03/06/2006 01:30 PM Senate HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB109 | |
| SB8 | |
| SB184 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 109 | TELECONFERENCED | |
| *+ | SB 8 | TELECONFERENCED | |
| *+ | SB 184 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 6, 2006
1:34 p.m.
MEMBERS PRESENT
Senator Fred Dyson, Chair
Senator Gary Wilken, Vice Chair
Senator Lyda Green
Senator Kim Elton
Senator Donny Olson
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CS FOR HOUSE BILL NO. 109(FIN)
"An Act relating to establishing a screening, tracking, and
intervention program related to the hearing ability of newborns
and infants; providing an exemption to licensure as an
audiologist for certain persons performing hearing screening;
relating to insurance coverage for newborn and infant hearing
screening; and providing for an effective date."
MOVED CSHB 109(FIN) OUT OF COMMITTEE
SENATE BILL NO. 8
"An Act relating to a student loan repayment program for nurses,
and amending the duties of the Board of Nursing that relate to
this program; and providing for an effective date."
HEARD AND HELD
SPONSOR SUBSTITUTE FOR SENATE BILL NO. 184
"An Act relating to mental health patient rights and to a
hospital's duty to provide same sex staff for providing care to
a mental health patient."
HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 109
SHORT TITLE: SCREENING NEWBORN FOR HEARING/AUDIOLOGIST
SPONSOR(s): REPRESENTATIVE(s) RAMRAS
01/26/05 (H) READ THE FIRST TIME - REFERRALS
01/26/05 (H) L&C, HES, FIN
02/04/05 (H) L&C AT 3:15 PM CAPITOL 17
02/04/05 (H) Heard & Held
02/04/05 (H) MINUTE(L&C)
02/07/05 (H) L&C AT 3:15 PM CAPITOL 17
02/07/05 (H) Moved CSHB 109(L&C) Out of Committee
02/07/05 (H) MINUTE(L&C)
02/09/05 (H) L&C RPT CS(L&C) NT 5DP 1NR
02/09/05 (H) DP: LYNN, LEDOUX, GUTTENBERG, CRAWFORD,
ANDERSON;
02/09/05 (H) NR: ROKEBERG
02/17/05 (H) HES AT 3:00 PM CAPITOL 106
02/17/05 (H) Moved CSHB 109(L&C) Out of Committee
02/17/05 (H) MINUTE(HES)
02/18/05 (H) HES RPT CS(L&C) NT 5DP 2NR
02/18/05 (H) DP: CISSNA, ANDERSON, MCGUIRE, SEATON,
WILSON;
02/18/05 (H) NR: GARDNER, KOHRING
04/11/05 (H) FIN AT 1:30 PM HOUSE FINANCE 519
04/11/05 (H) Heard & Held
04/11/05 (H) MINUTE(FIN)
04/12/05 (H) FIN AT 1:30 PM HOUSE FINANCE 519
04/12/05 (H) Moved CSHB 109(FIN) Out of Committee
04/12/05 (H) MINUTE(FIN)
04/14/05 (H) FIN RPT CS(FIN) NT 5DP 4NR
04/14/05 (H) DP: STOLTZE, KELLY, FOSTER, MEYER,
CHENAULT;
04/14/05 (H) NR: HAWKER, HOLM, WEYHRAUCH, MOSES
04/21/05 (H) TRANSMITTED TO (S)
04/21/05 (H) VERSION: CSHB 109(FIN)
04/22/05 (S) READ THE FIRST TIME - REFERRALS
04/22/05 (S) HES, FIN
03/06/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 8
SHORT TITLE: NURSE EDUC LOAN REPAYMENT PROGRAM
SPONSOR(s): SENATOR(s) FRENCH
01/11/05 (S) PREFILE RELEASED 12/30/04
01/11/05 (S) READ THE FIRST TIME - REFERRALS
01/11/05 (S) HES, STA, FIN
03/06/06 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 184
SHORT TITLE: MENTAL HEALTH PATIENT RIGHTS:STAFF GENDER
SPONSOR(s): SENATOR(s) DAVIS
04/21/05 (S) READ THE FIRST TIME - REFERRALS
04/21/05 (S) HES, FIN
02/08/06 (S) SPONSOR SUBSTITUTE INTRODUCED-REFERRALS
02/08/06 (S) HES, L&C
03/06/06 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
Representative Jay Ramras
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of HB 109.
