Legislature(2001 - 2002)
02/28/2001 01:39 PM Senate HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION & SOCIAL SERVICES COMMITTEE
February 28, 2001
1:39 p.m.
MEMBERS PRESENT
Senator Lyda Green, Chair
Senator Loren Leman, Vice Chair
Senator Gary Wilken
Senator Jerry Ward
Senator Bettye Davis
MEMBERS ABSENT
All Members Present
COMMITTEE CALENDAR
SENATE BILL NO. 96
"An Act relating to the issuance of certificates of participation
to finance demolition of all or part of the existing facility known
as the Alaska Psychiatric Institute and construction of a new
facility to be known as the Alaska Psychiatric Institute; giving
notice of and approving the entry into, and the issuance of
certificates of participation in, a lease-purchase agreement for
demolition of all or part of the existing facility known as the
Alaska Psychiatric Institute and construction of a new facility to
be known as the Alaska Psychiatric Institute; and providing for an
effective date."
HEARD AND HELD
SENATE BILL NO. 112
"An Act placing certain employees of the Alaska Mental Health Trust
Authority in the exempt service; establishing a minimum salary for
the long term care ombudsman; and providing for an effective date."
MOVED SB 112 OUT OF COMMITTEE
PRESENTATION BY THE DEPARTMENTS OF HEALTH AND SOCIAL SERVICES AND
ENVIRONMENTAL CONSERVATION ON FISH SAFETY MONITORING
PREVIOUS SENATE COMMITTEE ACTION
SB 96 - No previous action.
SB 112 - No previous action.
WITNESS REGISTER
Commissioner Karen Perdue
Department of Health and Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Discussed Alaska fish safety monitoring.
Dr. John Middaugh
Chief, Epidemiology Section
Department of Health and Social Services
PO Box 240249
Anchorage, AK 99524-0249
POSITION STATEMENT: Discussed Alaska fish safety monitoring..
Ms. Barbara Belknap
Alaska Seafood Marketing Institute
311 N Franklin, Suite 200
Juneau, AK 99801-1147
POSITION STATEMENT: Discussed Alaska fish safety monitoring.
Ms. Janice Adair
Division of Environmental Health
Department of Environmental Conservation
555 Cordova St.
Anchorage, AK 99501
POSITION STATEMENT: Discussed Alaska fish safety monitoring.
Deputy Commissioner Russ Webb
Department of Health and Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Testified in favor of SB 96.
Mr. Randall Burns
Director, Alaska Psychiatric Institute
Department of Health and Social Services
2900 Providence Ave.
Anchorage, AK 99508-4677
POSITION STATEMENT: Presented SB 96.
Mr. Scot Wheat
PO Box 2553
Homer, AK 99603
POSITION STATEMENT: Testified in favor of SB 96.
Mr. Hans Neidig
Staff to Senator Green
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Presented SB 112.
ACTION NARRATIVE
TAPE 01-16, SIDE A
Number 001
CHAIRWOMAN LYDA GREEN called the Senate Health, Education & Social
Services Committee meeting to order at 1:39 p.m. Present were
Senators Leman, Ward, Davis and Green. Chairwoman Green asked
representatives from the Department of Health and Social Services
(DHSS) and the Department of Environmental Conservation (DEC) to
give their presentation.
FISH SAFETY MONITORING
COMMISSIONER KAREN PERDUE, DHSS, stated that Chairwoman Green
offered DHSS briefing time to update the committee on a health
issue that has arisen regarding the safety of consuming Alaska
fish. She made the following comments.
A lot of information is becoming available in the media and in
scientific discussions about persistent organic pollutants, known
as POPs. POPs are chemicals that are usually not used in the
United States anymore, such as DDT, chlordane and PCBs. POPs
travel long distances through transboundary transmission, for the
most part by airways, and settle out in cold climates. POPs
persist in the Arctic environment more easily than in other places.
POPs biomagnify in the food chain so accumulation in lipids and of
heavy metals in the organs in marine mammals is of concern. Low
levels of POPs can cause adverse effects. High accumulation levels
could potentially affect reproductive, immunological and
neurological systems, and cause developmental problems and cancer.
