Legislature(1993 - 1994)
03/16/1994 01:40 PM Senate HES
* first hearing in first committee of referral
= bill was previously heard/scheduled
= bill was previously heard/scheduled
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE March 16, 1994 1:40 p.m. MEMBERS PRESENT Senator Steve Rieger, Chairman Senator Bert Sharp, Vice-Chairman Senator Loren Leman Senator Mike Miller Senator Jim Duncan Senator Johnny Ellis Senator Judy Salo MEMBERS ABSENT All members present. COMMITTEE CALENDAR SENATE BILL NO. 312 "An Act relating to school construction grants; and providing for an effective date." CS FOR SENATE BILL NO. 255(CRA) "An Act establishing a comprehensive policy relating to human resource development in the state." CS FOR HOUSE BILL NO. 2(RLS) "An Act requiring drug and alcohol tests for school bus drivers." HOUSE CONCURRENT RESOLUTION NO. 31 Relating to Alcohol-Related Birth Defects Awareness Week. SENATE BILL NO. 270 "An Act creating the Alaska Health Commission; relating to the delivery, quality, access, and financing of health care; relating to review and approval of rates and charges of health insurers; relating to certain civil actions against health care providers and health insurers; repealing Alaska Rule of Civil Procedure 72.1; and providing for an effective date." SENATE BILL NO. 284 "An Act establishing the Alaska Health Insurance Corporation and requiring licensed health care providers to comply with certain statutes and regulations relating to the corporation; relating to disability insurance claims processing and to approval of rates for disability insurance, including health insurance; and providing for an effective date." PREVIOUS SENATE COMMITTEE ACTION SB 312 - No previous action to record. SB 255 - See Community & Regional Affairs minutes dated 1/25/94, 2/1/94, 2/3/94 & 2/8/94. HB 2 - No previous action to record. HCR 31 - No previous action to record. SB 270 - See Health, Education & Social Services minutes dated 2/9/94, 2/18/94, 3/2/94, 3/9/94, 3/11/94 and 3/14/94. SB 284 - See Health, Education & Social Services minutes dated 2/14/94, 2/18/94, 3/2/94, 3/9/94, 3/11/94 and 3/14/94. WITNESS REGISTER Representative Jerry Mackie State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Supported SB 312. Shirley Armstrong, Staff Senator Randy Phillips State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Reviewed SB 255. Debbie Call, Chair Alaska Job Training Council 12342 W. Prince of Peace Eagle River, Alaska 99577 POSITION STATEMENT: Supported SB 255 and Amendment 1. Mary Shields, General Manager Northwest Technical Services Vice-Chair, Alaska Job Training Council 4041 B Street, STE 102 Anchorage, Alaska 99503 POSITION STATEMENT: Supported SB 255 and Amendment 1. Dan Middaugh Alaska Training Coordinators Association 1822 W Northern Lights #305 Anchorage, Alaska 99517 POSITION STATEMENT: Supported SB 255 and Amendment 1. Mike Heimbuch, Staff Representative Gail Phillips State Capitol Juneau, Alaska 99801-1182 POSITION STATEMENT: Reviewed HB 2. Romayne Kareen, Program Coordinator People Transportation, School Bus Safety Department of Education Juneau, Alaska POSITION STATEMENT: Reviewed HB 2. Brad Whistler Department of Health and Social Services Juneau, Alaska POSITION STATEMENT: Present for questions. Dr. Peter Nakamura, Director Division of Public Health Department of Health and Social Services P.O. Box 110610 Juneau, Alaska 99811-0610 POSITION STATEMENT: Reviewed public health issues. Jay Livey, Deputy Commissioner Department of Health and Social Services P.O. Box 110601 Juneau, Alaska 99811-0610 POSITION STATEMENT: Reviewed SB 270. ACTION NARRATIVE TAPE 94-20, SIDE A Number 006 CHAIRMAN RIEGER called the Senate Health, Education and Social Services (HESS) Committee to order at 1:40 p.m. He introduced SB 312 (SCHOOL CONSTRUCTION GRANT REVIEW) as the first order of business before the committee. SENATOR MILLER moved to adopt the CSSB 312 (HES) for discussion purposes. Hearing no objections, CSSB 312 (HES) was adopted. CHAIRMAN RIEGER pointed out that the HES CS adds language regarding participation of interscholastic school activities to the original bill. Section 2 removes the Alaska School Activities Association (ASAA), Inc. statutes AS 14.07.058 and AS 14.075.059 which would preclude an appeal to the Department of Education on cases such as eligibility. REPRESENTATIVE JERRY MACKIE stated that SB 312 was a result of discussions regarding school construction problems and the inability to set limits on school construction. He felt that SB 312 was necessary, especially during the current climate of declining revenues. He urged that the bill be moved out of committee. SENATOR MILLER moved CSSB 312 (HES) out of committee with individual recommendations. Hearing no objections, it was so ordered. Number 070 CHAIRMAN RIEGER introduced SB 255 (STATE POLICY ON HUMAN RESOURCE DEVELOPMT) as the next order of business before the committee. He noted the request for an amendment from Senator Randy Phillips. SHIRLEY ARMSTRONG, staff to Senator Randy Phillips, stated that SB 255 was introduced on behalf of the Alaska Joint Training Council. She urged passage of SB 255. The proposed amendment was passed by the Alaska Joint Training Council at their last meeting in order to assure the departments coordination of education and training programs. She offered to answer any