Jane Pierson, Legislative Aide
Staff to Representative Ramras
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Introduced HB 109.
Stephanie Burch, Section Chief
Women's, Children's, and Family Health
Division of Public Health
Department of Health & Social Services
PO Box 110601
Juneau, AK 99801-0601
POSITION STATEMENT: Provided information on HB 109.
Leena Ongley, Audiologist
Barrow, AK 99723
POSITION STATEMENT: Testified in support of HB 109.
Kerry Pippin, Speech Therapist
Fairbanks, AK 99701
POSITION STATEMENT: Testified in support of HB 109.
Pamela Mueller-Guy
Juneau, AK 99801
POSITION STATEMENT: Testified in support of HB 109.
Suzanne Rust
Anchorage, AK 99801
POSITION STATEMENT: Testified in support of HB 109.
Jodi Rumph
Juneau, AK 99801
POSITION STATEMENT: Testified in support of HB 109.
Lisa Owens
Anchorage, AK 99501
POSITION STATEMENT: Testified in support of HB 109.
Sandy Fricky, Nurse
Bartlett Regional Hospital
3260 Hospital Drive
Juneau, AK 99801
POSITION STATEMENT: Testified in support of HB 109.
Martin Beals, Chapter Champion
Alaska Chapter
American Academy of Pediatrics
Anchorage, AK 99507-6017
POSITION STATEMENT: Testified in support of HB 109.
Catherine Price-Carter, Nurse
Bartlett Regional Hospital
3260 Hospital Drive
Juneau, AK 99801
ACTION NARRATIVE: Testified in support of HB 109.
Mark Butler, Public Information Officer
Department of Health and Human Services
Municipality of Anchorage
825 L Street
Anchorage, AK 99501
POSITION STATEMENT: Testified in support of HB 109.
Marie Darlin, Coordinator
American Association of Retired Persons
Mountain View Senior Center
Juneau, AK 99801-1565
POSITION STATEMENT: Testified in support of SB 109.
Susan Walker
Anchorage, AK 99501
POSITION STATEMENT: Testified in support of HB 109.
Debbie Golden, Director
Program Services
March of Dimes
255 East Fireweed, Suite 102
Anchorage, AK 99503
POSITION STATEMENT: Testified in support of HB 109.
Senator Hollis French
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of SB 8.
Patricia Senner, Executive Director
Alaska Nurses Association
3701 E. Tudor Road, Suite 208
Anchorage, AK 99507
POSITION STATEMENT: Testified in support of SB 8.
Virginia Werthwein, Nurse
Homer, AK 99603
POSITION STATEMENT: Testified in support of SB 8.
Laura Wilkie, Nurse
Anchorage, AK 99501
POSITION STATEMENT: Testified in support of SB 8.
Senator Bettye Davis
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Sponsor of SB 184.
Richard Benavides, Legislative Aide
Staff to Senator Davis
Alaska State Capitol
Juneau, AK 99801-1182
POSITION STATEMENT: Introduced SB 184.
Andrea Schmook, Co-chair
Alaska Mental Health Board
431 N. Franklin Street, Suite 200
Juneau, AK 99801-1121
POSITION STATEMENT: Testified in support of SB 184.
Dorrance Collins, Mental Health Advocate
Anchorage, AK 99501
POSITION STATEMENT: Testified in support of SB 184.
Ron Adler, CEO
Alaska Psychiatric Institute (API)
2900 Providence Drive
Anchorage, AK 99508-4677
POSITION STATEMENT: Testified in opposition to SB 184.
