ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 18, 2008
3:08 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Bob Roses, Vice Chair
Representative Wes Keller
Representative Paul Seaton
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Anna Fairclough
OTHER MEMBERS PRESENT
Representative Jay Ramras
COMMITTEE CALENDAR
HOUSE BILL NO. 420
"An Act relating to the Uniform Anatomical Gift Act, to
anatomical gifts, to donations to the anatomical gift awareness
fund, to a registry of anatomical gifts, and to organizations
that handle the procurement, distribution, or storage of all or
a part of an individual's body."
- MOVED HB 420 OUT OF COMMITTEE
HOUSE BILL NO. 234
"An Act relating to the education loan repayment program and
establishing the education loan repayment fund."
- HEARD AND HELD
HOUSE BILL NO. 306
"An Act relating to providing a pre-elementary program within a
school district; and providing for the certification of early
childhood education plans."
- SCHEDULED BUT NOT HEARD
HOUSE BILL NO. 358
"An Act relating to continuing the public education of a
homeless student, to the purpose of certain laws as they relate
to children, to the determination of costs of maintenance of
certain children in foster care, and to the salaries and
benefits of certain social workers employed by the state; and
providing for an effective date."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 420
SHORT TITLE: ANATOMICAL GIFTS
SPONSOR(s): HEALTH, EDUCATION & SOCIAL SERVICES
03/13/08 (H) READ THE FIRST TIME - REFERRALS
03/13/08 (H) HES, JUD
03/18/08 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 234
SHORT TITLE: EDUCATION LOAN REPAYMENT PROGRAM
SPONSOR(s): REPRESENTATIVE(s) JOHNSON
04/13/07 (H) READ THE FIRST TIME - REFERRALS
04/13/07 (H) HES, FIN
05/01/07 (H) HES AT 3:00 PM CAPITOL 106
05/01/07 (H) Heard & Held
05/01/07 (H) MINUTE(HES)
01/24/08 (H) HES AT 3:00 PM CAPITOL 106
01/24/08 (H) Heard & Held
01/24/08 (H) MINUTE(HES)
03/18/08 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REBECCA ROONEY, Staff
to Representative Peggy Wilson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Introduced HB 420 on behalf of the House
Health, Education and Social Services Standing Committee,
sponsor by request, which is chaired by Representative Wilson.
DEBORAH BEHR, Chief Assistant Attorney General
Legislation & Regulations Section
Civil Division
Department of Law
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
420.
JAY BUTLER, M.D.
Chief Medical Officer
Office of the Commissioner
Department of Health & Social Services
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
420.
BRUCE ZALNERAITIS, Chief Executive Officer
Life Alaska Donor Services (LADS)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 420.
SHERRY BADILLO, Donor Mother
Palmer, Alaska
POSITION STATEMENT: Testified in support of HB 420.
KIM MCGEE, Organ Recipient
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 420.
JEANNE OSTNES, Staff
to Representative Craig Johnson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the committee substitute (CS) for
HB 234, on behalf of Representative Johnson, sponsor.
BRYNN KEITH, Research & Analysis
Division of Administrative Services
Department of Labor & Workforce Development
POSITION STATEMENT: Answered questions during the hearing on HB
234.
DIANE BARRANS, Executive Director
Postsecondary Education Commission
Department of Education and Early Development
Juneau, Alaska
POSITION STATEMENT: Testified during the hearing on HB 234.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:08:02 PM.
Representatives Wilson, Gardner, Roses, Keller, and Cissna were
present at the call to order. Representatives Seaton arrived as
the meeting was in progress. Representative Ramras was also
present.
HB 420-ANATOMICAL GIFTS
3:08:49 PM
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 420, "An Act relating to the Uniform Anatomical
Gift Act, to anatomical gifts, to donations to the anatomical
gift awareness fund, to a registry of anatomical gifts, and to
organizations that handle the procurement, distribution, or
storage of all or a part of an individual's body."
3:10:04 PM
REBECCA ROONEY, staff to Representative Peggy Wilson, Alaska
State Legislature, provided a sectional review, on behalf of the
sponsor, paraphrasing from a prepared statement, which read as
follows [original punctuation provided]:
Although 24 pages in length, HB 420 is basically a
cleanup bill that updates Alaska statutes regarding
organ donation.
There is a piece of model legislation called the
Uniform Anatomical Gift Act that serves to harmonize
organ and tissue donation laws in all 50 states and
the federal government. The UAGA has been doing this
for over 40 years.
Alaskan statues regarding organ donation are already
based on the UAGA, but they are modeled after the last
significant update, which was in 1987. HB 420 brings
Alaskan statutes in line with the most recent version,
the 2008 Revised UAGA.
The Department of Law, the Department of Health and
Social Services, the State Medical Examiners Office,
Life Alaska Donor Services, and representatives of the
National Conference of Commissioners on Uniform State
Laws were involved in the development of the bill
language to ensure a sound piece of legislation and so
far everyone has been happy with the results.