COMMISSIONER PERDUE said fish in Alaska are extremely healthy and
are an extremely important part of people's diets. Alaska seafood
has a very high nutritional value so the risk of eating Alaska
seafood is totally outweighed by the benefits. DHSS has been
involved in discussions with the Arctic Council and other countries
and some international work has been done on a global treaty to
eliminate or reduce POPs.
COMMISSIONER PERDUE informed the committee that several months ago
the U.S. Food and Drug Administration (FDA) and the U.S.
Environmental Protection Agency (EPA) issued an advisory about
consuming fish, including Alaska fish, that alluded to the fact
that Alaska fish had higher levels of mercury than was safe. DHSS
and DEC are quite concerned that the public will get the wrong
impression, given all of the media attention, that Alaska fish is
unsafe to eat. She asked Dr. Middaugh to provide specific
information about the FDA and EPA advisories.
DR. JOHN MIDDAUGH, Chief of the Section of Epidemiology, DHSS,
informed the committee that both he and Ms. Adair of DEC were quite
surprised to learn that the FDA and EPA issued a national press
release for a joint advisory, the FDA for commercial fish and the
EPA for non-commercial fish, in which they specifically targeted a
message at pregnant women, women of childbearing age who may become
pregnant, nursing mothers and young children to not eat any shark,
swordfish, king mackerel or tilefish. Those species of seafood are
known to have very high average levels of methyl mercury in the
flesh. The message also warned that group to limit their
consumption of other fish to 12 ounces per week of cooked fish.
The EPA, which has jurisdiction over recreational, subsistence and
sports fish, issued a joint release saying that group should limit
its consumption caught by family and friends to one meal per week.
He and Ms. Adair then heard that both agencies have planned, over
the next year, a massive national campaign to educate the American
people about the dangers of exposure to methyl mercury.
DR. MIDDAUGH explained that the FDA assumed the average level of
methyl mercury, the heavy metal of concern, in fish is 0.2 to 0.5
ppm. When he and Ms. Adair challenged that assumption, the FDA
said it held months of meetings with focus groups comprised of
industry and stakeholders but, in viewing the list of participants,
all were from locations east of the Mississippi River. The FDA
forgot about Alaska when issuing the advisory and agreed it had
made a mistake. He and Ms. Adair were able to provide data on
Alaska fish and the FDA agreed fish from Alaska waters are among
the most pristine in the world. Some of the FDA's own data showed
that Alaska salmon had levels of methyl mercury from zero to 0.06
ppm, about 10 times lower than the average level of fish upon which
the advisory was issued. According to DHSS's calculations, using
the most conservative method, a person could safely eat 1.9 pounds
of Alaska salmon per week for a lifetime using the EPA's standards.
Using the FDA's and World Health Organization's (WHO's) standards,
a person could safely consume 9 pounds of Alaska salmon per week
for a lifetime.
As a result, EPA has agreed to add to its national advisory the
following two sentences.
Some kinds of fish that are known to have much lower than
average levels of methyl mercury can be safely eaten more
frequently and in larger amounts. Contact your federal,
state or local health or food safety authority for
specific consumption recommendations about fish caught or
sold in your local area.
DR. MIDDAUGH discussed some data collected by DHSS that shows
methyl mercury exposure levels in humans collected from hair
samples in four countries. In the United States the average level
is 2.0 ppm. The worst mercury poisoning episode occurred in
Minimata, Japan, where the levels were 100 ppm. Two ongoing
studies are underway in the Seychelles and Faroe Islands to
determine a safe level of exposure to methyl mercury related to
potential adverse effects on the development of the brain of
fetuses, who are born and followed for seven years. The mean level
in maternal hair samples in the Seychelles is 6.8 ppm and in the
Faroe Islands, 4.8 ppm. In both locations, most children are doing
very well regarding neuro-developmental parameters, but some
abnormalities have been found in the Faroe Islands. The WHO
advisory maximum tolerable level is set at 6.0 ppm.
DR. MIDDAUGH provided data from five studies done from 1972 to
1991, on human hair mercury concentrations in Alaska. The 1990 and
1991 study of Nome women showed a mean level of 1.0 to 1.4 ppm.
That is very good news because all of those women were eating
subsistence foods.