CHAIR FRED DYSON called the Senate Health, Education and Social
Services Standing Committee meeting to order at 1:34:47 PM.
Present were Senators Donny Olson, Kim Elton, Lyda Green, Gary
Wilken and Chair Fred Dyson.
CSHB 109(FIN)-SCREENING NEWBORN FOR HEARING/AUDIOLOGIST
1:35:29 PM
CHAIR DYSON announced CSHB 109(FIN) to be up for consideration.
REPRESENTATIVE JAY RAMRAS, sponsor of HB 109, informed the
committee that every year 30 to 40 children are born with
congenital hearing impairment in Alaska. The impairments are
often not detected until the affected children are two to three
years old and have experienced significant delays in cognitive
and speech development as a result of the condition. While the
cost of administering a hearing exam at birth is almost
negligible, the state's education system incurs great expenses
while accommodating a student with a speech or cognitive
deficiency.
1:40:14 PM
JANE PIERSON, staff to Representative Jay Ramras, offered to
answer questions.
SENATOR LYDA GREEN remarked that the hearing test is only a
small part of the bill and asked the reason for requiring the
state to assume the responsibility of defining, tracking, and
treating cases of hearing impairment.
MS. PIERSON responded that the bill would create a standardized
procedure to track the progress of a child diagnosed with a
hearing impairment and it would direct the parents to resources
available within their community.
SENATOR GREEN asked whether participation in the program would
be terminated once the child reaches three years of age.
MS. PIERSON replied yes. She added that many parents of
children with hearing impairments do not have a system to guide
them through the various treatment programs that are available.
SENATOR GREEN expressed concern that the bill would give the
state far too much oversight over what should be a family
decision.
MS. PIERSON responded that the bill allows families to exit the
program at any time.
SENATOR GARY WILKEN asked how the legislation would enhance the
state's existing response to the problem.
MS. PIERSON replied it would establish a standardized program to
track the progress of children with hearing impairments. It
would also establish a procedure to direct the parents of a
hearing impaired child to resources available within their
community.
1:44:37 PM
SENATOR WILKEN asked whether the bill would add another layer of
bureaucracy upon a network of programs that is already working
effectively.
MS. PIERSON answered it would only establish standardized
procedures for programs that already exist throughout the state.
1:46:06 PM
CHAIR DYSON asked the reason that the fiscal note is so low.
MS. PIERSON replied it was due to the fact that the actual
hearing test machinery was already in place throughout the
state.
CHAIR DYSON questioned whether implementing the standards in the
bill would only cost the state $64,000 as is stated in the
fiscal note.
MS. PIERSON responded that the amount is appropriate so long as
the state continues to receive the same amount of federal grant
funding to address the problem.
SENATOR GREEN asked whether the Department of Health and Social
Services (DHSS) could send brochures on hearing impairment to
the birthing centers and hospitals in the state.
1:49:45 PM
STEPHANIE BURCH, Section Chief, Women's, Children's, and Family
Health, Division of Public Health, (DHSS), replied that the
department currently distributes a series of brochures on
hearing impairment and screening to all the hospitals and
birthing centers throughout the state.
1:51:33 PM
CHAIR DYSON remarked that the director of the Division of Public
Health is in favor of extending the screening program to all
infants in the state. He asked how the screening of infants was
related to other screening tests performed on newborns.
1:53:49 PM
MS. BURCH replied that most newborns are screened for a hearing
impairment when they are given the newborn metabolic screening
test. She added that while the metabolic test is required by
statute, the hearing test is not, and some children born at home
or in hospitals with high staff turnover are missed. Her
organization would like to see statutory requirements for
hearing screening and tracking similar to those for the
metabolic test.
CHAIR DYSON asked whether the bill would simply add one more
condition to an existing screening and tracking program.
MS. BURCH replied that is correct. She said that the purpose of
the legislation was to help affected families enroll hearing
impaired children in early intervention programs before they
enter the school system.
1:57:29 PM
CHAIR DYSON asked whether the passage of the bill would provide
additional remedial services to children with hearing
impairments.