Madam Chair, at this very moment, an estimated 180
Alaskans are in need of a life-saving transplant and
waiting for a donated organ to become available.
Hundreds more are waiting for tissue transplants.
Because the bill is basically a realignment of
statutes with the 2008 Uniform Anatomical Gift Act
language, I won't go through all the recommended
changes. You have a sectional in front of you that
attempts to explain them.
3:12:32 PM
MS. ROONEY then offered a panel of expert witnesses to answer
questions.
The committee took an at-ease from 3:12:57 PM to 3:15:04 PM.
3:15:06 PM
REPRESENTATIVE ROSES asked for clarification of the refusal
language on page 6, beginning at line 18, of the bill.
3:15:38 PM
DEBORAH BEHR, Chief Assistant Attorney General, Legislation &
Regulations Section, Civil Division, Department of Law,
explained that a donation of an anatomical gift is a totally
voluntary act and the refusal provision allows an individual to
set out in a document one's decision to not donate an anatomical
gift of their body.
3:16:31 PM
REPRESENTATIVE ROSES asked whether the bill creates a situation
wherein the only way to prevent an anatomical gift is to make
the provision to refuse.
3:16:53 PM
MS. BEHR explained that most provisions in Alaska are made by
the approval on one's driver's license. However, in the case of
an untimely death of a person who has not indicated a decision,
the family is left to decide. In fact, other provisions of HB
420 address that situation.
3:18:07 PM
CHAIR WILSON asked Ms. Behr to elaborate.
3:18:15 PM
MS. BEHR further explained that making a gift while you are
still alive can be done by the driver's license. For someone
dying in a hospital, instructions can be given to the doctors
and nurses.
3:18:51 PM
REPRESENTATIVE GARDNER asked whether the current language in the
bill differs in any way from the Uniform Anatomical Gift Act
(UAGA).
3:19:15 PM
MS. BEHR responded that this bill contains some minor changes to
deal with the operation of the medical examiner's office in
Alaska.
3:20:09 PM
REPRESENTATIVE GARDNER surmised that in all other respects this
bill would ensure that Alaska is in conformity.
MS. BEHR said yes. She added that, in a crisis situation, it is
important that the doctors and emergency medical technicians
(EMTs) know the law. Further, other states can be involved and
the uniformity of the law is critical.
3:20:48 PM
JAY BUTLER, M.D., Chief Medical Officer, Office of the
Commissioner, Department of Health & Social Services, stated
that the bill institutionalizes procedures that the state
medical examiner has been practicing in conjunction with the
donor agencies.
3:21:14 PM
REPRESENTATIVE GARDNER expressed her interest in the material
differences in the law that have to do with the individual's
choices and family involvement.
3:21:41 PM
REPRESENTATIVE CISSNA asked whether the language in the bill
would still allow Alaskans the freedom to express their wishes
appropriately.
3:23:05 PM
MS. BEHR opined that the advantages of the UAGA is that it
strengthens individual decision making by clearly stating what
an individual's wishes are about giving an anatomical gift. If
one's wishes have not been expressed, this bill incorporates a
provision to direct how that situation would be addressed. For
example, the majority opinion of children would prevail in a
decision regarding a parent. Ms. Behr continued to explain that
the statute recognizes the validity of donor registries, state
issued identification cards, and electronic transmissions for
the expression of will. She concluded that the improvements in
this bill are endorsed by over twenty states and many medical
associations.
3:25:28 PM
REPRESENTATIVE GARDNER asked whether there was access to the
donor registry in the instance of a lost or misplaced
identification card.
MS. BEHR indicated yes. In fact, the registry is available to
EMTs in an emergency situation.
3:26:12 PM
REPRESENTATIVE ROSES called the committee's attention to page
14, line 10, of the bill and read:
A hospital in this state shall enter into agreements
or affiliations with procurement organizations for
coordination of procurement and use of anatomical
gifts.
REPRESENTATIVE ROSES then asked whether this was a new or an
existing provision.
3:26:59 PM
BRUCE ZALNERAITIS, Chief Executive Officer, Life Alaska Donor
Services (LADS), stated that for the last 15 years, Life Alaska
Donor Services (LADS) has had signed agreements with all of
Alaska's hospitals to allow for the process of donation and the
recovery of organs and tissues for transplantation, research,
and education. Mr. Zalneraitis paraphrased from a prepared
statement, which read as follows [original punctuation
provided]:
We, at Life Alaska Donor Services, would like to
express our strong support for [HB 420, the companion
bill to] SB 181, The Revised Uniform Anatomical Gift
Act that will better facilitate the donation process
in Alaska.
There are close to 100,000 people waiting for an organ
transplant in the U.S. and around 180 patients waiting
in Alaska. Eighteen people in the U.S. die each day
while waiting for an organ transplant. It is
important to simplify and clarify the process of
becoming an organ and tissue donor.