questions. CHAIRMAN RIEGER moved Senator Randy Phillips amendment, Amendment 1, for discussion purposes. AMENDMENT 1 Page 3, line 5: Insert a new subsection to read: "(h) The legislative auditor shall conduct a performance audit of the implementation of the policy provided in this section during fiscal year 1998 and every four years thereafter." SENATOR ELLIS asked if the Alaska Job Training Council was the overall pick for the state under JTPA. SHIRLEY ARMSTRONG said yes and noted membership from the state, various industries, all the departments, and various disciplines. CHAIRMAN RIEGER reminded the committee of the motion before them. Hearing no objection, Amendment 1 was adopted into a HES CS. DEBBIE CALL, Chair of the Alaska Job Training Council, supported SB 255 and Amendment 1. She clarified that the Alaska Job Training Council is an advisory council to the Governor which oversees the Private Industry Council around the state. The Council advises the Governor on JTPA programs and human resource development issues. She stated that SB 255 is a comprehensive policy relating the human resource development in Alaska. Alaska will have to better coordinate the human resource development programs, especially in rural areas. She noted her own experience as a private sector employer who was attempting her own human resources development programs on the North Slope. SB 255 would help achieve better coordination and programs. Number 182 SENATOR ELLIS thanked Ms. Call for her testimony and the language on page 2 that addresses incentives and disincentives regarding the state public assistance programs to move people from public assistance to private sector employment. He encouraged everyone to be aware of federal level tools and initiatives, such as President Clinton's apprenticeship proposal, that could be used. DEBBIE CALL said that SB 255 does realize the national issues. She noted that some council members attend meetings in Washington, D.C. MARY SHIELDS, General Manager of the Northwest Technical Services and Vice-Chair of the Alaska Job Training Council, stated that SB 255 would enable movement forward on these human resource development issues. She urged passage of SB 255 with Amendment 1. She mentioned that the business community does like SB 255. DAN MIDDAUGH, Alaska Training Coordinators Association, explained that he is currently recoordinating labor's attempt to create a statewide job placement referral system, the Apprenticeship Information Center. He asserted that apprenticeship is the primary manner in which to train individuals to their highest potential through the trade. He expressed the need and desire to improve on these issues in rural areas. He stated support for SB 255 and Amendment 1 from the Alaska Training Coordinators Association. SENATOR MILLER moved SB 255 as amended out of committee with individual recommendations. Hearing no objections, it was so ordered. Number 267 CHAIRMAN RIEGER introduced HB 2 (DRUG TESTING FOR SCHOOL BUS DRIVERS) as the next order of business before the committee. SENATOR SALO asked if HB 2 applies to temporary drivers and how does HB 2 apply to volunteer drivers. MIKE HEIMBUCH, staff to Representative Gail Phillips, stated that the intent of HB 2 was to speak to those employed by the school district. The language seemed to be flexible enough to allow the Department of Education (DOE) to adopt the scope of the bill through regulations. SENATOR SALO noted that contracted drivers also fall within the scope of the bill. She informed the committee that currently, some districts are drug testing upon initial employment, randomly testing, or testing for cause. She expressed her belief that testing for cause was of primary importance. HB 2 would mandate drug testing. She asked who would pay for the testing. MIKE HEIMBUCH stated that at present there is an $84,000 fiscal note for DOE. SENATOR DUNCAN believed that the fiscal note does not specify who would pay for the testing. He assumed that the $79,000 contractual portion of the fiscal note would pay for the testing. He inquired of the possibility that individual drivers would be required to pay for the drug test if the fiscal note was zeroed out. MIKE HEIMBUCH could not answer. SENATOR DUNCAN did not believe that school bus drivers should have to pay for the testing. MIKE HEIMBUCH said that he read HB 2 as saying that the school districts or areas that provide for transportation would provide for the random drug testing. SENATOR DUNCAN noted that the language was "shall require." MIKE HEIMBUCH stated that HB 2 requires that the driver would submit to the testing, but not requiring that the driver pay for the testing. SENATOR DUNCAN explained that without funding for the state to pay for the testing, then the bill would not prohibit a school district requiring the drivers to submit and pay for the testing. He expressed the need to make the language explicit. MIKE HEIMBUCH pointed out that the language referring to developing regulations was thought to speak to the possibility that DOE and different districts could not adequately administer the testing, this language would allow them to address it quicker than through the statutes. SENATOR DUNCAN requested a DOE representative. SENATOR SALO inquired of the percentage of Alaska school bus drivers currently under a drug testing program. Number 