DR. MIDDAUGH discussed statistics from several studies: an FDA
study in December of 2000 on mercury levels in commercial seafood
species; a study done by the FDA on mercury concentrations in the
top 10 types of fish consumed by the U.S. population; a study done
on mercury in Alaska by the University of Alaska in 2000; and a
study done by the DEC lab in 1999 on methyl mercury levels in fish
tissue from samples taken around Alaska. All studies concluded
that the levels in Alaska salmon are very low. He noted that the
DEC study determined some areas of concern, for example levels in
cod from Cook Inlet were of concern, as were levels in very large
halibut in Frederick Sound.
DR. MIDDAUGH said Alaska must have an the ability to monitor these
levels on an ongoing basis to fend off the EPA and FDA and also to
answer concerns of American consumers with confidence. He asked
the committee to consider the request for funds for both DEC and
DHSS to continue monitoring so that they can provide scientific
evidence to respond to national advisories.
Number 1095
SENATOR WARD said he heard from a fisherman in Nikiski that farmed
salmon from Chile contains a lot of antibiotics. He asked if that
is true. He noted that when he was in Palm Springs, California, he
learned that no restaurant sells Alaska salmon, even though the
salmon on every menu is marketed as such. He also asked if any of
the studies show what is in farmed salmon.
COMMISSIONER PERDUE deferred to Barbara Belknap of the Alaska
Seafood Marketing Institute (ASMI).
Number 1197
MS. BARBARA BELKNAP, Director of ASMI, explained that farmed salmon
contains antibiotics, but much less so than the amount ten years
ago. Because of the density in the pens, the potential for disease
in farmed salmon is tremendous. If one fish becomes diseased, all
do. Farmed salmon are treated to prevent diseases, in particular
infectious salmon anemia. That disease is present in some wild
salmon but, because wild salmon are not in high densities, it does
not cause any harm.
SENATOR WARD noted the market for organically grown chicken has
grown to 18 percent because consumers have become aware of the feed
supplements used by large commercial operations. He asked if there
are any requirements in federal or state laws for disclosure of
feed supplements used in farmed salmon.
MS. BELKNAP said there are none.
SENATOR WARD asked if farmed salmon are measured for methyl mercury
levels.
MS. BELKNAP said they are not. She noted that she does not know
that farmed salmon would have a particular problem with mercury but
they do have antibiotics in them. Farmed salmon are fed other fish.
The interesting fact is that they are the only predator grown for
food. Farmed salmon operators were looking at feeding farmed
salmon the same sort of feed that is fed to cattle but with the mad
cow disease scare, the operators are still feeding farmed salmon
with pellets made from other fish caught off of the coast of South
America.
SENATOR WARD said he spent an entire day, when in Palm Springs,
trying to find a restaurant that served Alaska salmon. Four of the
restaurants billed their meals as "the Alaskan plate" but the fish
was not from Alaska. At the time he was unaware of the antibiotic
and mercury problems in fish but since, he learned some of those
fish are being fed byproducts of the livestock industry. He asked
if Alaska has to identify what is being fed to farmed salmon.
MS. BELKNAP said salmon are farmed in Canada, the United States,
Chile, Norway, Ireland and Scotland. It is a huge business. At
present, nothing requires the labelling of the ingredients in the
salmon. They are labelled Atlantic salmon, for example, in the
grocer's case, but nothing is available to tell you what it was
fed. Farmed salmon has no natural coloring because it does not
feed on the types of ocean feed that give salmon its color so a
coloring agent is used.
SENATOR WARD commented that the federal government is about to
caution the world about eating fish that is caught in the wild but
it is completely silent about what is fed to farmed salmon.
MS. BELKNAP said this is déjà vu because, first of all, Alaska had
the problem of people believing that all salmon are endangered
because Pacific Northwest salmon are endangered. Now, the FDA and
EPA have made a blanket announcement about fish. ASMI is trying to
differentiate Alaska's fish. ASMI believes that its partnership
with DHSS and DEC is a great way to bring the marketers into this
equation so that Alaska can bring its knowledge to the foreign
market, where food safety is a huge issue, and to work with DEC and
DHSS to market Alaska fish as safe. ASMI has just added the word
"safe" to its ads. It also uses the words "pristine environment,
pure, natural" and it wants to be able to show the world that is
true.
SENATOR WARD said his concern is in the labeling as other foods in
grocery stores contain a label if they are grown organically.
