 02/26/97 519 (S) READ THE FIRST TIME - REFERRAL(S) 02/26/97 519 (S) JUDICIARY 03/07/97 (S) JUD AT 1:30 PM BELTZ ROOM 211 03/07/97 (S) MINUTE(JUD) 03/10/97 653 (S) JUD RPT 2DP 1NR 03/10/97 653 (S) DP: PEARCE, MILLER; NR: ELLIS 03/10/97 653 (S) ZERO FISCAL NOTE (COURT) 03/12/97 (S) RLS AT 10:45 AM FAHRENKAMP RM 203 03/12/97 (S) MINUTE(RLS) 03/12/97 690 (S) RULES TO CALENDAR 3/12/97 03/12/97 696 (S) READ THE SECOND TIME 03/12/97 696 (S) ADVANCED TO THIRD READING UNAN CONSENT 03/12/97 696 (S) READ THE THIRD TIME SB 106 03/12/97 696 (S) PASSED Y20 N- 03/12/97 702 (S) TRANSMITTED TO (H) 03/14/97 661 (H) READ THE FIRST TIME - REFERRAL(S) 03/14/97 661 (H) JUDICIARY 04/25/97 (H) JUD AT 1:00 PM CAPITOL 120 BILL: SB 112 SHORT TITLE: MARRIAGE LICENSING FUNCTIONS SPONSOR(S): JUDICIARY BY REQUEST JRN-DATE JRN-PG ACTION 03/05/97 571 (S) READ THE FIRST TIME - REFERRAL(S) 03/05/97 571 (S) JUDICIARY 03/26/97 (S) JUD AT 1:30 PM BELTZ ROOM 211 03/26/97 (S) MINUTE(JUD) 04/01/97 915 (S) JUD RPT CS 3DP SAME TITLE 04/01/97 916 (S) DP: TAYLOR, PEARCE, MILLER 04/01/97 916 (S) ZERO FNS TO SB (COURT, DHSS) 04/03/97 (S) RLS AT 10:45 AM FAHRENKAMP RM 203 04/03/97 (S) MINUTE(RLS) 04/03/97 958 (S) ZERO FNS TO SB APPLY TO CS (COURT,DHSS) 04/03/97 957 (S) RULES TO CALENDAR 4/3/97 04/03/97 959 (S) READ THE SECOND TIME 04/03/97 960 (S) JUD CS ADOPTED UNAN CONSENT 04/03/97 960 (S) ADVANCED TO THIRD READING UNAN CONSENT 04/03/97 960 (S) READ THE THIRD TIME CSSB 112(JUD) 04/03/97 960 (S) PASSED Y20 N- 04/03/97 966 (S) TRANSMITTED TO (H) 04/04/97 984 (H) READ THE FIRST TIME - REFERRAL(S) 04/04/97 984 (H) JUDICIARY 04/25/97 (H) JUD AT 1:00 PM CAPITOL 120 BILL: SB 38 SHORT TITLE: ANATOMICAL GIFTS, LIVING WILLS & DNR ORDER SPONSOR(S): SENATOR(S) TAYLOR JRN-DATE JRN-PG ACTION 01/10/97 24 (S) PREFILE RELEASED 1/10/97 01/13/97 24 (S) READ THE FIRST TIME - REFERRAL(S) 01/13/97 24 (S) HES, JUD 01/24/97 125 (S) SPONSOR SUBSTITUTE INTRODUCED -REFERRALS 01/24/97 125 (S) HES, JUD 01/31/97 (S) HES AT 9:00 AM BUTROVICH ROOM 205 01/31/97 (S) MINUTE(HES) 02/03/97 (S) MINUTE(HES) 02/03/97 207 (S) HES RPT 4DP 1NR 02/03/97 207 (S) DP:WILKEN, WARD, LEMAN, GREEN; NR:ELLIS 02/03/97 207 (S) FISCAL NOTE TO SS (DHSS) 02/03/97 207 (S) ZERO FISCAL NOTE TO SS (DPS) 02/05/97 237 (S) FIN REFERRAL ADDED FOLLOWING JUDICIARY 02/14/97 (S) JUD AT 1:30 PM BELTZ ROOM 211 02/14/97 (S) MINUTE(JUD) 02/17/97 379 (S) JUD RPT CS 3DP SAME TITLE 02/17/97 379 (S) DP: TAYLOR, PARNELL, PEARCE 02/17/97 379 (S) FN SAME AS PREVIOUS (DHSS) 02/20/97 429 (S) ZERO FN SAME AS PREVIOUS (DPS) 02/25/97 (S) FIN AT 9:00 AM SENATE FINANCE 532 02/25/97 492 (S) FIN RPT 5DP 2NR (JUD)CS 02/25/97 492 (S) DP: SHARP, PEARCE, DONLEY, TORGERSON, 02/25/97 492 (S) PARNELL NR: ADAMS, PHILLIPS 02/25/97 492 (S) PREVIOUS FN (DHSS) 02/25/97 492 (S) PREVIOUS ZERO FN (DPS) 02/26/97 (S) RLS AT 12:30 PM FAHRENKAMP RM 203 02/26/97 (S) MINUTE(RLS) 02/27/97 536 (S) RULES TO CALENDAR 2/27/97 02/27/97 538 (S) READ THE SECOND TIME 02/27/97 538 (S) JUD CS ADOPTED UNAN CONSENT 02/27/97 539 (S) ADVANCED TO THIRD READING UNAN CONSENT 02/27/97 539 (S) READ THE THIRD TIME CSSSSB 38(JUD) 02/27/97 539 (S) PASSED Y17 N- E3 02/27/97 543 (S) TRANSMITTED TO (H) 03/05/97 535 (H) READ THE FIRST TIME - REFERRAL(S) 03/05/97 535 (H) JUDICIARY, FINANCE 04/18/97 (H) JUD AT 2:00 PM CAPITOL 120 04/18/97 (H) MINUTE(JUD) 04/25/97 (H) JUD AT 1:00 PM CAPITOL 120 BILL: SB 3 SHORT TITLE: MINOR'S CURFEW VIOLATIONS SPONSOR(S): SENATOR(S) PEARCE, Donley JRN-DATE JRN-PG ACTION 01/03/97 14 (S) PREFILE RELEASED 1/3/97 01/13/97 14 (S) READ THE FIRST TIME - REFERRAL(S) 01/13/97 14 (S) HES,JUD 02/21/97 (S) HES AT 9:00 AM BUTROVICH ROOM 205 02/21/97 (S) MINUTE(HES) 02/21/97 446 (S) HES RPT 2DP 2NR 1AM 02/21/97 446 (S) DP:WILKEN,WARD;NR:ELLIS,GREEN; AM:LEMAN 02/21/97 446 (S) FISCAL NOTE (COURT) 02/21/97 446 (S) ZERO FN (DPS) 02/21/97 446 (S) INDETERMINATE FNS (ADM, DHSS) 02/21/97 446 (S) FIN REFERRAL ADDED FOLLOWING JUDICIARY 03/07/97 (S) JUD AT 1:30 PM BELTZ ROOM 211 03/07/97 (S) MINUTE(JUD) 03/10/97 652 (S) JUD RPT CS 3DP 1NR NEW TITLE 03/10/97 652 (S) DP: PEARCE, MILLER, PARNELL; NR: ELLIS 03/14/97 739 (S) PREVIOUS INDETERMINATE FN APPLIES (DHSS) 03/21/97 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/21/97 (S) MINUTE(FIN) 03/21/97 (S) MINUTE(FIN) 03/25/97 (S) FIN AT 9:00 AM SENATE FINANCE 532 03/25/97 (S) MINUTE(FIN) 03/25/97 (S) MINUTE(FIN) 03/25/97 850 (S) FIN RPT 4DP 2NR JUD CS 03/25/97 850 (S) DP: PEARCE, SHARP, PARNELL, TORGERSON 03/25/97 850 (S) NR: PHILLIPS, ADAMS 03/25/97 850 (S) PREVIOUS FN (COURT) 03/25/97 850 (S) PREVIOUS INDETERMINATE FNS(ADM, DHSS) 03/25/97 850 (S) PREVIOUS ZERO FN (DPS) 04/09/97 (S) RLS AT 11:16 AM FAHRENKAMP RM 203 04/14/97 (S) RLS AT 10:45 AM FAHRENKAMP RM 203 04/14/97 (S) MINUTE(RLS) 04/15/97 1144 (S) RULES TO CALENDAR 4/15/97 04/15/97 1144 (S) READ THE SECOND TIME 04/15/97 1145 (S) JUD CS ADOPTED UNAN CONSENT 04/15/97 1145 (S) ADVANCED TO THIRD READING UNAN CONSENT 04/15/97 1145 (S) READ THE THIRD TIME CSSB 3(JUD) 04/15/97 1145 (S) PASSED Y15 N2 E3 04/15/97 1145 (S) DUNCAN NOTICE OF RECONSIDERATION 04/16/97 1227 (S) RECONSIDERATION NOT TAKEN UP 04/16/97 1228 (S) TRANSMITTED TO (H) 04/17/97 1131 (H) READ THE FIRST TIME - REFERRAL(S) 04/17/97 1131 (H) JUDICIARY 04/25/97 (H) JUD AT 1:00 PM CAPITOL 120 BILL: HB 234 SHORT TITLE: ABORTIONS UNDER GENERAL RELIEF PROGRAM SPONSOR(S): REPRESENTATIVE(S) MARTIN, Green, Kohring, Kott, Dyson, Sanders, Kelly JRN-DATE JRN-DATE ACTION 04/04/97 990 (H) READ THE FIRST TIME - REFERRAL(S) 04/04/97 990 (H) JUDICIARY, FINANCE 04/07/97 1019 (H) COSPONSOR(S): DYSON 04/08/97 1030 (H) COSPONSOR(S): SANDERS 04/09/97 1047 (H) COSPONSOR(S): KELLY 04/23/97 (H) JUD AT 1:00 PM CAPITOL 120 04/23/97 (H) MINUTE(JUD) 04/25/97 (H) JUD AT 8:30 AM CAPITOL 120 WITNESS REGISTER DOUG WOOLIVER, Administrative Attorney Office of the Administrative Director Alaska Court System 820 West 4th Avenue Anchorage, Alaska 99501-2005 Telephone: (907) 264-8265 POSITION STATEMENT: Presented SB 106 and CSSB 112(JUD). JOE AMBROSE, Legislative Assistant to Senator Robin Taylor Alaska State Legislature Capitol Building, Room 30 Juneau, Alaska 99801 Telephone: (907) 465-4906 POSITION STATEMENT: Presented sponsor statement for HCS CSSSSB 38(JUD). KARYN DENTON, Associate Director LifeCenter Northwest 600 Broadway, Suite 260 Seattle, Washington 98122-5371 (After August 1, 1997: 2575 76th Avenue SE Mercer Island, Washington 98040-2758) Telephone: (888) 543-3287 POSITION STATEMENT: Testified on HCS CSSSSB 38(JUD). EDWARD HUPPMAN, JR., Executive Director LifeCenter Northwest 600 Broadway, Suite 260 Seattle, Washington 98122-5371 (See above for address after August 1, 1997) Telephone: (888) 543-3287 POSITION STATEMENT: Testified on HCS CSSSSB 38(JUD). JENS SAAKVITNE, Director Life Alaska, Incorporated 1205 East International Airport Road, Suite 103 Anchorage, Alaska 99518 Telephone: (907) 562-5433 POSITION STATEMENT: Testified on HCS CSSSSB 38(JUD). LISA KIRSCH, Legislative Administrative Assistant to Representative Joe Green and Committee Aide for the House Judiciary Standing Committee Alaska State Legislature Capitol Building, Room 118 Juneau, Alaska 99801 Telephone: (907) 465-4931 POSITION STATEMENT: Testified on HCS CSSSSB 38(JUD). MATT ANDERSON, Unit Manager Emergency Medical Services Unit Community Health and Emergency Medical Services Division of Public Health Department of Health and Social Services P.O. Box 110616 Juneau, Alaska 99811-0616 Telephone: (907) 465-3027 POSITION STATEMENT: Provided department's position and answered questions regarding HCS CSSSSB 38(JUD). MYRNA MAYNARD, Legislative Administrative Assistant to Senator Drue Pearce Alaska State Legislature Capitol Building, Room 518 Juneau, Alaska 99801 Telephone: (907) 465-4747 POSITION STATEMENT: Presented sponsor statement for CSSB 3(JUD). ROBERT BUTTCANE, Juvenile Probation Officer Division of Family and Youth Services Department of Health and Social Services McLaughlin Youth Center 2600 Providence Drive Anchorage, Alaska 99508 Telephone: (907) 562-2285 POSITION STATEMENT: Provided department's position and answered questions regarding CSSB 3(JUD). REPRESENTATIVE TERRY MARTIN Alaska State Legislature Capitol Building, Room 502 Juneau, Alaska 99801 Telephone: (907) 465-3783 POSITION STATEMENT: Presented sponsor statement for HB 234. NANCY WELLER, Medical Assistance Administrator Division of Medical Assistance Department of Health and Social Services P.O. Box 110660 Juneau, Alaska 99811-0660 Telephone: (907) 465-5825 POSITION STATEMENT: Provided department's position and answered questions regarding HB 234. PETER NAKAMURA, MD, MPH, Director Division of Public Health Department of Health and Social Services P.O. Box 110610 Juneau, Alaska 99811-0610 Telephone: (907) 465-3090 POSITION STATEMENT: Provided department's position and answered questions regarding HB 234; expressed concern about health issues. DEBORAH BEHR, Assistant Attorney General Legislation and Regulations Section Civil Division (Juneau) Department of Law P.O. Box 110300 Juneau, Alaska 99811-0300 Telephone: (907) 465-3600 POSITION STATEMENT: Provided department's position and answered questions regarding HB 234; expressed concern about constitutional and other issues. CARLA TIMPONE, Lobbyist for the Alaska Women's Lobby 211 Fourth Street, Number 108 Juneau, Alaska 99801 Telephone: (907) 586-1107 POSITION STATEMENT: Testified in opposition to HB 234. ACTION NARRATIVE TAPE 97-63, SIDE B Number 1391 (FIRST PORTION OF TAPE 97-63 IS MORNING MEETING OF SAME DATE) CHAIRMAN JOE GREEN called the House Judiciary Standing Committee meeting to order at 1:06 p.m. Present at the call to order were Representatives Green, Bunde, Porter and James. Representatives Berkowitz and Rokeberg arrived at 1:11 p.m. and 1:56 p.m., respectively. The meeting was teleconferenced to Anchorage and to Seattle, Washington. SB 106 - NOTARY PUBLIC BOND CHAIRMAN GREEN announced that the first order of business was Senate Bill No. 106, "An Act relating to the bond required of a notary public." DOUG WOOLIVER, Administrative Attorney, Office of the Administrative Director, Alaska Court System, came forward to present the bill, saying the court system had requested its introduction. Right now, when a person submits an application to be a notary public, the application must first receive a signature from the clerk of the superior court; the clerk then forwards it to the office of the lieutenant governor, which oversees notaries. The clerks only ensure that applications are filled out before signing and forwarding them; it is not something they are uniquely qualified to do. This bill deletes the requirement for the clerk's signature, allowing someone to send the application directly to the lieutenant governor, which eliminates an extra step. Number 1515 REPRESENTATIVE JEANNETTE JAMES asked whether Mr. Wooliver knew why that signature had been required. MR. WOOLIVER said he had checked; it had been a requirement since statehood. At that time, the court performed other duties, including work related to passports. However, Mr. Wooliver had been unable to find any reason why this specifically