345 ROMAYNE KAREEN, Program Coordinator for People Transportation in the School Bus Safety section, the Department of Education, did not know the percentage of the large districts with the contracted operations. She noted some internal requirements of drug testing in the contracted operations. On the peninsula, random testing is prohibited by the union contract with the drivers, the company and the school district. SENATOR SALO suggested that perhaps 80 or 90 percent of the drivers are under drug testing. ROMAYNE KAREEN thought the percentage was probably not that high. SENATOR DUNCAN asked who would be charged under HB 2. ROMAYNE KAREEN explained that the fiscal note was present with the understanding that DOE would coordinate and oversee the program on a statewide basis. If the fiscal note was zeroed out, Ms. Kareen assumed that DOE would have to address that situation. SENATOR DUNCAN expressed concern that the bus drivers may be required to pay for the drug testing. He suggested that the language be made more explicit. ROMAYNE KAREEN stated that regarding the contractual amount, the fiscal note would include the cost of the testing. She pointed out various ways to handle this issue: a written contract between the school district and the school bus contractor, and an agreement between the department and school districts who run their own transportation system. SENATOR DUNCAN did not understand why the language could not be more explicit and say that the school bus driver would not be charged for the drug testing. ROMAYNE KAREEN explained that school bus drivers have a high turnover rate and there are incentives for the employer to pick up some costs. For instance, the commercial drivers license and the mandatory training program are some of the up front costs a bus driver may face. SENATOR SALO stated that there are reasons that contacts between companies and bus drivers have opposed random testing. Many believe that random drug testing is demeaning not to mention the possibilities of a false positive. She felt that drug testing for cause is appropriate. She explained that in this time of fiscal constraints with educational funding, money could be better spent elsewhere. She indicated that HB 2 could open up to drug testing in other areas, such as food service workers. She believed that the drug testing of HB 2 does not in general protect the individual. Perhaps, it would act as a deterrent to some extent. She said that the fiscal note must only be coordination of the program, how could that include the testing. ROMAYNE KAREEN informed the committee that the $84,000 fiscal note included the testing. She detailed the fiscal note for the committee: $5,000 for a hearing officer, $3,000 for travel, $2,000 for supplies, $2,000 for printing and postage, and the remaining $72,000 for testing. She stated that there should have been an attachment to the fiscal note explaining the details. Number 427 SENATOR DUNCAN asked if HB 2 would override those contracts such as the Kenai Peninsula that prohibit random drug testing. ROMAYNE KAREEN said that HB 2 would override those contracts that currently prohibit random drug testing. She indicated that the school bus industry believes random drug testing would be a deterrent. SENATOR SALO asked if the school bus industry believes there is a problem. ROMAYNE KAREEN said yes, the industry does feel there is a problem in some areas that they are notable to address currently. SENATOR SALO inquired of the industries' ability to test for cause. ROMAYNE KAREEN stated that it would depend upon the internal structure between the school and the bus contractor within the company. SENATOR SHARP moved HB 2 out of committee with individual recommendations and the accompanying fiscal note. Senator Salo objected. A hand vote was taken and the bill moved. Number 455 CHAIRMAN RIEGER introduced HCR 31 (ALCOHOL-RELATED BIRTH DEFECTS AWARENESS) as the next order of business before the committee. SENATOR MILLER moved HCR 31 out of committee with individual recommendations. Hearing no objections, it was so ordered. Number 465 CHAIRMAN RIEGER introduced SB 270 (COMPREHENSIVE HEALTH CARE) and SB 284 (COMPREHENSIVE HEALTH INSURANCE ACT) as the final order r of business before the committee. He directed the committee to a discussion of public health regarding these bills. BRAD WHISTLER, Department of Health and Social Services, deferred the discussion of public health to Dr. Nakamura. DR. PETER NAKAMURA, Director of the Division of Public Health in the Department of Health and Social Services, deferred to Jay Livey to present the position of the department. He said that he could address public health and those elements critical to any health care reform. JAY LIVEY, Deputy Commissioner of the Department of Health and Social Services, noted that they had proposed an amendment in the House that had been adopted, which would be suggested for SB 270. He explained that the amendment has a public health focus in terms of developing a public health plan and providing public health information and guidance through the Commission. CHAIRMAN RIEGER asked if the establishment of a Public Health Advisory Committee was the only amendment from Healthy Alaska 2000 that the department would like in this legislation. JAY LIVEY said that they were not ready to propose legislation regarding Healthy