CHAIRWOMAN GREEN asked that Senator Ward and Ms. Belknap discuss
this problem and report back to the committee. She noted that when
Commissioner Perdue brought this information to her attention, the
Commissioner was very troubled by what Alaska had run into.
Chairwoman Green said she was extraordinarily pleased that the
state agencies took quick, direct action and got the language in
the message softened. Chairwoman Green said she believes the state
needs to go further and asked if the EPA and FDA were asked to
specifically mention Alaska fish.
MS. JANICE ADAIR, Director of the Division of Environmental Health,
DEC, said she and Dr. Middaugh had that discussion with the FDA.
They talked not only about specific states, but also about specific
species of fish. The FDA was not inclined to do that because it
felt that questions would arise about specific information from
everywhere.
CHAIRWOMAN GREEN noted that brings into question the accuracy of
their advisory. She said the committee was trying to figure out
what direction, on a practical level, it could take to underscore
the work done by the state agencies. She expressed concern about
the alarm the advisory could cause and that people who saw it might
never eat fish again. She offered to entertain any suggestions.
COMMISSIONER PERDUE felt it was gratuitous that they were able to
get the wording changed. She said they have been concerned about
making a very big issue about this because the more it is talked
about, if information is inaccurate, the more it gets into the
psyche of people. She said she honestly believes that Alaska based
data needs to be collected on both humans and fish.
CHAIRWOMAN GREEN said this issue should be brought to the Alaska
congressional delegation. She noted that Gavel to Gavel was
invited today because she wanted to minimize the alarm and let
people know that state agencies can be contacted for information,
but Gavel to Gavel did not come.
Number 1754
SENATOR LEMAN asked if different fish processing methods, such as
smoking fish, has any impact on contamination levels.
CHAIRWOMAN GREEN asked that a representative from DEC get back to
the committee with that information. She then thanked the
participants for their presentation and announced that SB 96 was up
for consideration.
SB 96-C.O.P.S FOR API DEMOLITION/CONSTRUCTION
DEPUTY COMMISSIONER RUSS WEBB, DHSS, introduced Randall Burns,
Director of the Alaska Psychiatric Institute (API), and informed
the committee that SB 96 will make a capital investment needed to
replace an old facility and provide an efficient place to perform a
core function of government far into the future.
MR. RANDALL BURNS, API, said he asked the committee for the
opportunity to make the case for passage of SB 96, the Governor's
bill regarding certificates of participation to finance the API
2000 project. He is also here to represent the staff and managers
of the hospital and, most importantly, the API patients. The
existing API facility does not meet current therapeutic environment
standards for patient care, which impacts the care that is
provided. From his perspective, that is the most important issue
behind SB 96. However, from a practical standpoint, the facility
needs to be replaced.
API has reached the end of its useful life. The facility contains
sprayed-on asbestos material, which is falling off. In addition,
asbestos-based adhesive was used on tile in the building. The
fire-life-safety and mechanical support systems are worn out and
expensive to maintain. The roof repair will cost in excess of $.5
million. The sprinkler system piping is not seismically braced so
that its fire suppression equipment is vulnerable if an earthquake
were to occur.
API was not designed as a psychiatric hospital. In 1962, it was
paid for by the federal government as a facility that could be
converted into a medical/surgical hospital within 24 hours to treat
military casualties in case of war. The lifespan of most major
facilities is 40 years. Because it is a hospital, it is open 365
days per year, 24 hours per day. The state has recognized, since
1988, that API needs to be replaced. A study was done to determine
whether it made sense to renovate the existing facility; the answer
was no.
The decision to replace API was first supported by the legislature
in the early 1990s when it appropriated $6.1 million over a 3-year
period for design work. After about five years, API went to bid on
a hospital but came up short of funds with which to build because
the facility had been designed and redesigned. The only reason
DHSS did not go forward at that time was the lack of funds. Once
those bids were withdrawn, DHSS embarked on some additional
planning processes: building a replacement API; purchasing a new
facility; or partnering with Providence Hospital to build a joint
facility. The plan to partner with Providence Hospital relied upon
a land swap between the University of Alaska and the Alaska Mental
Health Trust Authority (AMHTA). That was too complex to be
accomplished so Providence withdrew from that consideration in
1998. DHSS then looked at purchasing a replacement hospital and
put out a response for bids, which Charter Hospital responded to.
