Legislature(1995 - 1996)
04/19/1995 09:02 AM Senate HES
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SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
April 19, 1995
9:02 a.m.
MEMBERS PRESENT
Senator Lyda Green, Chairman
Senator Loren Leman, Vice-Chairman
Senator Mike Miller
MEMBERS ABSENT
Senator Johnny Ellis
Senator Judy Salo
COMMITTEE CALENDAR
HOUSE BILL NO. 214 am
"An Act relating to the maintenance by health care providers of
medical records in an electronic format."
CS FOR HOUSE BILL NO. 125(JUD)
"An Act relating to disclosures to school officials of information
about certain minors; and providing for an effective date."
SENATE BILL NO. 138
"An Act relating to the state's tuberculosis control program,
including provisions for certain penalties; and providing for an
effective date."
PREVIOUS SENATE COMMITTEE ACTION
HB 214 - No previous action to record.
HB 125 - No previous action to record.
SB 138 - See Health, Education & Social Services minutes dated
4/12/95.
WITNESS REGISTER
Representative Gary Davis
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Prime sponsor of HB 214.
Garrey Peska
Alaska State Hospital and Nursing Home Association
PO Box 240185
Douglas, Alaska 99824
POSITION STATEMENT: Supported HB 214.
Melinda Gruening, Staff
Representative Joe Green
State Capitol
Juneau, Alaska 99801-1182
POSITION STATEMENT: Discussed HB 125.
Lieutenant Ted Bachman
Alaska State Troopers
Public Safety
9700 G. Tudor Road
Anchorage, Alaska
POSITION STATEMENT: Supported the concept of HB 125.
Steve McPhetres, Executive Director
Alaska Council of School Administrators
326 4th Street, #404
Juneau, Alaska 99801
POSITION STATEMENT: Supported current version of HB 125, but would
like stronger version.
Helen Mehrkens
Department of Education
801 W. 10th Street
Juneau, Alaska 99801
POSITION STATEMENT: Supported HB 125.
John Cyr
National Education Association-Alaska
PO Box 2776
Palmer, Alaska
POSITION STATEMENT: Supported CS HB 125(JUD).
Margot Knuth, Assistant Attorney General
Criminal Division
Department of Law
PO Box 110300
Juneau, Alaska 99811-0300
POSITION STATEMENT: Discussed disclosure between school districts.
Russell Webb
Division of Public Health, DHSS
PO Box 110610
Juneau, Alaska 99811-0610
POSITION STATEMENT: Emphasized the importance of having the
necessary tools available to control
tuberculosis.
Elfrida Nord, Chief
Nursing Section
Division of Public Health, DHSS
PO Box 110611
Juneau, Alaska 99811-0611
POSITION STATEMENT: Explained the nature of tuberculosis.
Kristen Bomengen, Assistant Attorney General
Human Services Section
Department of Law
PO Box 110300
Juneau, Alaska 99811-0300
POSITION STATEMENT: Discussed SB 138.
ACTION NARRATIVE
TAPE 95-31, SIDE A
HB 214 MEDICAL RECORDS IN ELECTRONIC FORM
Number 002
CHAIRMAN GREEN called the Senate Health, Education and Social
Services (HESS) Committee to order at 9:02 a.m. and introduced
HB 214 as the first order of business.
REPRESENTATIVE GARY DAVIS, prime sponsor, explained that HB 214 is
an act relating to the maintenance of health care providers by
health care providers keeping medical records in an electronic
format. He informed the committee that electronic medical records
are legally accepted in lieu of records on paper. Hospitals and
nursing homes are moving towards paperless offices in an attempt to
promote efficiency. Representative Davis explained that some
providers hesitate to implement the electronic retention and
maintenance of medical records without a hard copy backup due to
the lack of explicit legal authority. Currently, statute does not
prohibit or permit medical records being kept electronically. He
indicated that Legislative Legal Services had noted a similar
concern. HB 214 would clarify the medical records statute.
