HB 292-ABORTION: INFORMED CONSENT; INFORMATION CHAIR WILSON announced that the final order of business would be HOUSE BILL NO. 292, "An Act relating to information and services available to pregnant women and other persons; and ensuring informed consent before an abortion may be performed, except in cases of medical emergency." Number 1389 REPRESENTATIVE NANCY DAHLSTROM, Alaska State Legislature, as sponsor of HB 292, answered questions from the committee. Number 1400 REPRESENTATIVE COGHILL moved to adopt the proposed committee substitute (CS) for HB 292, Version 23-LS0867\I, Lauterbach, 5/15/03, as a work draft. Hearing no objection, Version I was before the committee. CHAIR WILSON told the committee that there are two amendments that will be considered. Number 1445 REPRESENTATIVE SEATON moved to adopt Amendment 1. REPRESENTATIVE COGHILL objected for purposes of discussion. Number 1649 REX SHATTUCK, Staff to Representative Nancy Dahlstrom, Alaska State Legislature, explained changes to CSHB 292(HES), proposed amendments, and answered questions from the members. Amendment 1 read as follows: Page 4, line 28, following "woman": Insert "and the pregnant woman's estate, and only to the pregnant woman and the pregnant woman's estate," Following "damages": Insert "caused by the violation" MR. SHATTUCK told the committee that the language on page 4, line 28, is to ensure that a lawsuit could only be brought by the pregnant woman or her estate. On line 29, following the word "damages", the insertion of the words "caused by the violation" is speaking to a lawsuit that may be brought forward. Number 1649 REPRESENTATIVE COGHILL removed his objection. CHAIR WILSON announced that without objection Amendment 1 has been adopted by the House Health, Education and Social Services Standing Committee. Chair Wilson announced that the committee would now take up Amendment 2. Number 1584 REPRESENTATIVE COGHILL objected for the purpose of discussion. MR. SHATTUCK briefly reviewed Amendment 2, which read [original punctuation provided]: Page 1, line 13, After "on the Internet" insert the words that is reviewed and approved for medical  accuracy and appropriateness by recognized  Obstetric/Gynecological specialists designated by the  State Medical Board and Page 2, line 2, After "on the Internet" insert the words that is reviewed and approved for medical  accuracy and appropriateness by recognized  Obstetric/Gynecological specialists designated by the  State Medical Board Page 2, lines 7 through 9, Delete all material Page 2, line 22, After "and services;" insert and Page 2, 23, Create a new sub-section that shall read  {C} agencies, services, clinics and facilities  designed to assist or provide contraceptive options  and counseling to help prevent future unwanted  pregnancies; Page 2, line 30, After "abortions services;" insert and the circumstantial criteria for the  availability of medical assistance benefits for  contraception; Page 3, line 12, After "objective, nonjudgmental, and" insert that is reviewed and approved for medical  accuracy and appropriateness by recognized  Obstetric/Gynecological specialists designated by the  State Medical Board and Page 3, line 15, After "information that" insert is reviewed and approved for medical accuracy and  appropriateness by recognized Obstetric/Gynecological  specialists designated by the State medical Board and Page 3, line 20, After "unbiased information" insert that is reviewed and approved for medical  accuracy and appropriateness by recognized  Obstetric/Gynecological specialists designated by the  State Medical Board Page 3, line 24, Create a new sub-section that shall read (9) contains objective, unbiased and  comprehensive information that is reviewed and  approved for medical accuracy and appropriateness by  recognized Obstetric/Gynecological specialists  designated by the State Medical Board on different  types of available contraceptive choices and the  medical risk and possible complications commonly  associated with each method as well as the possible  psychological effects that have been associated with  using contraceptives;  Page 3, line 24, Delete (9) Insert (10) Page 4, line 30, After "AS 18.16.060(b)(1){C} insert and (D) Page 4, line 31, After "evidence that" delete the person gave to the woman a written And insert the woman received or reviewed a Page 5, line 1, After "AS 18.05.032" insert at least 24 hours Page 5, line 21, After "the abortion" insert , a member of the physician's staff who is a  licensed healthcare provider Page 5, line 21, After "physician has" delete orally  And insert verbally    Page 6, line 1, After "shall provide it;" insert the requirements of this subparagraph may be  satisfied by a member of the physician's staff who is  a licensed healthcare provider performing the required  activities if they offer the person the opportunity to  consult a physician; the requirements of this  paragraph may also