API spent two years trying to purchase Charter Hospital, but strong
local opposition to planning and zoning considerations made that
option impossible.
DHSS decided that it needs to build the facility that it planned to
build sometime ago. The AMHTA recently announced it will convey
the 80 acre parcel on which API is located to DHSS. This 80 acre
parcel was granted to AMHTA in the land settlement in 1993.
Number 2300
SENATOR WILKEN asked where the University of Alaska is in relation
to the 80 acre parcel.
MR. BURNS said it is across the street to the north. He said the
parcel is already zoned appropriately for a hospital. API has been
located in the area and other hospitals grew up around it, so API
would not be moving into a new neighborhood. API is a teaching
hospital so it will remain convenient to the University and other
hospitals. API is a specialty hospital so being close to
medical/surgical hospitals will allow API patients to get medical
care quickly, when necessary. The University Community Council and
residents are very supportive of the location and the Anchorage
Planning and Zoning Commission recommended that API remain at its
present site.
MR. BURNS said DHSS cannot build a replacement hospital without
additional funding. SB 96 will provide the financing to demolish
the old facility and build a new one. DHSS would build a 54 bed,
expandable to 72 bed, hospital, giving the state the flexibility
necessary to serve the inpatient psychiatric needs that are not met
by local communities. A portion of the old building would be
reused as storage space and a gym. The existing facility is
considered to be a hazardous waste site; SB 96 will cover the cost
of cleaning that parcel.
SENATOR WILKEN asked why it is considered to be a hazardous waste
site.
MR. BURNS said it is because of the asbestos only. The asbestos is
friable and has fallen off of all of the beams and is sitting
throughout the structure. SB 96 will approve $58,750,000 for the
construction. DHSS has $22.2 million, made up of $19.2 million
from the original API 2000 project and $3 million from the AMHTA
for demolition work. The remaining $36.5 million would be raised
through certificates of participation in a lease purchase
agreement.
TAPE 01-16, SIDE B
MR. BURNS said the state's obligation would be $3.7 million per
year for 15 years, after which the state would own the building.
The total cost of constructing a new building will be $48.2
million, demolishment costs will be $9.7 million, phasing will cost
$.5 million and financing will cost $250,000. He discussed the cost
per bed comparison with three other hospitals in Alaska.
SENATOR WARD asked how the API per bed cost compares to the per bed
cost of Providence Hospital's new addition.
MR. BURNS said he did not know the answer to that but DHSS might
have that information.
SENATOR WARD asked if anything would stop DHSS from requesting
proposals for design, build, and operation of this facility.
MR. BURNS said he believes that would require some statutory
changes and would get back to Senator Ward with an answer.
COMMISSIONER PERDUE reminded the committee that API is the only
state psychiatric hospital and she believes no state has privatized
its entire state psychiatric services. DHSS has outsourced some
work to private hospitals in Anchorage and Fairbanks.
SENATOR WARD said he appreciates that, however there are companies
with the ability to operate a facility with fewer than 60 beds. He
pointed out he was contacted as Co-Chair of the Privatization
Commission by some of these companies.
Number 2171
MR. BURNS said replacing API is one aspect of an ongoing three-
pronged effort between DHSS, the AMHTA and the Mental Health Board.
The second prong is to privatize a variety of treatment
alternatives to hospitalization at API. Statutorily, DHSS is
mandated to work on making sure that patients are treated in the
least restrictive environment and as close to home as possible.
DHSS provides services locally, instead of through API, whenever
possible. The third prong is quality of care. API recently scored
98 out of 100 by the Joint Commission in December of last year.
MR. BURNS explained that in Anchorage, API will be using a single
point of entry service, the idea being that any law enforcement
official or family member will know where to bring a person who is
experiencing a mental health crisis. When the person is admitted,
the staff will determine what type of services to refer that person
for. In many parts of the state, inpatient services are
nonexistent. API is the safety net when other services are not
available. In addition, API houses forensic patients and patients
who are not guilty by reason of insanity and it provides competency
evaluations to the courts.
MR. BURNS explained that the new facility will be constructed to
hold 72 beds because until communities have a full range of
services necessary, API will not be able to function at 54 beds.