Alaska 2000. At this point, the public health focus would be included in SB 270. DR. PETER NAKAMURA pointed out that the proposed amendment includes a public health improvement plan which would identify the essential functions necessary to ensure that public health is addressed. He explained that health care reform usually addresses cost containment, access, universal coverage, and tort reform; those issues relating to clinical services. He observed that population based public health services, such as safe water and food, never seem to be addressed. In order to develop a public health plan, those major population based public health services must be addressed; that would include the Healthy Alaska 2000 objectives. Number 524 SENATOR DUNCAN did not see any directives toward public health in the proposed amendment. JAY LIVEY noted that the amendment before the committee was not the version that the House passed. Mr. Livey stated that they supported the House version amendment being added to SB 270. DR. PETER NAKAMURA explained that the House version of the amendment is similar to Representative Sitton's bill. He clarified for Senator Duncan that the development of the health improvement plan is permissive, not required. SENATOR DUNCAN inquired of the rationale behind adopting permissive language. JAY LIVEY noted that the majority of the discussion was centered on available resources and what could be achieved without attaching the large fiscal note of the original public health bill. SENATOR DUNCAN informed the committee that the fiscal note of Representative Sitton's public health bill was approximately $300,000. He suggested that the permissive language indicates that they are not going to do public health because they are not going to have the money. He expressed surprise that Dr. Nakamura would agree with this language. Public health can already be addressed now, legislation is not necessary. He stated that the language should require public health be addressed. JAY LIVEY said that the public health issue was a matter of scope regarding what could be reasonably achieved given current resources. He noted that some additions to the original fiscal note were made in order to provide some resources to do public health work. He agreed with Senator Duncan, the scope is not as broad as that of Representative Sitton's bill. Getting a start on public health planning is reasonable even if a comprehensive plan cannot be achieved. SENATOR DUNCAN did not understand how a start could be made with this permissive language. He suggested that they develop a scope that could be achieved in the first year and use mandatory language. He expressed frustration with the Administration's view that nothing can be done; therefore, resources, which are not present anyway, should not be committed. JAY LIVEY offered to work with the committee on the scope and language regarding the public health issue. SENATOR DUNCAN discussed Dr. Nakamura's efforts towards public health. He stated that there was not a piece meal approach to public health or comprehensive health care reform. He suggested that the Administration say exactly what they are doing with these issues so that the legislature could continue its work. JAY LIVEY reiterated the added resources for public health. He expected that if the amendment passes they would work on a public health plan. TAPE 94-20, SIDE B Number 593 CHAIRMAN RIEGER stated that Healthy Alaska 2000 had more specific recommendations than occur in either SB 270 or SB 284. He indicated that he may choose some of those recommendations to bring before the committee for consideration. He welcomed other committee members to do the same. He regarded both bills as setting up an entity to further develop the public health improvement plan. This hearing was an opportunity to review specific legislative recommendations from Healthy Alaska 2000 which are not present in either bill. SENATOR DUNCAN disagreed with Chairman Rieger and pointed out that page 16 of SB 284 has recommendations that the public health improvement plan must include. He said that this section basically takes the language from Representative Sitton's bill. DR. PETER NAKAMURA explained that they are trying to avoid choosing specific activities without knowing the trade-off costs of those activities. He stated that choosing something at the cost of something else could result in a greater deficit situation. He indicated that knowing all the issues and the base core functions would create the ability to choose specific activities identified in Healthy Alaska 2000 and know their actual cost. Dr. Nakamura expressed concern that the issue of public health often gets lost in dialogue. He stated that the public health improvement plan can be done while the dialogue regarding cost containment, financing, insurance, deductibles, and comprehensive coverage issues continues. He did not want public health improvement to be lost in this debate. Number 552 SENATOR DUNCAN asked for the total of the fiscal note for Representative Sitton's bill. DR. PETER NAKAMURA estimated that it was about $358,000. JAY LIVEY believed the fiscal note was around $350,000. SENATOR DUNCAN was interested in how Representative Sitton's fiscal note matches that of SB 284. There being no further business before the committee, the meeting was adjourned at 2:30 p.m.