be satisfied if the physician or a  member of the physician's staff receives from the  person an appropriately dated and signed from [sic] of  the type described in AS.18.05.032(a)(10) and retains  the form in the patient's file; Page 6, line 12, After "required in (b)(1)" insert {A}-{C} Page 6, line 15, After "ask questions." insert Provision of the information telephonically or by  electronic mail or regular mail at least 24 hours  prior to the person's appointment satisfies the  requirements of this section as long as the person  whose consent is required under (a) of this section  has an opportunity to ask questions after receiving  the information. MR. SHATTUCK told the committee that the change in language on page 1, line 13 is agreed upon language provided so that someone is designated as an appropriate medical person to review the material for accuracy and appropriateness. REPRESENTATIVE COGHILL commented that it appears that the entire first page of the amendment deals with conforming language to the Medical Board having purview on this information. He told the members that that had been his objection when the bill was heard the first time. He said he reviewed the statutes and found that this is an appropriate role for the state Medical Board; therefore, he will remove his objection to this portion of the amendment. MR. SHATTUCK agreed with Representative Coghill's statement that the first page is conforming language inserted all the way through the bill. MR. SHATTUCK referred the committee to the next change, beginning on page 3, line 24, which creates a new subsection. He said this change again uses the agreed upon language "medical accuracy and appropriateness by recognized Obstetric/Gynecological specialist", but in this case it is directed toward contraceptive use. On the same page and line there is a renumbering of the sub-sections to reflect the insertion of the new sub-section. On page 4, line 30, it inserts "and (D)", which includes an earlier section. He said, "Page 4, line 31, changes the language, so..." REPRESENTATIVE SEATON asked if the change on page 4, line 31, was made to allow for a woman to download the information off of the Internet. MR. SHATTUCK responded that is correct. MR. SHATTUCK said that on page 5, line [21], the agreed upon language was inserted after looking into the definition of a licensed healthcare provider. It does reach the threshold of ensuring that it is a licensed nurse, physician's assistant, or someone with a medical background. MR. SHATTUCK pointed out that on page 5, line 21, there is a change recommended by Legislative Legal and Research Services that deletes the word "orally" and inserts "verbally". MR. SHATTUCK said that on page 6, line 1, the amendment poorly reflects the transaction that should actually take place. He told the committee the inserted language is a rewording of that section. In response to a request for clarification from Representative Coghill, he explained that the change beginning on page 6, line 1, would read as follows: After the words "physician shall provide it;" delete the requirement of this subparagraph may also be  satisfied if a nurse who is a member of the  physician's staff informs the person of the  availability of the Internet information, distributes  a copy of the Internet information to the person, if  requested, and offers the person an opportunity to  consult with the physician and insert  the requirements of this subparagraph may be  satisfied by a member of the physician's staff who is  a licensed healthcare provider performing the required  activities if they offer the person the opportunity to  consult a physician; the requirements of this  paragraph may also be satisfied if the physician or a  member of the physician's staff receives from the  person an appropriately dated and signed from of the  type described in AS.18.05.032(a)(10) and retains the  form in the patient's file; MR. SHATTUCK responded to a question by Representative Coghill regarding the changes on page 6, by saying they relate to electronic communication. CHAIR WILSON commented that this language provides for patients to get information [ahead of their visit] by means of the Internet. [By doing this first, before traveling to see a doctor, the 24-hour period they currently have to wait would be met already]. Then patients could just go for a doctor's visit and leave. She said that she believes this change is a big improvement. REPRESENTATIVE COGHILL removed his objection to Amendment 2. Number 1889 CHAIR WILSON announced that, without objection, Amendment 2 has passed the House Health, Education and Social Services Standing Committee. Number 1908 REPRESENTATIVE COGHILL moved to report CSHB 292 [Version 23- LS0862\I, Lauterbach, 5/15/03, as amended] out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 292(HES) was reported out of the House Health, Education and Social Services Standing Committee.