The current patient capacity fluctuates. API must admit patients
who need services, no matter what other service providers will not.
Number 1955
SENATOR WILKEN asked why they are not planning a facility with more
than 54 beds.
MR. BURNS said in 1994, after three years of planning, DHSS sought
funding from the legislature to plan for a 114 bed, $65 million
facility. DHSS was appropriated $22.8 million and told to build a
72 bed facility. Therefore, DHSS has been working within that
guideline and a 54 bed facility is the long term goal of the mental
health system. The goal is to offer enough services in communities
so that API will be more of a tertiary care facility.
SENATOR WILKEN expressed concern that if the legislature approves
this plan, DHSS will be back before the legislature, just about the
time API opens its doors, asking for another building unless there
is some way to restrain the growth.
MR. BURNS said, regarding the single point of entry, Providence
Hospital is in the business of receiving people who are
experiencing a mental health crisis in Anchorage; 68 percent of
patients are from the Anchorage area. They are referred for other
services from there so, on its face, that will stop some of those
people from coming to API. An important part of this plan is
designated evaluation and treatment, which will reduce API's intake
considerably. He believes that over time, the plan that is being
implemented should result in a reduction in the bed need at API.
SENATOR WILKEN asked if this plan was designed in the early 1990s.
MR. BURNS said the plan was finalized in 1996.
SENATOR WILKEN asked if any redesign of the plan was considered,
given fiscal constraints.
MR. BURNS said it was discussed but the issue is the $19.2 million
in the bank right now. DHSS has worked hard to maintain those
funds and it would be costly to do another redesign.
CHAIRWOMAN GREEN thought DHSS has been constrained by the framework
placed on it by the legislature.
SENATOR WILKEN repeated that it seems strange to build a four-lane
highway that will be full when the ribbon is cut.
MR. BURNS said that is why it will be expandable to 72 beds.
SENATOR WILKEN noted that 72 beds will not be sufficient.
MR. BURNS repeated that DHSS hopes other programs will be on line.
The crisis treatment capacity has been expanded in Anchorage as
well as the de-tox capacity. The hope is that more people can be
kept out of the hospital by referring them to other services.
SENATOR WARD asked if a wing for youth has been incorporated into
the new design for API
MR. BURNS said currently API has 12 beds, the new facility will
have nine.
Number 1723
SENATOR WARD asked if the Alaska Native Hospital is charged when
IHS-eligible patients stay at API.
MR. BURNS said 28 percent of API's residents are Alaska Native and
the cost of their treatment is primarily borne by the state and
with federal Medicaid funds.
SENATOR WARD asked what that percentage is.
MR. BURNS explained that API gets a form of Medicaid named
Disproportionate Share Hospital (DSH) because many of its patients
are indigent. Those funds used to comprise 46 percent of API's
budget. This is the first year the federal government, in the 1997
Budget Reconciliation Act, cut DSH funds to public hospitals
beginning in the federal fiscal year 01. Over three years, those
funds will have been cut by 66 percent.
Number 1648
SENATOR LEMAN said he would like a reconfirmation that the new
facility is not too elaborate for the state's revised vision for
institutional treatment. He also asked whether all options for the
existing building have been explored, such as University ownership.
MR. BURNS said at one point, the University considered using the
facility as a repository for books and storage. The engineers felt
the building wouldn't bear the weight so the University withdrew
its consideration. API is using that facility because it is
grandfathered into it; he does not believe any other public entity
could move into that facility without a substantial clean up of the
asbestos.
SENATOR LEMAN asked if that clean up could cost as much as the
demolition.
MR. BURNS said that is correct. He noted that regarding the
appropriateness of the design to the state's vision, DHSS spent
four years discussing the appropriateness of the design. The
building will be a single story, which is controversial, but it was
designed that way for patient care issues. It is very attractive
and will be very functional.
SENATOR WILKEN expressed concern that DHSS is taking an old effort,
and given some fiscal constraints, and saying that effort will be
adequate for the next 50 years. He asked if it is time to look at
alternatives and, if more money is needed, come up with a proposal
that will not require a revision in five years. He noted the next
committee of referral will be the place to talk about the financial
aspect of this plan.
COMMISSIONER PERDUE said, regarding the question of whether the
facility is large enough, the 1990 census at API was 200 patients.