MS. BURCH replied that the fiscal note provides for a possible
expansion of the services currently offered by hearing resource
consultants. Funding for the expansion would be allocated only
if the number of hearing impaired children in the state
increases.
SENATOR DONNY OLSON asked how rural hospitals have responded to
the proposed legislation.
MS. BURCH replied they have received an outstanding response
from the rural hospitals.
SENATOR OLSON asked whether there were penalties for not
complying with the mandate.
MS. PIERSON replied no.
2:00:37 PM
CHAIR DYSON asked what would happen to medical providers that
don't comply.
MS. BURCH replied that physicians and hospital managers
generally comply with recommendations from the American Academy
of Pediatrics and nearly 100 percent of physicians comply with
the program today.
SENATOR GREEN suggested that programs for diagnosis usually
generate pressure to establish programs for treatment. She
expressed concern that many communities would not be able to
provide services for hearing-impaired children and there would
almost certainly be requests for travel funding from affected
families. She asked the witness whether that was a pertinent
concern.
2:05:15 PM
MS. BURCH acknowledged Senator Green's concern and informed the
committee that there are several pediatric audiologists in the
Native health care system who travel to villages to perform
screening and follow up. She added that while some travel is
necessary within the program, her organization has been fairly
successful in keeping travel costs in line.
LEENA ONGLEY testified in support of HB 109. She emphasized that
early diagnosis of hearing impairment is crucial. While
statistical analysis predicts that there will be 30 children
born in Alaska with some degree of hearing impairment in a given
year, other children develop hearing impairment later in
childhood as a result of frequent ear infections. She said that
the screening of newborns provides audiologists with an
important baseline by which to diagnose the later form of
hearing impairment.
MS. ONGLEY added that in her experience, about half of the
children living in the villages of the North Slope have chronic
ear pathology accompanied by moderate hearing loss by the time
they turn one year old. Hearing loss is an oft-undiagnosed
cause of delayed language acquisition, which is a major problem
in North Slope school districts.
2:09:18 PM
KERRY PIPPIN, Speech Therapist, testified in support of HB 109.
She said the bill was important in that it would maintain the
priority of the program throughout the state. She said it is
particularly important for rural areas where the program is
often overlooked due to the high turnover rate among hospital
staff.
2:13:47 PM
PAMELA MUELLER-GUY, Anchorage, testified in support of HB 109.
SUZANNE RUST, Anchorage, testified in support of HB 109. She
said that her daughter benefited tremendously from early
treatment for hearing loss. She relayed her difficult
experience seeking appropriate treatment due to a lack of
information and remarked that the bill would do much to help
families in similar situations. She added that hearing
impairment is the most common birth defect in the United States
and many states have already implemented similar legislation.
2:21:43 PM
JODI RUMPH, Juneau, testified in support of HB 109. She said
that her son was born with a correctable hearing impairment that
was not detected for years because there were no hearing
machines available in the communities in which they lived. Her
son's first hearing test was inconclusive because the results
could not be compared to any baseline from previous tests and
his condition was not properly diagnosed until he started
showing significant delays in his speech development. She urged
the committee to pass HB 109 to prevent similar cases from
occurring.
2:23:56 PM
SENATOR GREEN asked the witness whether she believed that she
would have been covered under HB 109.
MS. RUMPH replied that it was her understanding that her son's
condition would have been diagnosed earlier if his baseline were
established at birth.
SENATOR GREEN said she understood the bill to be limited in
scope and suggested that it might not apply to home births.
MS. RUMPH responded the bill would standardize the requirements
for hearing screening. It would require public health nurses
who travel to small communities to test children in the
communities for hearing impairment. She expressed concerned
that the state's excellent hearing program may fall apart as the
equipment ages and rural hospital staff changes.
2:25:50 PM
SENATOR OLSON commended the witness on her testimony. He asked
how much a rural family not covered by Medicaid could expect to
spend while seeking therapy for a hearing impaired child.