went through a court clerk. He noted that other types of bonds must be submitted to various agencies that oversee the activities, none of which go through the court system. He said the reason this came up was that the clerk of court in Anchorage was signing these one day and wondering why it was done, as it slows the process and seems to serve no purpose. Number 1571 REPRESENTATIVE JAMES advised that she had been a notary previously. She said there were two ways to execute an official bond. One was to buy a bond from an insurance company and the other was for a person to put up his or her own bond that guaranteed possession of the personal means to back it up. She asked whether the ability to put up one's own bond might relate to approval by the clerk of the court. MR. WOOLIVER explained that the clerk does not actually check any of those bonds. He referred to the handbook and said it specifies that currently, a person cannot be his or her own surety. REPRESENTATIVE JAMES acknowledged that it may have changed. MR. WOOLIVER concurred and said he was not sure. He did know that when clerks looked at the applications, they did not look to see whether or not an applicant actually had the bond. He explained, "Somebody else can act as a surety for you. They just put their name down; they say they have assets worth $1,000 and they're willing to put them up. We don't check that. All we do is make sure the form is filled out - all the blanks are filled in - and we put a signature on it." Number 1685 CHAIRMAN GREEN wondered whether there was some tie with statehood that had long since disappeared. REPRESENTATIVE JAMES commented that this is the kind of bill she likes, as it repeals a duty that is no longer necessary. She said the legislature should applaud the court for bringing it forward. REPRESENTATIVE CON BUNDE made a motion to move SB 106 from committee with individual recommendations and a zero fiscal note. There being no objection, SB 106 was moved from the House Judiciary Standing Committee. CSSB 112(JUD) - MARRIAGE LICENSING FUNCTIONS CHAIRMAN GREEN announced the next order of business was CS for Senate Bill No. 112(JUD), "An Act relating to marriage licenses; and transferring responsibility for marriage licensing from judicial officers to the state registrar of vital statistics." Number 1773 DOUG WOOLIVER, Administrative Attorney, Office of the Administrative Director, Alaska Court System, presented CSSB 112(JUD). The court system had asked that this bill be introduced; it is part of a plan to move away from the court system some functions that are not judicial. He advised that the bill was jointly written with the registrar of Vital Statistics; that agency is taking over vital statistics duties from the court system. The court has already transferred most vital statistics functions to that agency, as well as the personnel that go along with those duties. However, transferring the marriage license function must be done by statute because under the statute, judges issue marriage licenses. This bill allows Vital Statistics to issue marriage licenses. MR. WOOLIVER explained that in most courts, as a matter of practicality, court employees will still be issuing the marriage licenses. However, they will do so as the local registrars for Vital Statistics. But in Anchorage, Fairbanks and Juneau, there are Vital Statistics offices that will issue marriage licenses. Number 1868 REPRESENTATIVE ETHAN BERKOWITZ asked whether this makes it more difficult to obtain a license. MR. WOOLIVER said it should make it easier in Anchorage, Fairbanks and Juneau, at least, because there will be one location to obtain the license and record it. Currently, a person must go to the court to obtain a marriage license and to Vital Statistics to record it. Elsewhere, it would remain the same; the local magistrate or clerk of court would perform the function, but under the auspices of Vital Statistics rather than as a judicial function. Number 1922 REPRESENTATIVE BUNDE made a motion to move CSSB 112(JUD) from committee with individual recommendations. There being no objection, CSSB 112(JUD) was moved from the House Judiciary Standing Committee. CSSSSB 38(JUD) - ANATOMICAL GIFTS, LIVING WILLS & DNR ORDER CHAIRMAN GREEN announced the next order of business was CS for Sponsor Substitute for Senate Bill No. 38(JUD), "An Act relating to anatomical gifts, living wills, and do not resuscitate orders." Number 2010 JOE AMBROSE, Legislative Assistant to Senator Robin Taylor, presented the sponsor statement. He advised that there was a committee substitute, which he offered to explain after presenting the gist of the bill. MR. AMBROSE said the bill clarifies the existing statute dealing with living wills; it also adds a provision by which those who execute a living will can choose to become an organ donor or tissue donor. By adding this provision to the statutory language of a living will, loved ones and health care professionals would be fully informed of the wishes of family members and patients. Mr. Ambrose pointed out that we live in a technological age in which the need for tissue and organ donation is much greater than the supply. While it is not a legitimate function of government to dictate whether a person should become an organ or tissue donor, it is wise to facilitate the process. MR. AMBROSE explained that the bill would also instruct the Division of Motor Vehicles to indicate on a driver's license not only that the bearer had elected to become an organ donor but also that the bearer had a living will. Other than nominal expenses, the legislation should cost little to enforce and may become invaluable if it increases Alaskans' participation in organ and tissue donor programs. MR. AMBROSE advised that they had contacted the Center for Transplant Services at the University of Washington hospital to determine the scope of transplants involving Alaskans. Since 1989, 19 Alaskans have received (indisc.--papers over microphone) transplants through that facility. Twelve have received liver transplants, and one received both a kidney and a pancreas. As of January 24th of this year, that one facility had a wait-list of 20 Alaskans needing kidney transplants, 11 seeking donated livers and one waiting for a donated pancreas. The United Network for Organ Sharing, the national clearinghouse, had 68 Alaskans on their wait- list. Since 1988, that same organization documented 207 Alaskans who have received donor organs. Mr. Ambrose offered to address the committee substitute. REPRESENTATIVE JAMES made a motion to accept the committee substitute, version 0-LS0183\L, Bannister, 4/4/97, as a work draft. There being no objection, that version was before the committee. Number 2253 CHAIRMAN GREEN asked: If this is enacted and a person is somewhere else in the state or in another state, how would the organs get to where they need to be? MR. AMBROSE suggested that a representative from Life Alaska Transplant, Incorporated, explain how that happens. TAPE 97-64, SIDE A Number 0006 MR. AMBROSE said he understands there is reciprocity with some states; they have been asked to look at that larger issue for possible future legislation. Right now, the basic problem is that two separate statutes contain provisions that should relate to each other but do not. The bill attempts to correct this. Mr. Ambrose said they have worked with Department of Health and Social Services personnel, especially those providing emergency medical technician (EMT) services, for whom this becomes critical. MR. AMBROSE referred to page 4 of the proposed committee substitute and said there is an inherent conflict in this process. Most people fill out a living will to inform health care providers that they do not want to be resuscitated in certain situations, and that is a living will's generally accepted purpose. However, an organ donation for transplant must occur almost immediately after death. Therefore, a terminal patient who wants to be an organ donor but who has a "do not resuscitate" (DNR) order presents a conflict. MR. AMBROSE read the new language on page 4, beginning at line 6, and indicated this provision in the living will addresses the problem. Referring to line 8, he said the phrase "hospital setting" is there because if a person is in a medical setting, these evaluations can take place. He noted that a valid DNR order is issued by a doctor; it is not something the individual fills out. He explained, "There are folks who have certain conditions, and if they're involved in an accident, for instance, there is notification on their driver's license that the doctor has issued a `do not resuscitate' order. We don't want to put our EMTs in a situation that they have to disregard that, okay? So we want that to happen in the hospital setting." MR. AMBROSE mentioned the language relating to 71 years of age and deferred to the representative from Life Alaska Transplant, Incorporated, to explain where that came from. He commented, "That worked itself in during some consultation between the organ donor groups and the drafting attorney." Number 0288 MR. AMBROSE referred to page 6, beginning at line 14, and explained, "We reiterate the provision as far as the hospital setting, and this is for the protection of the EMTs. The rest of that, through page 8 at line 11, is language that basically involves the revocation of `do not resuscitate' orders and things that apply to EMTs; and there is someone from the division that can walk you through that." MR. AMBROSE referred to page 6, beginning at line 27 and continuing to page 7. He said the Department of Law recommends deletion of subsections (e)(2) and (e)(4); the sponsor agrees. Mr. Ambrose advised that those two subsections have to do with guardians and powers of attorney. MR. AMBROSE reported that the remaining language in the proposed committee substitute, beginning with Section 16, is from the original bill. Number 0392 CHAIRMAN GREEN asked whether by deleting subsections (e)(2) and (e)(4), guardianship of an individual may take precedence over the subsequent signing of an organ donation form or living will. He asked what the priorities are for these various documents. MR. AMBROSE replied that the way this provision reads, a physician may not revoke a DNR order at the request of a person who did not ask for it in the first place. CHAIRMAN GREEN posed a scenario where a person is mentally incapacitated but has organs from the neck down that function fine. He asked whether there is a potential for conflict. MR. AMBROSE offered to call someone from the Department of Law to explain the recommendation. CHAIRMAN GREEN said he would appreciate that. He asked Karyn Denton whether she had information to add to the discussion. Number 0551 KARYN DENTON, Associate Director, LifeCenter Northwest, testified via teleconference from Seattle, Washington. She acknowledged that she had heard the conversation and stated, "But it seems to be more an order of priority in terms of the consent processes related to the living will part, rather than the actual part that we (indisc.), an individual being