Psychotropic drugs and other community services have really driven
that number down. DHSS feels confident that it can work with the
bed capacity in the new plan as long as it remains flexible up to
72. Regarding the design, Commissioner Perdue said the facility
will be 98,000 square feet. It has been controversial because it
takes up the entire site. If DHSS could get the assurance that it
will have the money to build, it may be able to take an objective
look at whether it can be built cheaper if redesigned. DHSS does
not want to continue to use the seed money it has for another
redesign. DHSS could look at partnering, if the building is
designed as a multi-story facility.
Number 1366
SENATOR WARD said that he sat in on some of the citizens committee
meetings and pointed out that one of the reasons for designing the
building with a single story is that it provides the best
therapeutic atmosphere for patients.
CHAIRWOMAN GREEN announced the committee would take teleconference
testimony.
MR.SCOTT WHEAT, informed the committee that he has served on the
API governing body for a number of years. Over 10 years of
following this issue, the certificate of participation idea is the
best he has heard for funding. Providing a single point of entry
will allow people to get the proper support they need. The
question of moving the hospital has caused a lot of anxiety among
patients, families and staff. He noted the quality of care and
operations of the hospital are very good. The use of a single
story with a courtyard will provide the most attractive environment
for patient care.
DEPUTY COMMISSIONER WEBB said this is a long standing problem that
needs a solution.
There being no further questions or testimony on the bill,
CHAIRWOMAN GREEN announced she would set the bill aside for now and
the committee would take up SB 112.
SB 112-LONG-TERM CARE OMBUDSMAN;MENTAL HLTH AUTH
MR. HANS NEIDIG, staff to Senator Lyda Green, explained that SB 112
would place the employees of the AMHTA in the exempt service while
establishing a minimum salary for the long term care ombudsman.
Currently, The executive director position is partially exempt, the
financial officer is fully exempt, and four other employees are
partially exempt. SB 112 would make all partially exempt positions
fully exempt. SB 112 was introduced at the request of the AMHTA to
address concerns about its ability to run efficiently as a state
corporation. In addition, this legislation establishes a minimum
salary for the long term care ombudsman at a range 21. That
position is currently a range 20.
MR. JEFF JESSE, Executive Director of the AMHTA, stated the bill
contains two parts. The first part pertains to the exempt status
of the current AMHTA employees. The AMHTA outfit is small; it
needs to be able to retain the employees who are doing a good job.
On the other hand, it cannot afford to hold on to people who are
not able to meet its level of fiduciary responsibility so it needs
more flexibility to manage. He looked at other state corporations
with a similar structure and their employees are in the exempt
service. Regarding the long term care ombudsman, the Governor, via
an executive order, transferred the responsibility for
administering the office of the long term care ombudsman to AMHTA.
The trustees were willing to take on that responsibility on the
condition that they could look at how the office was functioning.
The ombudsman was paid at a range 20, which is a lower to mid-level
manager range, yet this person is responsible for wielding the
power of subpoena over confidential records and to bring lawsuits
if necessary. AMHTA wants some flexibility to look for the
qualifications needed to make that office successful so it
suggested a minimum salary of a range 21. Any additional costs
will be absorbed by reorganizing AMHTA's existing budget.
There being no further questions or testimony, SENATOR WARD moved
SB 112 out of committee with individual recommendations and its
zero fiscal note. There being no objection, the motion carried.
SENATOR WILKEN asked Mr. Jesse to what extent he has been involved
in the API facility.
MR. JESSE said probably more than he could have ever imagined.
CHAIRWOMAN GREEN informed the committee that she will be looking at
all proposals for exit exam legislation over the weekend and will
draft a bill to work from. She asked committee members to let her
know of any ideas or new thoughts on the issue.
Number 636
SENATOR LEMAN said he took the ideas in the memo he sent to
Chairwoman Green and had it drafted into a bill.
SENATOR WILKEN noted that the school organizations have visited the
Capitol and are all over the map on the issue but all agree that
Chairwoman Green has done a good job on this issue.
SENATOR WARD noted, for the record, that Lisa Caress has been on
line to testify on SB 112, if necessary, and that her letter is in
committee members' file. He thanked her for her efforts on this
issue.
CHAIRWOMAN GREEN then adjourned the meeting at 3:05 p.m.
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