MS. RUMPH replied such families incur enormous traveling
expenses while traveling to larger cities for testing and
therapy.
2:31:27 PM
LISA OWENS, Anchorage resident, testified in support of HB 109.
SANDY FRICKY, nurse, Bartlett Regional Hospital, testified in
support of HB 109. She said it was not difficult for the staff
at Bartlett Regional Hospital to incorporate hearing screening
into their standard metabolic tests.
2:34:28 PM
CHAIR DYSON asked Ms. Fricky whether HB 109 would change any of
the activities that she performs at the hospital.
MS. FRICKY replied no.
SENATOR ELTON asked whether the hospital performs hearing
screening for babies born at home.
MS. FRICKY replied that the hospital performs screening on
children born at home only if a home birth attendant requests
it.
MARTIN BEALS, Representative of the Alaskan Chapter of the
American Academy of Pediatrics (AAP), testified in support of HB
109. He emphasized that the screening is not a simple
positive/negative test and it often yields false-positive
results. Establishing standard procedures for follow up and
tracking would simplify the administration of the test and
increase the efficiency of the treatment of affected children.
2:39:25 PM
CATHERINE PRICE-CARTER, nurse, Bartlett Regional Hospital,
testified in support of HB 109. She said that the bill would
lend greater legitimacy to Bartlett's existing program.
MARK BUTLER, Public Information Officer, Department of Health
and Human Services, Municipality of Anchorage, testified in
support of HB 109.
MARIE DARLIN, AARP Coordinator, Capitol City Task Force,
testified in support of HB 109.
SUSAN WALKER, Anchorage resident, testified in support of HB
109.
2:44:42 PM
DEBBIE GOLDEN, Director, Program Services, March of Dimes,
Alaska Chapter, testified in support of HB 109.
2:48:24 PM
SENATOR OLSON asked Ms. Golden whether hearing tests performed
by nurses and audiologists yield different rates of false
positive results.
MS. GOLDEN replied no.
CHAIR DYSON recognized no further witnesses and closed public
testimony.
2:52:29 PM
SENATOR ELTON moved to report CSHB 109(FIN) from committee with
individual recommendations and attached fiscal notes. There
being no objection, it was so ordered.
SB 8-NURSE EDUC LOAN REPAYMENT PROGRAM
CHAIR DYSON announced SB 8 to be up for consideration.
2:53:32 PM
SENATOR HOLLIS FRENCH, sponsor of SB 8, said SB 8 was designed
to help stem the shortage of nurses in the State of Alaska by
establishing a tuition loan reimbursement program. Under the
program, nurses who work in the State of Alaska would receive
$2,000 per year from the state to devote towards their
outstanding student loans.
SENATOR FRENCH informed the committee that there was an
estimated shortage of 9,000 to 11,000 nurses in the state at the
present time. The Alaska Department of Commerce expects the
shortage to continue to grow until the year 2010. He remarked
that providing incentives for nurses to work in the state is
particularly important because there is a nationwide shortage.
CHAIR DYSON asked Senator French whether he had reviewed the
fiscal note for the bill.
SENATOR FRENCH replied that he had and added that it is a small
price to pay to have well-staffed hospitals and clinics
throughout Alaska. He added that it is possible to reduce the
size of the proposed program.
CHAIR DYSON asked whether the fiscal note was based on a worst-
case scenario.
SENATOR FRENCH deferred the question to the author of the fiscal
note. He added that he took issue with the assumption in the
fiscal note that the state would grow at the rate of three
percent a year since that was low in comparison to the
predictions of the Department of Commerce.
2:57:55 PM
SENATOR OLSON asked Senator French whether the state would incur
greater costs if it does not address the nursing shortage.
SENATOR FRENCH replied that he could not offer a numerical
comparison, but added that the state would incur significant
expenses related to travel and overtime if it does not address
the shortage.
SENATOR OLSON commented that Nome incurred significant expenses
when its hospital was shut down due to a nursing shortage and
had to Med-evac patients to Anchorage.