GARREY PESKA, representing the Alaska State Hospital and Nursing
Home Association, supported HB 214.
SENATOR LEMAN moved that HB 214 am be reported out of committee
with individual recommendations. Hearing no objection, it was so
ordered.
HB 125 JUVENILE RECORD INFORMATION TO SCHOOLS
Number 086
CHAIRMAN GREEN introduced HB 125 as the next order of business
before the committee.
MELINDA GRUENING, staff to Representative Joe Green, informed the
committee that violence is one of the leading problems facing
Alaskan schools. There is no requirement that a school principal
be given criminal records regarding a delinquent that is attending
the school. She noted the hard work on SB 54 last year which was
a juvenile waiver bill that addressed discretionary disclosure of
agency records to school officials. There has been little effort
to develop a protocol for the sharing of information; there are no
regulations as of yet. She said that there is confusion regarding
the disclosure of this information. As illustrated in two polls
taken last month surveying school officials and teachers, little
disclosure is actually occurring. School officials favor
disclosure occurring as soon as possible.
Ms. Gruening explained that HB 125 would require law enforcement
and the Division of Family & Youth Services (DFYS) to disclose
these criminal records to school officials. She pointed out that
House HESS had approved a CS that provided mandatory disclosure of
the courts and law enforcement of felonious crimes. The
information provided with disclosure would protect the victims of
juvenile crime, students, and teachers. Furthermore, the school
principal could utilize the school's resources in order to provide
assistance to a delinquent youth.
Ms. Gruening discussed two meetings in which various agencies and
interested parties came together to discuss the issue of
disclosure. From the perspective of the school, disclosure which
is not happening should be mandatory. From the perspective of the
Department of Law and the Department of Public Safety, the new law
should be afforded the opportunity to work on a discretionary
basis. However, everyone agreed that disclosure should have a set
procedure. These meetings resulted in the passage of the House
Judiciary CS which removed the mandatory nature of the disclosure
and added language requiring that a mutually agreeable procedure
between DFYS, law enforcement agencies, and local school officials
be established. Such an agreement would ensure that criminal
records would be transferred to schools. She noted that the
transfer of information would be different in each school district.
The Anchorage Police Department felt that a dedicated fax line
would be the easiest manner in which to communicate this
information. In smaller schools and communities, the procedure
could be done by a phone call that is followed up by written
confirmation. The option was left up to the local law enforcement
and school districts to work out the procedure between them.
Ms. Gruening pointed out that the bill has a 90 day deadline
beginning at the time of the bill's effective date for establishing
the procedures; it is critical that this be done quickly. She said
that Representative Green encourages everyone involved with
disclosure to begin now. Representative Green intends to follow up
on this issue in the fall with polling in order to determine if
disclosure is happening on a discretionary basis. If disclosure is
not happening at that time, Representative Green plans to introduce
legislation that would mandate disclosure next session. The CS
gives the discretionary disclosure an opportunity to work. Ms.
Gruening emphasized that school officials must have the necessary
information regarding school violence, if the schools are to be
held responsible for the safety of students and faculty.
Number 189
CHAIRMAN GREEN asked if there was anything in this legislation that
would require that one school communicate information to another
school regarding a violent student. MELINDA GRUENING said there
was not. The current disclosure under SB 54 has strict
redisclosure confinements.
LIEUTENANT TED BACHMAN, Alaska State Troopers assigned to the
Directors Office in Anchorage, stated that the Department of Public
Safety (DPS) supported the concept of the release of this type of
information to the schools. There has been a policy drafted
regarding disclosure for the State Troopers which should be in
place by May 1st statewide. The State Troopers would utilize a
form that would inform the school of incidents. The school would
then fill out a portion of the form and fax it back to the Troopers
in order to verify that the school received the information and to
determine if the school has this student. He explained that the
policy also provides for disclosure of information to other schools
in which the student is not enrolled; this measure would protect
surrounding areas which may be in danger from this student.