an organ donor." CHAIRMAN GREEN said that earlier, a question had been asked about what happens if someone is in a less-than-desirable setting, rather than in a hospital where the organ can be easily extracted and preserved until use. He asked whether there is a precedent or something in the living will that would say, for example, that costs would be paid for out of the deceased person's estate or by the state. MS. DENTON replied, "No, absolutely not." She explained that when a patient is found to be suitable for a solid organ donation and has indicated that is their wish, those costs are borne by the organ recovery process and system. There is no charge to the family's estate nor to the state where the deceased resided. To her knowledge, in 15 years of organ recovery within their service area, that had never been a problem. Number 0670 REPRESENTATIVE BERKOWITZ asked Ms. Denton to explain the provision regarding 71 years of age. MS. DENTON said the age criteria for solid organs ranges from zero to 70 years, although they have evaluated patients beyond that. There seems to be concern about using the standard zero-to-70 warning because of the question of what to do if a person is closer to 71 years of age than 70. As she recalled it, the recommendation was made to her organization to simply raise the upper age limit to 71 years so that 70-to-71-year-old individuals are included. She stated, "That age, I would say, encompasses the most likelihood of the older individual who ..., because of the criteria used to evaluate organs, ... would be found to be a suitable organ transplant candidate." She deferred to the director of LifeCenter Northwest to address that. Number 0757 EDWARD HUPPMAN, JR., Executive Director, LifeCenter Northwest, testified via teleconference from Seattle, Washington. He stated that the age criteria was a concern of someone from Life Alaska Transplant, Incorporated. Noting that the industry standard is around age 70, he said an unlimited age criteria would create more confusion for, and an excess burden on, EMTs in the field who found a DNR order and an organ donation identification for someone beyond what is considered a normal age for organ donation. They want to avoid having the bill become a major problem for emergency medical service (EMS) personnel with regard to people beyond that age limit, whom his organization would not consider organ donors. Number 0823 REPRESENTATIVE BERKOWITZ responded, "You put me in an awkward position, because I don't want to tell people over the age of 70 that their bodies have little value. It seemed to me that it's more of a policy question for you to determine, since you're the folks who want the organs." He stated that he would rather not put the 71-year-old limit in the legislation. He believes that should be up to individual evaluation. MR. HUPPMAN replied, "Then we totally agree. I have no problem with having that age criteria removed." Number 0865 REPRESENTATIVE BUNDE commented that in other committees where he had served, there had been extensive discussions about organ and tissue donation. In every case, it had been strongly affirmed that this was at the expense of the recipient, not the donor. As to the 71-year-old limit, he acknowledged the dilemma for an EMT of a "do not resuscitate" order for an organ donor; if EMTs were uncertain how to proceed, the age criteria would at least indicate that the person was unlikely to be an organ donor and, therefore, the EMTs could abide by the DNR directive. He asked: Are you aware of anyone over the age of 71 having been an organ donor? MR. HUPPMAN replied that there are very few occasions where that has happened. He knew of one or two where, because of demand for organs, they had extended their criteria for considering people beyond age 70. However, that is only in the rarest of instances. They try to evaluate an organ more from a physiological standpoint than a chronological one. He said they have had to put a qualifier somewhere, and age 70 seems to be the "high-end limit" for consideration. He advised that those people are evaluated very, very carefully. Number 0996 CHAIRMAN GREEN questioned Mr. Huppman's answer to Representative Berkowitz indicating he had no problem with removing the 71-year restriction. He noted that Mr. Huppman had just mentioned having to put some age limit in there. MR. HUPPMAN replied, "That was more internally." CHAIRMAN GREEN asked, "`Internally' saying that you probably wouldn't look at someone over 70, but there isn't a reason that they couldn't have this type of an arrangement?" MR. HUPPMAN replied, "That's correct." REPRESENTATIVE BUNDE noted that they were looking at a fairly narrow segment of people who both have a DNR order and a wish to donate organs. There would be no dilemma for an EMT if someone had no DNR order, for example. Number 1083 REPRESENTATIVE JAMES said she had carried a card for 30 or 40 years that says she will donate her eyes or corneas to the Lions eye bank. Noting that it will not be long before she is 70, she asked whether she should stop carrying that card. MR. HUPPMAN replied, "No, absolutely not." He said tissue and eye donation have different criteria, and he suggested a representative of Life Alaska, Incorporated, address that. Mr. Huppman said the age-70 cut-off applies to solid organs. In contrast, eye donation has an unlimited age criteria, if not for transplant purposes, then definitely for eye research. Number 1161 JENS SAAKVITNE, Director, Life Alaska, Incorporated, testified via teleconference from Anchorage. He agreed that while there are specific criteria as far as an upper age of 70 for organ donation, there is almost no upper age limit for tissue donation. He stated, "We have had donors in their 90s where tissue was used for transplants; for research donation, there's absolutely no upper age. But for tissue donation, we also have up to 24 hours after the heart stops." MR. SAAKVITNE continued, "The reason for both the hospital setting and, to an extent, the inclusion of the under-age-71 criteria is that the EMS is faced in the field with a very short period of time. When they come upon a `non-heart-beating' patient or someone who's about to die [and] they find a DNR card and an organ donor card, what do you do? What is the best way to support this person's wishes?" MR. SAAKVITNE noted that most people who carry DNR cards tend to be older and may have a terminal illness that will pretty much rule out organ donation. Medical personnel do not want to do a disservice to a family by needlessly resuscitating patients, generating all sorts of costs and a lot of heartache. Mr. Saakvitne stated, "So, we try and come up with criteria such as the `in a hospital setting,' number one, and number two, some type of age criteria that says people that are older than this age, let's not even go ahead and try to extend this resuscitation period, to make it simpler." CHAIRMAN GREEN referred to page 6, lines 27 through 29, and page 7, lines 1 through 4. He asked Lisa Kirsch to discuss the pros and cons of dropping those two subsections, (e)(2) and (e)(4). Number 1287 LISA KIRSCH, Legislative Administrative Assistant to Representative Joe Green and Committee Aide for the House Judiciary Standing Committee, advised that she had spoken with someone from the Department of Law regarding those two deletions. Subsection (e), defines when a DNR order can be revoked. The physician cannot revoke the order unless the individual himself or herself does so. However, if the individual is unconscious, for example, it can also be revoked by a parent; a guardian appointed under AS 13.26.116; a person to whom that decision has been communicated from the individual; or a person who has power of attorney for the individual. MS. KIRSCH referred to subsection (e)(2) and explained that although AS 13.26.116 puts guardianship orders into effect, it does not give an appointed guardian the power to put a "do not resuscitate" order into effect. The concern of the Department of Law is that by giving guardians the power to take such orders out of effect, it may imply they also have the power to put them into effect. They do not want to create any ambiguity as to whether guardians or persons with power of attorney have those powers of life and death over their wards or over persons for whom they hold power of attorney. Number 1440 REPRESENTATIVE BERKOWITZ suggested two categories were missing from that list: the spouse and the child. He believes spouses and children should be allowed the opportunity to make that call. MS. KIRSCH asked whether he was talking about revoking a "do not resuscitate" order, as this would be for a person who had filled out such an order. She indicated he may be talking about a situation where the spouse or child had been given that power, since that is the way the others are written. REPRESENTATIVE BERKOWITZ responded, "At the very least, I think it's something that people want to talk about, or I think maybe we should talk about." MS. KIRSCH suggested in that context, perhaps they should be talking about amendments to Title 13, rather than this bill, which focuses more on organ donation. She deferred to the sponsor for a response, then commented that she does not believe the intent is to create any new law. She said those deletions are to focus on organ donation and avoid changing existing law on guardianships or guardianship-like circumstances where a concerned person and someone incapacitated are involved. Number 1532 REPRESENTATIVE BRIAN PORTER commented on the remaining two exceptions under subsection (e) and suggested, "I don't think it would be changing much if we said that a guardian, spouse or child who had been given that authority specifically, by the person who filled it out, would have the authority to pull it. But, I mean, you're defeating the whole purpose of it if you say that anyone else can change my mind." Number 1579 REPRESENTATIVE BUNDE concurred, asking what would be the point of a DNR order if anybody could revoke it. Number 1615 MATT ANDERSON, Unit Manager, Emergency Medical Services Unit, Community Health and Emergency Medical Services, Division of Public Health, Department of Health and Social Services, came forward to testify, expressing the department's support of the bill as written. He stated, "We believe that SB 38 will make it much easier for health care workers to identify individuals who have living wills and to those who will be able to identify patients who ... wish to donate organs and issues. We hope this will ensure that we are able to comply more fully with the patients' wishes regarding medical care, anatomical gifts, and that that, in turn, will increase the availability of organs and tissues available for donation." MR. ANDERSON continued, "In addition, this bill clarifies how `do not resuscitate' orders can be revoked, something which was not clear in existing state statute and is an issue that is extremely important for pre-hospital emergency care workers." He expressed appreciation to the sponsor for his willingness to allow the department to make