SENATOR WILKEN remarked that while he appreciated the intent of
the bill, he was wary of offering loan forgiveness programs due
to their tendency to create excessive expenses for the state. He
said the shortage could be addressed in more cost effective ways
such as offering low-interest housing.
3:02:00 PM
PATRICIA SENNER, Executive Director, Alaska Nurses Association,
testified in support of the bill. She said she believes that
the fiscal note is overstated because it is unlikely that 70
percent of the graduating nursing students would be in debt.
She remarked that the bill was not a mandate because it grants
awards based on the amount of money available from interest on
state student loans.
3:04:17 PM
CHAIR DYSON questioned whether a $2,000 per-year incentive would
effectively entice nurses to come to the state.
MS. SENNER replied that the bill would give the Nursing Board
some flexibility to focus the program's funds as an incentive to
place nurses in areas where they are under-represented.
3:07:02 PM
VIRGINIA WERTHWEIN, Nurse, testified in support of SB 8. She
said the hospital where she works often couldn't staff the ICU,
ER, or labor delivery unit when one of the nurses called in
sick. She said that the nursing workforce is aging and the
shortage will worsen if the state does not attract more young
nurses.
LAURA WILKE testified in support of SB 8. She remarked that
nursing journals regularly feature ads for recruitment that
offer far more than nurses are able to make in Alaska. She
remarked that although $2,000 per year seems insignificant,
passing the bill would send a message that the Legislature
appreciates the services that nurses are able to provide.
CHAIR DYSON held the bill in committee.
SB 184-MENTAL HEALTH PATIENT RIGHTS:STAFF GENDER
CHAIR DYSON announced SB 184 to be up for consideration.
3:14:00 PM
CHAIR DYSON clarified that the committee was using version F as
the working document.
RICHARD BENAVIDES, Staff to Senator Davis, described the changes
made within the sponsor substitute. He said the title was
changed from "Hospital's Duty to Provide Same Sex Staff" to
"Right to Choose the Sex of Hospital Staff Providing Intimate
Care."
Mr. Benavides added that the phrase "same sex staff" on line 6,
page 1 of SB 184 was changed to "right to select staff" in the
sponsor substitute. The sponsor substitute also includes a
provision on page 2 requiring documentation of any incident in
which a patient was assigned a care provider opposite of the sex
that was requested.
A provision was also added on line 19 of the sponsor substitute
that exempts a hospital from compliance with the bill if a
psychiatrist determines that compliance would adversely affect
the treatment of the patient. The psychiatrist would have to
document the decision. He advised the committee that there were
a few other minor things inadvertently removed from the original
bill that were included back into the sponsor substitute.
3:17:09 PM
ANDREA SCHMOOK, Co-chair, Alaska Mental Health Board, testified
in support SB 184. She said that an investigative report
conducted in the mid 1990s revealed that the condition of
several children seeking psychiatric treatment for sexual abuse
was made significantly worse after they were subjected to
restraint by medical staff of the opposite sex.
3:20:06 PM
DORRANCE COLLINS, Mental Health Advocate, testified in support
SB 184. He said that many of the major patient rights
organizations across the nation support similar legislation. He
remarked that the Disability Law Center has issued an opinion
saying that patients have a legal right to gender choice.
3:22:57 PM
RON ADLER, CEO, Alaska Psychiatric Institute (API), DHSS, stated
that the Department opposes SB 184. He said API believes that
such issues are best resolved in policy and procedure rather
than legislation.
He said that DHSS and the Department of Law (DOL) would not
support any legislation that mandates the inclusion of non-
medical information in a patient's medical record. He said that
such a requirement provides a clear pathway for potential
litigants to sue for non-adherence to a non-clinical issue.
SENATOR DAVIS asked the witness to give her a written statement
of his testimony.
CHAIR DYSON held the bill in committee.
There being no further business to come before the committee,
Chair Dyson adjourned the meeting at 3:25:03 PM.
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