Lieutenant Bachman specified that under current statutes the State
Troopers can inform other schools that the student does not attend.
He informed the committee that there would be a packet put together
that would be passed out to all police departments in order to
implement this procedure without any material changes needed. This
packet should be distributed in the first week of May.
STEVEN MCPHETRES, Executive Director of the Alaska Council of
School Administrators, informed the committee that he represented
over 500 elementary and high school principals and district staff
as well. The Council supported the current version of HB 125,
although a stronger version as originally introduced would be
welcomed.
Number 266
HELEN MEHRKENS, representing the Department of Education, supported
Sections 2, 3, and 4. She discussed the escalating concerns for
the safety of students from other students. This bill is
appropriate. The cooperation between departments and agencies is
important regarding the safety of students in school.
CHAIRMAN GREEN asked if Ms. Mehrkens had heard of the need for
district to district disclosure and would it be possible to do so.
HELEN MEHRKENS said she had heard that concern, but was unable to
comment on the possibility of that under this legislation.
JOHN CYR, Vice President of NEA-AK, supported CS HB 125(JUD). He
informed the committee that a telephone poll of its members had
rated school violence as the number one concern amongst empolyees
in both rural and urban Alaska. NEA-AK had hoped that the bill
would have a mandatory provision. In response to Chairman Green
regarding district to district disclosure, there is a problem. A
district has no idea of the problems a transfer student may have;
transfers are more of a problem than problem students in a
district's own school because those students can be tracked. Mr.
Cyr said that confidentiality is important, but confidentiality is
superseded by the right to know.
MARGOT KNUTH, Criminal Division of the Department of Law, said that
district to district disclosures are permitted under existing law.
There are two forms that the state has developed, one is from DHSS
and the other is from the State Troopers. The form from DFYS
indicates all reports about a juvenile specifies that the form may
be placed in the student's record. School districts may adopt
further policies for disclosure of this type of information. She
appreciated the cooperation that Representative Green had extended
with solving this problem. In time, refinement will occur as the
system is used.
CHAIRMAN GREEN noted that some information in a student's file is
purged when their files are transferred.
LIEUTENANT TED BACHMAN pointed out that AS 47.10.93 specifies that
a state, municipal agency or employee may disclose information
regarding a case to school officials. Most school employees are
state or municipal employees which may allow school to school
disclosure. CHAIRMAN GREEN indicated that perhaps, school to
school disclosure is doable now, but it may not be the trend.
SENATOR LEMAN moved that CS HB 125(JUD) be moved out of committee
with individual recommendations. Hearing no objection, it was so
ordered.
SB 138 TUBERCULOSIS CONTROL
Number 374
CHAIRMAN GREEN introduced SB 138 as the next order of business
before the committee.
RUSSELL WEBB, Division of Public Health, said that tuberculosis
remains a serious public health problem in Alaska. There have been
several serious outbreaks in the last year. Current law makes it
difficult to combat tuberculosis and its threat to the public's
health. He explained that tuberculosis is an airborne disease that
is easily spread by routine contact such as coughing in a confined
area. Tuberculosis can be successfully treated, however, the
treatment can be lengthy. He specified that treatment can take 6
to 24 months and may require taking multiple drugs. Some persons
may find it difficult to voluntarily complete treatment. Mr. Webb
emphasized that it is critical to complete the entire treatment
because tuberculosis can develop a resistance to drugs. He
informed the committee that there are strains that are resistant to
all known antibiotics. Therefore, someone who does not complete
treatment could possibly pass on a drug resistant strain to others.