suggestions to improve the bill as it went through the process. He offered to answer questions. Number 1680 CHAIRMAN GREEN referred to discussion of whether a guardian or person holding a power attorney should have authority to revoke a "do not resuscitate" order. He asked Ms. Denton whether Washington or other states have a similar provision. MS. DENTON replied, "Not that I'm aware of." REPRESENTATIVE PORTER made a motion to amend the proposed committee substitute by deleting subsections (e)(2) and (e)(4), found at page 6, lines 27 through 29, and page 7, lines 1 through 4. CHAIRMAN GREEN asked whether there was any objection. There being none, the amendment was adopted. REPRESENTATIVE JAMES noted that the other subsections would be renumbered accordingly. Number 1760 REPRESENTATIVE BERKOWITZ made a motion to remove the 71-year restriction. He said it seemed to be a little arbitrary. In addition, he did not feel it was right to single out "people who have reached that exalted stage." Number 1775 MR. AMBROSE advised that the sponsor would have no objection so long as the language "in a hospital setting" remains; that evaluation could be made in the hospital. He explained, "We just don't want it to be in a situation where it's in the field and the folks that provide these wonderful responses in the field have to be making these choices." CHAIRMAN GREEN noted that the age reference occurs in at least two places. He asked, "Would your amendment be to actually find them or just wherever that restriction is, ... it would be removed but not ... the `hospital setting' portion of that." REPRESENTATIVE BERKOWITZ replied, "What you said, Mr. Chairman." Number 1808 CHAIRMAN GREEN asked whether there was any objection to that concept. REPRESENTATIVE BUNDE suggested the 71-year age would remain for nonmedical settings, such as in the field for EMTs. CHAIRMAN GREEN concurred. REPRESENTATIVE BUNDE said in that case, he had no objection. CHAIRMAN GREEN asked whether there was further objection. Hearing none, he advised that the conceptual amendment was adopted. REPRESENTATIVE PORTER made a motion that the proposed committee substitute, as amended, be moved from committee with individual recommendations and the attached zero fiscal note. There being no objection, HCS CSSSSB 38(JUD) was moved from the House Judiciary Standing Committee. SB 3 - MINOR'S CURFEW VIOLATIONS CHAIRMAN GREEN announced the next item of business was CS for Senate Bill No. 3(JUD), "An Act authorizing prosecution and trial in the district court of municipal curfew violations, and providing for punishment of minors upon conviction for violation of a curfew ordinance." Number 1904 MYRNA MAYNARD, Legislative Administrative Assistant to Senator Drue Pearce, came forward to present CSSB 3(JUD) on behalf of the sponsor. The bill had been introduced in response to an article in the Anchorage newspaper relating to Juneau. The City and Borough of Juneau had wanted to institute a curfew ordinance but was unable to do so because juvenile curfew cases are heard by the Division of Family and Youth Services (DFYS) and then go to the superior court. Ms. Maynard said curfew violations were low on the agenda for DFYS and did not get heard. Kids knew that even if they were cited for a curfew violation, nothing would happen to them. Thus, this bill was introduced. MS. MAYNARD noted that the bill has the support of the Municipality of Anchorage, the City and Borough of Juneau, the mayor's task force on youth in Juneau and the Alaska Peace Officers Association. She advised that there was a fiscal note from the court system for $24,000. REPRESENTATIVE BERKOWITZ expressed concern that the bill may impede a municipality's ability to choose how to proceed. MS. MAYNARD responded, "No, it will have no effect. ... If you have a youth court or some other system in place, this does not affect it at all." REPRESENTATIVE BERKOWITZ asked: If a municipality chose to proceed under the juvenile rules, would they be precluded from doing that? MS. MAYNARD replied, "No." REPRESENTATIVE BERKOWITZ said that alleviated his concern. MS. MAYNARD reported that Judge Peter Froehlich of the Alaska District Court in Juneau has a Friday afternoon juvenile court where he hears violations relating to tobacco, firearms, alcohol and so forth. "And he loves this and wants to put it in place, because they have a real problem, evidently, here in Juneau," she stated. "And he doesn't think the fiscal impact is going to be great because probably 75 percent of the kids they see already, under the alcohol and those other violations, would also be the curfew [violators]." MS. MAYNARD said at the request of Assemblyman Murdy from Anchorage, they put in the ability to have community work in lieu of a fine. She explained, "We couldn't mandate that because that's putting them into servitude, and then they would be entitled to a trial by jury; so, we've made it that the violator can choose to do community work if they can't pay the fine. And perhaps some parents who choose not to pay the fine will encourage their children to choose community work because it will have more effect on them, and they may think twice before they violate the curfew again. At least, that's our hope." Number 2081 REPRESENTATIVE BERKOWITZ indicated he had discussed this with "some of the folks at APD" who were doing truancy work; they believe that this is a highly effective way of doing community-based policing and that it has a big impact on reducing overall crime rates. CHAIRMAN GREEN asked whether the sponsor had received comments about the state's taking action on behalf of municipalities. MS. MAYNARD said no, although a parent had come to one meeting to voice support, hoping juveniles will stop after the first or second violation. Number 2132 REPRESENTATIVE PORTER advised that he was trying to find in the bill where there is an option on how to deal with a violation, such as sending the case to a youth court. CHAIRMAN GREEN called an at-ease. He called the meeting back to order at 2:00 p.m. Number 2207 ROBERT BUTTCANE, Juvenile Probation Officer, Division of Family and Youth Services, Department of Health and Social Services, came forward to testify. One concern the department has about the bill is that although it appears to be a civil infraction to violate a curfew or tobacco ordinance, in practice a citation is issued and if the young person fails to appear in district court in response to that citation summons, the court issues a "failure to appear" warrant. MR. BUTTCANE explained that although that is not a problem in most of Alaska, 20 to 30 percent of the detention population at the Johnson Youth Center in Juneau are young people who have failed to appear in district court for possession of tobacco or minor- consuming-alcohol violations. He stated, "And this bill, although it doesn't directly cause young people to be detained in our youth facilities or to fall into the juvenile system, kind of by default, because they are in violation of this `failure to appear' order and then subject to contempt issues, they're clogging up our detention facilities." MR. BUTTCANE advised that Margot Knuth had been unable to attend this hearing but could speak more to the legalities. He explained, "We would like to see some provision that would ensure that it stays in a civil realm. In terms of the options available to municipalities, I know Anchorage did go to a hearing officer for these cases. They had something in the neighborhood of 1,100 or 1,200 curfew violations, I believe, once they instituted the ordinance in the Municipality of Anchorage. And even if a small portion of them started ending up in our detention facility in Anchorage, the system would grind to a halt." He said they did not need to put people who smoke tobacco in "concrete and cinder block." Number 2301 REPRESENTATIVE BERKOWITZ mentioned the difference between civil and criminal contempt. He said most failures to appear are outgrowths of criminal contempt charges. He suggested if there were a way of proceeding for civil contempt, even though it may subject someone to a warrant and arrest, it would not have the same criminal consequences as a criminal contempt charge would. He said he wished someone were present who could address that. MR. BUTTCANE replied that he could ask the Department of Law to respond. He stated, "I do know here in Juneau there were 41 detention admissions at the Johnson Youth Center from the district court for those. So, whatever those nuances are, we are ending up with people detained at our youth facility for failure to appear on these issues." Number 2345 REPRESENTATIVE JAMES asked what kind of statistics Mr. Buttcane had regarding the admissions to the Juneau youth facility. She asked how long people were detained and what has happened to them following that. MR. BUTTCANE replied that he did not have specific numbers broken down in that way, although he believed they could be obtained. "They are identifiable cases, and we could summarize what they look like," he added. Number 2366 REPRESENTATIVE JAMES suggested they meet about that later. She said she has always been a proponent of the reform school concept, mostly because many of her foster kids came from that concept. She noted that many offenders are not "super-bad" but will not mind their parents, who have lost control of them. She wanted to know whether that was the last they heard from kids put in that system for minor infractions or whether their behavior worsened because of the influence of others in the system whose misbehavior was more serious. MR. BUTTCANE indicated the department could provide that information. Number 2412 REPRESENTATIVE BUNDE mentioned "turnstile jumping" in New York and suggested that youth who violated curfew may in fact have committed more serious offenses as well. He agreed to not wanting to clog the "cinder block and bars" with simple curfew violations. However, failure to appear in court is a much more serious offense than a curfew violation. He concurred with exploring the idea of channeling that down a civil contempt route, so that there would be increased penalties for being a scofflaw. He said without that, there might as well be no curfew. TAPE 97-64, SIDE B Number 0006 [Begins mid-speech] MR. BUTTCANE said a truly civil track still provides the consequence for noncompliance with some social order without the expense of detention. He advised that he would ask department employees to look into that and clarify it. CHAIRMAN GREEN noted that except for the court's fiscal note, the others were zero fiscal notes. He asked who would ensure that the youth do what they are supposed to do. Number 0030 MS. MAYNARD replied, "I assume the court system." REPRESENTATIVE BERKOWITZ said normally, fines go through the court clerk, who keeps track of those. CHAIRMAN GREEN said his question related to Section 6 and the ability to do community work. MS. MAYNARD responded, "Actually, some judges already assign community work, although evidently you can't mandate it. But some of them do. Judge Froehlich here in Juneau