Mr. Webb emphasized the importance of having the tools to ensure
that people who fail to voluntarily comply with treatment are
required to comply with treatment. SB 138 would provide such tools
and update the current law. SB 138 would provide some
constitutional safeguards for persons who are involuntarily
required to comply with treatment. He anticipated that quarantine
and isolation would be necessary in rare cases, however, when that
is necessary the ability to implement that is critical. In
conclusion, Mr. Webb reiterated the importance of SB 138 to Alaska
and the efforts to control tuberculosis.
SENATOR LEMAN asked if there were other diseases such as
tuberculosis where this type of action, quarantine, may be
necessary. He also asked what was being done about those disease
if they exist. RUSSELL WEBB clarified that he was not a medical
doctor. Mr. Webb said that he had been informed, after discussions
with Dr. Nakamura and Dr. Middaugh, that tuberculosis is a
particular case because of the manner in which the disease is
spread as well as the difficulty faced in treatment. Treatment for
tuberculosis often requires taking a combination of drugs for a
lengthy time period.
Number 443
ELFRIDA NORD, Chief of Public Health Nursing, explained that there
are no other diseases that are like tuberculosis as far as
quarantine is concerned. The air-sharing nature of tuberculosis
allows a person to get the disease without any effort on their
part; that is the specialness of tuberculosis. Most other diseases
require an individual to have some part in getting the disease.
SENATOR LEMAN said that he did not have a problem with this
procedure. However, there may be other diseases which could have
a better effort to protect the public for the same reasons as
SB 138. Why are those aggressive procedures not being done with
those other diseases? He commended everyone for bringing this
issue to everyone's attention.
RUSSELL WEBB pointed out that there are a variety of other control
mechanisms being used for other diseases and those mechanisms are
being utilized. Tuberculosis is a special case which requires a
change in the law in order to address the disease.
CHAIRMAN GREEN asked if tuberculosis was more of a problem in
Alaska because of the circumstances of Alaska. ELFRIDA NORD
replied no. Ms. Nord specified that with tuberculosis the problem
stems from the nature of the disease and the nature by which this
disease is spread to others. Furthermore, the long term aspect of
tuberculosis also poses problems. Ms. Nord indicated that the goal
is to keep a person with tuberculosis under surveillance while the
treatment is given to the person regularly.
Number 474
SENATOR MILLER informed the committee that he had a proposed
amendment from the department. Senator Miller moved that Amendment
1 be adopted.
RUSSELL WEBB explained that the amendment provides for protection
of the privacy rights by allowing the option of closed court
proceedings relating to a tuberculosis court order. The other
portion of the amendment would eliminate the criminal penalty for
failure to comply with a tuberculosis order. He noted that
provision had been left in due to a drafting error. He indicated
that the criminal penalty is ineffective and unnecessary. SB 138
provides more effective civil means in which to protect the public
health. DHSS and the Division of Public Health are interested in
protecting the public health without imposing criminal penalties.
CHAIRMAN GREEN asked if there was any objection to Amendment 1.
Hearing no objection, Amendment 1 was adopted.
KRISTEN BOMENGEN, Human Services Section with the Department of
Law, explained that currently in tuberculosis cases the State
Medical Officer can order an examination and quarantine. The next
tool is the enforcement of the order by notifying law enforcement
officials and leveling a criminal charge for failure to follow a
medical order. SB 138 would provide the needed intermediate steps
between the initial order and the enforcement of the order. She
noted that the bill is designed to provide due process
considerations such as a hearing before an impartial decision-
maker, an opportunity to be represented by council and raise
constitutional issues. Ms. Bomengen informed the committee that
this was before the legislature now because of a case encountered
in the past year in which the department was before the courts with
a criminal order to enforce the quarantine provisions. In regards
to the amendment, the criminal penalties were not necessary when
the intermediate steps were in place; a civil contempt proceeding
is more appropriate to enforce the order.
SENATOR MILLER moved that CS SB 138(HES) be moved out of committee
with individual recommendations. Hearing no objection, it was so
ordered.
There being no further business before the committee, the meeting
adjourned at 9:43 a.m.
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