has assigned community work to some kids, and they find that those kids pay more attention than if ... some parent pays a $250 fine." CHAIRMAN GREEN asked, "But doesn't it require somebody to be with the person or persons that are doing community work?" MS. MAYNARD said she did not know. Number 0070 REPRESENTATIVE BERKOWITZ explained, "Usually what happens is, if there is court-ordered community work service, it's done through the ASAP program, and ASAP monitors the amount of work that's done. So, if someone has an eight-hour work requirement, they would check in with ASAP; ASAP would send them off to do a job; there would be some sort of supervision; and they would come back and their eight hours would be checked off. ASAP would send something back to the court, and the court would know that the work had been completed. ... That's the norm, and I would imagine that this program envisions expanding that supervision to tribal councils and some of the other entities that are designated, some kind of supervision." Number 0110 REPRESENTATIVE PORTER pointed out that the Alcohol Safety Action Program (ASAP) exists only in Anchorage and Fairbanks. Other communities approach it differently but have some accountability mechanism. He referred to the desire not to have a warrant result from failure to appear and asked: Is the parent notified at the time that the original curfew violation citation is issued? MS. MAYNARD replied, "Under this, the parent has to come to the court with the child." REPRESENTATIVE PORTER asked: Why not change that to an order to show cause against the parent? He asked whether this kind of offense could go through a magistrate's office if that was the only option. He further asked whether "district court" included a magistrate. MR. BUTTCANE responded, "That's the way we understand the intent of this." Number 0158 REPRESENTATIVE BERKOWITZ referred to Representative Porter's suggestion about an order to show cause. He said although he was not taking a position because he had not yet thought it through, there has been much discussion about vicarious liability, making parents responsible for children. To his knowledge, that had been extensively litigated. He suggested before they required an order to show cause, they should explore that. REPRESENTATIVE PORTER responded that over the last four or five years, the legislature has passed several statutes that go towards recognizing parental responsibility and increasing parents' financial responsibility for property damage by children. He does not believe there is a constitutional issue when the parent is properly put on notice. He pointed out that an order to show cause is not a finding. He suggested if it is required that the parent be notified of the original citation, in effect it is the parent who fails to come to court, not the child. Number 0226 CHAIRMAN GREEN said, "This says the parent, guardian or legal custodian." He asked: If it were under the DFYS, would someone from that agency be there during the sentencing? MS. MAYNARD replied, "Or the foster parent, if they were in a foster home." CHAIRMAN GREEN asked whether that person would be held accountable as well. REPRESENTATIVE PORTER replied, "Well, what we're talking about is someone who fails to appear in response to the original citation. And the parent or guardian is notified and asked to appear with the child for that appearance. And that's made before the scheduled time of the appearance. So, to me, it is the parent who is saying, `I'm not going to be responsible for showing up here,' not the kid. So, why not, if we're going to take an action because of that failure to appear, why not take it against the person that's responsible?" Number 0296 REPRESENTATIVE BUNDE said while he was not unsympathetic to that point, having authored the bill that increased financial responsibility, it also provided a "hammer" to an incorrigible young person who wanted to make life difficult for his or her parents, if the parents would be in contempt for the young person's failure to appear. REPRESENTATIVE PORTER responded that an order to show cause is not a criminal charge; it is a "rather forceful subpoena" that tells them to come before the court to explain why the court should not presume that the failure to appear should be treated seriously. Number 0340 REPRESENTATIVE BUNDE said that increased his comfort level somewhat. However, he believed both parent and child should be required to appear for a curfew violation, not the parent alone. REPRESENTATIVE PORTER said he would presume that would be the order. Number 0368 REPRESENTATIVE JAMES said she agreed with Representative Porter on this. However, either these kids are minors and under parental control or they are not; there must be consistency. Unless a minor has been emancipated or is under the responsibility of the DFYS, she believes that "anything done to the kids" must include the parents. Number 0440 REPRESENTATIVE BERKOWITZ pointed out that they had just passed a juvenile crime bill through committee that said the opposite, that juveniles could be treated as adults. He said the requirement that parents or guardians be present at all proceedings has to do with the juveniles' ability to knowingly, intelligently and voluntarily waive any rights that attach during a proceeding. The focus is on the juvenile, with the parent or guardian in the position of ensuring that the juvenile knows what is going on. Traditionally, the requirement has not been in recognition of parental rights but rather in recognition of the juvenile's understanding of his or her rights. Number 0483 REPRESENTATIVE JAMES also referred to the juvenile crime bill. She said when a minor commits a crime against a person, that is a different situation; had they kept the parents involved with earlier transgressions by that child, that might not have occurred. But by the time it happens, public safety is a concern, which is one reason they want to come down harder on those with crimes against a person. Number 0516 CHAIRMAN GREEN called an at-ease at 2:22 p.m. [END OF TAPE 97-64] TAPE 97-65, SIDE A Number 0006 CHAIRMAN GREEN called the meeting back to order at 2:30 p.m. He asked if there were further questions or comments. He then announced he would hold the bill over and check with the Department of Law. Number 0105 REPRESENTATIVE NORMAN ROKEBERG apologized for being late and asked whether they had addressed the issue of why only the elderly and disabled were identified for community work. MS. MAYNARD responded that it did not mean "only." In rural communities, people felt this was where services could be used. REPRESENTATIVE ROKEBERG said it seemed restrictive and he had concerns about it. CHAIRMAN GREEN advised that the committee would try to hear the bill again on Monday, April 28. HB 234 - ABORTIONS UNDER GENERAL RELIEF PROGRAM CHAIRMAN GREEN announced the final item of business was House Bill No. 234, "An Act relating to assistance for abortions under the general relief program; and relating to financial responsibility for the costs of abortions." Two people had testified during that morning's hearing. Number 0236 REPRESENTATIVE TERRY MARTIN, sponsor of HB 234, offered a more detailed background for the bill than presented that morning. He said over the years, people have been offended by the public's paying for elective services, especially abortions. Although there is perhaps less stigma to abortions than previously, people do not feel they should pay for someone's elective procedure. REPRESENTATIVE MARTIN said Alaska's laws have been supported by the federal government, which says a male is responsible for a child out of wedlock at least until the age of 18. He asked: If males are to be responsible for a child who is born, why should they not be responsible for an abortion, especially when it competes against other medical needs of our society? Representative Martin stated, "... and in the House, it was about $500,000 we analyze on abortions that in many cases could be paid for by the male." Number 0443 REPRESENTATIVE MARTIN indicated the legislature had never taken direct action to pay for abortion; it has been an interpretation by the attorney general and the Department of Health and Social Services. The idea was that when there was a shortage of federal Medicaid money, the state would pick it up under the general relief medical program. A number of years ago, a department head had decided to use that money for abortions. Representative Martin said that offended many people. While some proposed dropping medical relief money as a complement to Medicaid funds, he said that is not an answer. Currently, senior citizens are denied emergency medical and dental services while elective abortions are covered. He believes that is a poor way to run a medical assistance program. REPRESENTATIVE MARTIN referred to an amendment by Representative Rokeberg that was not formally before the committee. He expressed support for it, saying when he first read it, he had been confused; however, after discussion, he believes it is right on target, as it makes a rapist or person convicted of incest responsible for paying for an abortion. Representative Martin stated that he opposes abortion, period, and is more opposed to state money being used for elective abortions. Even more offensive is when a person has been convicted of rape or incest and the state pays the bill. He said the permanent fund dividend is tapped for many purposes and Representative Rokeberg's amendment is "very rational." Number 0680 REPRESENTATIVE MARTIN advised that he disagreed with a second amendment proposed by Representative Rokeberg. Not yet formally before the committee, that amendment makes the parent or legal guardian of a minor liable for the cost of an abortion. REPRESENTATIVE MARTIN recalled that ten years before, he and other legislators had received phone calls from a mother who was outraged when she received a medical bill for her daughter's abortion; prior to that, she had no idea it had occurred. Expecting confidentiality, the daughter had gone through the public health system. He stated, "So, we did work it out that they would stop charging parents for abortions, especially when they weren't even consulted or involved." REPRESENTATIVE MARTIN said this second amendment touches on the same thing. Because of the confidentiality issue, he believes it is a conflict of interest to introduce legislation making the parent responsible. He discussed personal experience working with kids in boys' clubs and past attitudes towards out-of-wedlock pregnancy. REPRESENTATIVE MARTIN briefly addressed the fiscal note, which he acknowledged is high at $5.5 million. He said he disagreed with "the other half" because Medicaid money cannot be used for abortions. If anyone pays for it, it should be the male. He expressed disappointment that no representative from the Department of Law was present to address legal aspects. Number 0845 REPRESENTATIVE JAMES asked what the cost of an abortion usually is. REPRESENTATIVE MARTIN believes abortions cost between $300 and $600. He advised that especially in Southeast Alaska, the public health service flies women to Tacoma, Washington, to use a clinic there; it is a same-day operation and the travel cost is in addition to the abortion. Number 0886 REPRESENTATIVE JAMES recalled that the legislature had passed a bill the previous year relating to identifying the father in the case of a birth. REPRESENTATIVE MARTIN agreed. He stated, "And that's where this comes from. We're using the same law, Chapter 47, that allows for that on the federal and state ...." Number 0911 REPRESENTATIVE JAMES commented that two people make a pregnancy and therefore both should be responsible to decide whether to keep the child and to pay for it. She noted that it is possible to determine paternity for a living child and asked: What do you do with an aborted fetus if the alleged father denies paternity? REPRESENTATIVE MARTIN replied that DNA could still be taken from an aborted fetus, to his knowledge. REPRESENTATIVE BUNDE questioned whether the fiscal note included that testing. He concurred with Representative James in holding fathers responsible. He mentioned an Alaskan man who had bragged about fathering 19 children with 11 different women; he suggested there should be higher penalties than taking a permanent fund dividend. He also noted that current law says convicted felons do not receive dividends. He asked for confirmation of that. REPRESENTATIVE MARTIN said when he and Representative Rokeberg had discussed it, it was possible the dividend was already covered; however, they had wanted to be explicit. He mentioned that there is a special account for victims of crime. REPRESENTATIVE BUNDE, acknowledging that the amendments were not officially before the committee, named the longer amendment "Amendment 1" and the shorter one "Amendment 2." He asked whether Representative Martin would support an amendment that made the parents liable when they had given consent for the abortion. REPRESENTATIVE MARTIN replied, "I would be flexible there, because ... I think that in a case like this here -- in most cases, and maybe I'm now reminded on the old law where we want to keep it confidential from the parents. And so now that we've got the judicial bypass, I still feel uncomfortable in the confidentiality. If a parent were to go ahead, there's nothing wrong with that at all, for the parent to -- and perhaps they may not even want their daughter to get involved in the government aspect of it but just quietly and cheaper do it through private sources." Number 1160 REPRESENTATIVE BUNDE said his point was that if someone could not afford the abortion but her parents gave consent, should the parents not be financially responsible? REPRESENTATIVE MARTIN commented that on a given day, the children of the most wholesome parents could do something out of character. In a case like this, where the child makes money including permanent fund dividends, perhaps this would curtail activity. REPRESENTATIVE ROKEBERG asked: Given the bill that the legislature is about to pass regarding consent, would that impact this bill as written? And is there not a need to require confidentiality between the mother and father of the unborn child? Number 1380 REPRESENTATIVE MARTIN replied that the mother and father would usually know each other. He said in Chapter 47, which relates to when the child is born, the mother-to-be is responsible for disclosing who the father is at the time of birth. He said through Representative Bettye Davis's law, passed four years ago, that seemed to work. REPRESENTATIVE PORTER said that is voluntary, not required. REPRESENTATIVE MARTIN concurred. REPRESENTATIVE ROKEBERG commented that when there is an abortion, there is no birth. He was uncertain how that body of law related to this. He believes confidentiality should be maintained regarding the father as well as the mother's parents. He said apparently Representative Martin does not agree with his theory that there is either a constitutional or legal requirement to maintain confidentiality as it relates to the father. He noted that from earlier testimony, many times the father is unknown. Number 1487 REPRESENTATIVE BERKOWITZ asked: What would happen if the woman did not want to release the father's name? REPRESENTATIVE MARTIN likened it to child support enforcement. Only when applying for Medicaid does it becomes a problem; he did not know the rationale. If a mother keeps the child, he did not know at what point the state would deny Medicaid or other welfare. He said it is predicated on federal law and asked, "If it's okay under federal law to disclose who the father is, and now state law has been upheld, then why not for the abortion? And the confidentiality is right there within the department." Number 1562 REPRESENTATIVE BERKOWITZ asked whether Representative Martin envisioned a situation where the state would compel the woman to disclose the identity of the father. REPRESENTATIVE MARTIN said he did not put it beyond the state to compel anything; it has gone way out of bounds for many things, not only for childbirth or abortion. He said we can always imagine government getting out of control, which is why we have legislators to adjust it. Number 1598 REPRESENTATIVE JAMES commented that this is an area about which she has long been concerned. She believes there is equal responsibility, except in the case of rape or incest. She had supported trying to identify the father at the time of birth, which she believes is when the father is most vulnerable. She was not taking a position on this bill until seeing the other consequences. However, she supports the concept of the man paying at least half of the cost. She specified she was willing to divide it in half, as a joint responsibility. REPRESENTATIVE MARTIN thanked Representative James and said that is his sentiment as well. CHAIRMAN GREEN advised that they would lose their quorum shortly. He suggested taking testimony immediately and addressing the two amendments later. NANCY WELLER, Medical Assistance Administrator, Division of Medical Assistance, Department of Health and Social Services, came forward to testify. Referring to Section 3 of the bill, she said it eliminates the ability of the department to fund abortions for low- income women by placing abortions and related services first on the priority list in AS 47.25.205. Since 1986, due to budget reductions relating to the general relief medical program, the department has not had sufficient financial resources to fund the first seven items on the existing list. MS. WELLER advised that the accompanying fiscal note, which she had prepared, assumes that 80 percent of the number of women currently receiving abortions would bear the children, with both mothers and children having medical costs paid for by the state through the Medicaid program. MS. WELLER said other sections of the bill, related to financial responsibility and garnishment of permanent fund dividend checks to recoup the costs of abortion, would not come into effect because Section 3 eliminates the ability of the department to fund abortions. MS. WELLER advised that the department also has a number of administrative problems with sections relating to garnishment of the permanent fund dividends and tracking the recipients' estates. She explained, "We do not track people's estates and go after their estates in order to recoup costs. We would not have the ability to force a putative father to come in for DNA testing in order to determine whether they would be the father of the unborn child. Fetal DNA testing can be done by a laboratory in the state; it would cost $975 plus transportation for the parties; we would have to set up an administrative procedure for getting the fetal tissue from the facilities. Many abortions are done outside of the state, so it would be a significant administrative `adventure' dealing with setting up these procedures." Number 1857 CHAIRMAN GREEN asked, "You said that we're funding many abortions now that are done outside the state?" MS. WELLER said yes, particularly in Southeast Alaska, from which women go to Seattle. CHAIRMAN GREEN asked what the relative cost would be for someone to go to Seattle rather than have it done in Juneau. MS. WELLER said she believes people in Southeast Alaska go south because there are no facilities in Juneau. She explained that there are many different medical procedures, some related to miscarriages and other "birthing disasters." The range of payments for these procedures is $365 to $900. When the department pays for services out of state, they pay the Medicaid rate for the state where the service is provided; those rates are significantly less than the fee schedule in Alaska. CHAIRMAN GREEN asked whether the department pays for transportation. MS. WELLER said yes. Last year, they paid for 737 abortions at a cost of $487,000, of which $300,000 was directly related to the abortions. The remainder was related to transportation and other services. Number 1940 CHAIRMAN GREEN suggested that averaged $500 each. He asked about the assumption that 80 percent of the women now receiving abortions would deliver instead. He also asked whether most abortions paid for by the state are for lower-income people. MS. WELLER said the state only pays for low-income people. REPRESENTATIVE ROKEBERG asked whether Ms. Weller was indicating that 80 percent of Medicaid-covered women have abortions. MS. WELLER replied, "No, I'm saying that in preparing the fiscal note for the bill, the way I came up with this cost is that I was assuming that of the people who receive an abortion every year, 80 percent of those people would not have an abortion through their own means or some other means and would become Medicaid-eligible, and that the Medicaid program would pay for the costs of the birth and for the child, because children receive automatic Medicaid eligibility for the first year of life when their mother is on Medicaid." CHAIRMAN GREEN asked for approximately how many births or abortions the state would expect difficulty in trying to find a father who is not voluntarily assuming responsibility. MS. WELLER explained that for Medicaid and public assistance programs, they operate under federal rules that require the woman to identify the father of the child in order to receive public assistance, cash assistance or Medicaid. However, there are exceptions, such as when a woman fears for her life or there is abuse. CHAIRMAN GREEN asked whether that is for a small percentage. MS. WELLER said although she would assume that, she did not know. CHAIRMAN GREEN suggested finding the father really is not the major problem in most cases. Number 2085 MS. WELLER responded, "I don't know what percentage would be in disagreement, because ... when someone applies for cash assistance, the state has an obligation to go and get a child support order. Child support enforcement is required to issue an administrative order for child support for the children whose mothers are receiving assistance, and then the state and the federal government share the child support funds that are collected on behalf of the children that are on assistance, in order to recoup the amount of money that we're paying for assistance." CHAIRMAN GREEN stated his understanding that it is a requirement to determine the father. MS. WELLER affirmed that it is a requirement, which is there because the state obtains a child support order against the father who is not supporting a child on assistance. The department had never tried to recoup funds for abortions. REPRESENTATIVE ROKEBERG asked whether exceptions to the required identification of the father are examined on a case-by-case basis. He further asked whether there is a statutory or regulatory provision for those exceptions. MS. WELLER answered that it is a federal law, with specific criteria. If the woman can assert that there is danger to her life or her children because of some abusive situation, that exception applies; she is not required to prove it. REPRESENTATIVE ROKEBERG requested that Ms. Weller provide the committee with those references. He restated his desire that the legislation not breach that confidentiality. Number 2185 MS. WELLER emphasized that Section 3 would eliminate the ability of the department to pay for abortions, so that the other sections in the bill related to responsibility and garnishment of the permanent fund dividend would become moot. REPRESENTATIVE ROKEBERG suggested that the definitions of abortion under Section 7, found on page 4, would allow them to perform some procedures. MS. WELLER responded, "We are allowed under the Medicaid program, using state and federal funds, to pay for abortion services as a result of rape, incest or danger to the life of the mother." She said they could claim federal funds, under the Medicaid program, to pay for abortions in only those circumstances. Under the general relief medical program, the funding is used to pay for elective abortions. MS. WELLER stated, "And as you heard this morning, ... we are operating under consent decrees since 1993 with the ACLU that we would not, in enforcing the GRM abortion regulations, require proving that there was a threat to the woman's life or that she had a psychological problem with the pregnancy in order for her to get the funding for the pregnancy." Ms. Weller offered to make a copy of that consent decree available to the committee. CHAIRMAN GREEN asked whether that was a public record. MS. WELLER said yes. Number 2259 REPRESENTATIVE MARTIN said he was glad to hear that they could perhaps save 590 lives, out of the 730 lost through abortion. He said there was not enough money for other needed medical services. He asked: If it would make the individual responsible for paying for abortions, wouldn't that free up more money for the dental care needed for seniors, as well as eyeglasses? He noted that approximately $500,000 was involved. MS. WELLER noted that they are different programs. REPRESENTATIVE ROKEBERG asked whether there are any requirements that the department look to the parents or legal guardians for reimbursement for these procedures. He asked whether an unemancipated minor could request a Medicaid reimbursement for an abortion, even though her parents would not be eligible for Medicaid. MS. WELLER explained, "A minor can come to the Division of Public Assistance because she is pregnant and apply for assistance to pay for an abortion procedure and claim that ... they want their information to be confidential; they have not told their parents. And so, in those circumstances, we would not request information on the parents' financial information in determining the eligibility of the minor, because we would be invading ... their confidentiality in order to do that." REPRESENTATIVE ROKEBERG asked: What if she did not request confidentiality? MS. WELLER replied that if the applicant were a minor, she would have to supply financial information from her parents. REPRESENTATIVE ROKEBERG asked whether the state would seek reimbursement from the parents at that time. MS. WELLER answered that if the family was low-income, the young woman could qualify for Medicaid assistance. However, if the family was over-income because of the parents' income, she would be ineligible. REPRESENTATIVE ROKEBERG asked whether that was for the initial grant. He also asked whether the division would look into that prior to allowing the procedure. MS. WELLER explained that a person had to be found eligible prior to that. The two criteria are that she must be financially eligible and pregnant. Number 2409 REPRESENTATIVE BUNDE said if the parental consent bill passed, then when a minor asked for financial assistance for an abortion, there would have to be either judicial bypass or parental consent if the mother-to-be was under 16 years of age. "So, that takes care of the confidentiality problem that currently exists," he added. MS. WELLER replied, "It could impact the confidentiality, yes. They have to have parental consent." She reiterated that Section 3 of this bill would prevent the department from paying for abortion procedures altogether. TAPE 97-65, SIDE B Number 0006 PETER NAKAMURA, MD, MPH, Director, Division of Public Health, Department of Health and Social Services, came forward to testify. He specified he was speaking on the bill just from a health perspective. DR. NAKAMURA stated, "We've got a lot to learn from history. Before access to this procedure was available - and by access, we're talking about financial access, we're talking about legal access and we're talking about medical access - we had a period of time where we had hospitals dedicated to doing nothing more than taking care of the complications of illegal back-alley abortion procedures, self-induced abortions. Once we had legal access, and once we had medical access, we began to bring these numbers down to the point now where doing an abortion of any type is much safer than a normal delivery." DR. NAKAMURA emphasized that financial access is highly significant. They are talking about a vulnerable population of women who without financial means would have no access, despite the legal possibility and medical safety. He concluded by expressing concern about HB 234 because it decreases that very important financial access. REPRESENTATIVE BUNDE asked whether this might result in lawsuits to overturn the law or court pressure to increase funding. DR. NAKAMURA replied that he could not begin to speculate. However, he hoped something would happen to allow additional funds to come forward, to make sure that these highly vulnerable women do have access. CHAIRMAN GREEN asked why a court would require a voluntary surgery. Number 0117 REPRESENTATIVE BUNDE said as he understands current federal law, because abortion is legal, the state must provide it for people who cannot afford it; at least, that is Alaska's attorney general's interpretation. Because of abortion's placement on the priority list, funding was cut off de facto. He asked whether the courts would say the legislation was flawed or require the state to put enough money in or rearrange priorities so that the money goes far enough down the list to include abortion. REPRESENTATIVE MARTIN commented that many states do not provide for abortions. He suggested that information could be obtained from a right-to-life organization. CHAIRMAN GREEN said, then, it is not federally mandated. He asked whether Representative Bunde's concern was that Alaska statute may have to be revised or that this may be in conflict. REPRESENTATIVE BUNDE noted that Alaska's attorney general has said the state must provide access to all, even those who cannot afford it. He himself believes people should be able to pay for services they want, and he opposes elective surgery of any kind being state- funded. However, if the state supreme court says the state must provide access, including financial support if necessary, then the portion of the bill that lists abortion below the cut-off level would deny access. The bill may be unconstitutional. He suggested more far-fetched would be that the court would say the legislature must put more money into the Department of Health and Services budget so that the money goes far enough to reach that level. CHAIRMAN GREEN asked whether there were more questions for Dr. Nakamura and then called upon Deborah Behr. Number 0265 DEBORAH BEHR, Assistant Attorney General, Legislation and Regulations Section, Civil Division (Juneau), Department of Law, came forward to testify. She specified that although she was a regulations attorney, she had in the past advised the Medicaid and general relief medical programs. She was also counsel when then- Governor Hickel was preparing his abortion regulations and had done considerable research in this area. MS. BEHR noted that this is a highly complex area of law and that answers differ in various states. When the federal Medicaid program first began, Medicaid funding for abortions was fairly wide-open. However, the U.S. Congress cut that back so it was only covered in cases of rape and incest, with occasional coverage when the life of the mother was in danger. MS. BEHR explained, "It's usually done by a rider on the appropriation bills in Congress." There had been major lawsuits all over the U.S. regarding whether Congress could discriminate against poor people. The U.S. Supreme Court determined that this was a benefit, that Congress can decide what level of benefit to fund and that it was fine under federal law. MS. BEHR advised that there had been a second wave of case decisions in states having a constitutional right to privacy. Noting that the case decisions in this area were different, she offered to provide case cites later. MS. BEHR explained that generally, decisions in states with a constitutional right of privacy, as Alaska has, deemed that the state does not have to fund any service. However, if it chooses to fund a service and enters into a zone of what they call `privacy,' it must do so with neutrality. For example, if the state funds pregnancy services, it must fund the other side of the coin, which is abortion services. MS. BEHR advised that there were decisions in Connecticut and a couple of other states that she could provide if requested. MS. BEHR recounted that when she was assisting then-Governor Hickel in drafting regulations, she was looking at options. She said, "And one of the things that most of the states in those areas said, at minimum, you've got to cover therapeutic abortions." She noted that this bill does not cover therapeutic abortions; it only takes into account the possible death of the mother. "So it truly does not address those kinds of cases," she added. MR. BEHR said at the time they put out the regulations, they knew they were into a gray area in the state of Alaska, which had no case decisions in this area. "The regulations came out, and we were in court within hours," she said. She noted that legislative counsel looked at those. Ms. Behr has memos in her files from 1992 that essentially say the regulations put in by then-Governor Hickel were unconstitutional. She stated, "And I would suggest strongly that you have your own counsel look at this bill and see if her conclusion has changed, ... based on those decisions." Ms. Behr asked whether she could provide further information. Number 0373 CHAIRMAN GREEN asked about the case cites Ms. Behr had offered to obtain. MS. BEHR stated, "Yes, I can speak with your counsel later and help you on it. It's a difficult area of the law; it really is." CHAIRMAN GREEN said as he understood it, the state had no obligation in this area. However, if it chose to act, there was an obligation to cover both sides of the coin. MS. BEHR said yes, that is the basic problem of the question with a constitutional right of privacy. She noted that at least one constitutional amendment was proposed to try to stop state funding for abortions but did not pass the electorate. "So I'm fairly certain that this type of bill would not pass constitutional muster in this state," she advised. Number 0412 REPRESENTATIVE MARTIN referred to a case in 1982, which he said was brought before the people but did not pass. He asked: Even though Ms. Behr says the state has a responsibility to finance abortions, are they limited as to the source of the revenue? MS. BEHR said she was confused. She stated that the Division of Medical Assistance cannot fund any abortion without an appropriation. "So, in that way, the state of Alaska has to fund abortions, because it has to be done through an appropriation process," she added. REPRESENTATIVE MARTIN asked: "And if we are appropriating money from the parent, from the father who is responsible for the pregnancy, what's wrong with that?" MS. BEHR noted that she had been a child support attorney. She stated, "And it's very difficult establishing paternity of a child. It's very difficult, once you establish paternity of a child, doing collection of it. Oftentimes, the amount of money that you're talking about, in the case of an abortion, is the cost of collection, the cost of court action and the costs of DNA [testing]. I'm not sure that they'd necessarily net out." Number 0462 CHAIRMAN GREEN asked about the difficulty of determining who the father is. MS. BEHR said given that people applying for general relief medical assistance are low-income, it is a better than 50/50 chance that litigation would be required to establish paternity. At very early stages, it perhaps could be done through DNA testing, without necessarily going through a whole court process. Although a man could admit to paternity, he certainly did not have to. CHAIRMAN GREEN said earlier testimony indicated they could determine who the father was. MS. BEHR explained that when a woman applies for public assistance, she has to name a person, whether she is right or wrong. She noted that in some cases, the woman is unsure and there must be DNA testing of several people to determine paternity. REPRESENTATIVE MARTIN said with child support enforcement, there has been much more success than anticipated. He said all the fears being brought up now were brought up earlier about "forcing the poor woman to disclose who the father was." He suggested the cost involved in finding out who the father is has diminished significantly. He said as to collection, Alaskans receive permanent fund dividends and it is easy to put a lien against that check. CHAIRMAN GREEN said, "If they can prove that that's the father." REPRESENTATIVE MARTIN concurred. He restated that collection is minor. He said one important reason why the child support enforcement law is working well is that the state has an incentive. Last year, the federal government gave the state a $2.1-million incentive because of the success rate in finding the fathers. He commented, "You can't say that 80 percent of the kids will be welfare cases when they're having such good success now in finding who the fathers are and make them -- take them off of welfare." Number 0638 CARLA TIMPONE, Lobbyist for the Alaska Women's Lobby, came forward to testify. The Alaska Women's Lobby is unequivocally opposed to any piece of legislation that limits a woman's right to access a safe and legal abortion. In addition, they have specific concerns about HB 234. MS. TIMPONE noted that under the bill, a woman applying for general relief medical (GRM) assistance to pay for an abortion must name the putative father, unless the department determines that she has good cause not to do so. The definition of `good cause' as outlined by Representative Rokeberg's amendment includes rape or incest. Ms. Timpone stated, "Quite frankly, the Women's Lobby would like to see that definition not just be limited to rape or incest but to be left the way the language is currently in the bill, because we feel it's broader. There are many women who are victims of domestic violence who find themselves in life- threatening situations. And we would not like them to be excluded from the `good cause' definition by limiting it to rape or incest." MS. TIMPONE continued, "The woman then has to assign to the department the right of recovery to the funds to pay for this service. We're concerned - and we don't think that it's outside the realm of possibility that this could happen - that a woman will name a putative father, of course he won't be found, because that is far and away most often the case, the woman's PFD ...." CHAIRMAN GREEN interjected with a question: "You say far and away; is that because the person has gone or that this is a fictitious name or ....? MS. TIMPONE replied, "I would say either." Acknowledging that she is not a medical expert, she said she assumes fetal tissue would have to be used for paternity tests, which would occur after the abortion. That would be unlike paternity establishment used by the Child Support Enforcement Division of the Department of Revenue, which is usually a blood test because it involves two living people. MS. TIMPONE said like the Child Support Enforcement Division, that also assumes the Division of Public Assistance would have at its disposal a team of employees whose only job is to locate absent parents. However, she does not believe the latter agency has that. MS. TIMPONE explained, "We've heard testimony that when a woman - a single woman - comes in to apply for public assistance, she must give them the name of the father. And that is absolutely true. However, that pretty much ends the responsibility of the Division of Public Assistance. They get the name, they pass it on to Child Support Enforcement and Child Support Enforcement picks it up from there." MS. TIMPONE continued, "At least the way I read the bill, that is not going to be the case here. ... Because the bill does not say that anybody else is responsible, I'm assuming that the Division of Public Assistance, Department of Health and Social Services, would be responsible for doing that location. And I am not sure that they have staff that do that or even qualify to do that." MS. TIMPONE continued, "So, the woman has to assign her right of recovery to the department. If the father cannot be found and/or made to pay, then the woman's PFD is garnished. What happens, then, if the father is located? The woman can't recover a portion of what was taken from her, financially, to pay for the procedure, because she has assigned her right of recovery to the department. ... It doesn't say that that assignment is null and void once, and if, he is found. So, in other words, a woman's PFD is garnished to pay for the entire amount of the procedure. Dad suddenly turns up or she finds him. She is prohibited from seeking half the cost of the procedure, because she has assigned her right of recovery to the Department of Health and Social Services." CHAIRMAN GREEN asked why that would preclude the woman from getting back half from the father. MS. TIMPONE replied, "Because she has assigned the right of recovery of the payment to the department." CHAIRMAN GREEN said, "For the permanent fund dividend. So, she gives that up and then they find me, why can't I repay her?" MS. TIMPONE answered, "You could voluntarily. But if you don't choose to voluntarily, she has no legal recourse to try to get it, because she has assigned her right of recovery to the Department of Health and Social Services. So, we have a concern about that." MS. TIMPONE continued, "We also have some concerns about the nature of singling out this particular procedure because it is an elective procedure, or, in any case, that's how it has been characterized. I believe that there is a possibility that there are other circumstances under which treatment is paid for under GRM for people who suffer a medical condition or an injury as a result of a situation over which they had control. For instance, if a homeless alcoholic falls asleep on the curbside and is run over by the garbage truck and requires medical treatment as a result of his choice to drink himself into stupefaction, I might have some problems with the state's paying for treatment of that person." MS. TIMPONE continued, "I think that we start to go down a slippery slope when we start to prohibit some medical procedures because we have moral or religious problems with that particular kind of procedure, because there's a wide spectrum of procedures that different ones of us could have moral or religious problems with. Someone who is GRM-eligible ... steals a bike, takes a ride without a helmet, suffers a head injury. Is the state obligated to treat that person? Some of us might have a problem with that. So, we have a concern in that regard." MS. TIMPONE continued, "And while I understand that what the sponsor is trying to get to, and don't disagree at all, is an equality of responsibility, I think, then, we also have to address equality of class, for lack of a better word. The bill is not a referendum or a statement on abortion. It's a statement on who we feel deserves to have one. It's okay to have an abortion if you can afford to pay for it out of your pocket; it's not okay to have an abortion if the state has to pay for it. I think we begin to get into a whole other set of issues there that relate primarily to class, and we certainly have some concern with that as well." Number 1005 CHAIRMAN GREEN suggested there is a class distinction anyway, regarding insurance, for example, that pays for a private room or does not. MS. TIMPONE replied, "Well, to a degree. You're still receiving the medical service. You may just be receiving it in nicer surroundings." CHAIRMAN GREEN referred to Ms. Timpone's discussion of an inebriate that gets run over by a truck and questioned her willingness to provide one service over the other. MS. TIMPONE clarified that if the state pays in one case, she believes it should pay in the other. CHAIRMAN GREEN suggested the reverse may be true: If it does not pay in one case, perhaps it should not pay in the other. MS. TIMPONE emphasized that there should be equality. CHAIRMAN GREEN asked whether there were questions, then requested that Ms. Timpone answer future questions from committee members. (HB 234 was held over.) ADJOURNMENT Number 1135 CHAIRMAN GREEN adjourned the House Judiciary Standing Committee meeting at 3:44 p.m.