[HB 420, the companion bill to] SB 181 will update
Alaska's UAGA [Uniform Anatomical Gift Act] to the
2006 version from the 1987 version and will remove
obstacles to organ and tissue donation by clarifying
language on who can grant consent to organ donation.
It also recognizes the benefits of donor registries.
Alaska's first-person consent donor registry is now
over 330,000 citizens and continues to grow at 800
people per week, mostly through DMV sign-ups. The
revised UAGA version also prioritizes donation for
transplantation over research.
[HB 420, the companion bill to ] SB 181 also further
improves the relationship between the donation
organizations and the medical examiner's office. The
medical examiner plays a key role in the donation
process as most organ and tissue donations involve
sudden, unexpected deaths which fall under the
jurisdiction of the medical examiner.
3:29:26 PM
SHERRY BADILLO, donor mother, related the loss of her 17 year-
old daughter due to a car accident. Her daughter had a signed
donor card and became a skin, tissue, ligament, and bone donor,
whose gift benefitted 48 people across the nation, from age 6 to
65 years of age. As a donor mother, she believes that her
daughter's legacy lives on, and knowing this has helped her to
cope with the loss of her daughter. Ms. Badillo urged everyone
to carry a donor card and to make their wishes known. Recently,
her father became a donor, in memory of his granddaughter, and
lives on as well.
3:32:35 PM
CHAIR WILSON thanked Ms. Badillo for her testimony.
3:32:41 PM
REPRESENTATIVE ROSES praised Ms. Badillo for her positive
influence on others.
3:33:02 PM
MS. BADILLO stressed the importance of the mission of Life
Alaska Donor Services.
3:33:20 PM
CHAIR WILSON observed that it is great to know how many have
benefited from the gift.
MS. BADILLO advised that, because of the Health Insurance
Portability and Accountability Act (HIPAA), it is now up to the
recipient to contact the donor or sponsor family after the
receipt of an anatomical gift.
3:34:43 PM
KIM MCGEE, organ recipient, informed the committee that she is
a two organ recipient and received a pancreas and a kidney
transplant 20 months ago. She expressed her gratitude for the
law and stated that recipients are aware of, and grateful for,
the decisions made by donors and donor families. She shared her
experience as a diabetic in poor health for 38 years prior to
her transplant. Ms. Mcgee stated that her life completely
changed when she received the transplant, and she stressed the
importance of registering as organ donors. In response to a
question, Ms. Mcgee said that she takes good care of her health
and protects her new organs.
3:39:00 PM
CHAIR WILSON closed public testimony.
3:39:21 PM
CHAIR WILSON said that the testimony from a donor parent and a
recipient was meaningful.
3:39:44 PM
REPRESENTATIVE GARDNER asked whether there are transplant
facilities in Alaska.
3:39:59 PM
DR. BUTLER indicated not; however, there are procedures
addressed in the bill that can be performed in the state.
3:40:23 PM
REPRESENTATIVE GARDNER moved to report HB 420 out of committee
with individual recommendations and the accompanying fiscal
notes.
There being no objection, HB 420 was reported out of the House
Health, Education and Social Services Standing Committee with
individual recommendations and the accompanying zero fiscal
note.
HB 234-EDUCATION LOAN REPAYMENT PROGRAM
3:41:16 PM
CHAIR WILSON announced that the next order of business would be
HOUSE BILL NO. 234, "An Act relating to the education loan
repayment program and establishing the education loan repayment
fund."
3:41:30 PM
REPRESENTATIVE ROSES moved CSHB 234, Version 25-LS0772\K, Cook,
3/5/08, as a working document. [There being no objection,
Version K was before the committee.]
3:41:54 PM
JEANNE OSTNES, staff to Representative Craig Johnson, Alaska
State Legislature, explained that many of the questions
regarding the original version of the bill were administrative
in nature. In addition, the committee requested amendments to
the bill that address "regional severe shortages." She shared
that the Department of Labor & Workforce Development (DLWD)
advised that it could not administer a regional aspect of the
bill, although there is public support for a regional aspect.
Furthermore, the Department of Health Social Services (DHSS)
recommended that, instead of specifying a "shortage", a
"turnover" or "vacancy" rate for each duty station would be more
appropriate. Ms. Ostnes also stated that the Department of
Administration's (DOA) Workgroup report regarding recruitment
and retention disclosed that the removal of specific degree
requirements or replacing a specific general degree with field
specific credits was directed by Administrative Order #237.
3:45:18 PM
MS. OSTNES continued to explain that the sponsor's intent, that
the bill would apply to a student who came to Alaska to work in
a job identified with a severe shortage status, is not possible
to legislate at this point. The DLWD is interested in finding a
better way to identify how critical vacancies and shortages
would be listed, perhaps on a regional basis, but the statute
cited by the bill is not applicable at this time. She
acknowledged that there are anecdotal reports of labor shortages
and offered further testimony by a statistician from the DLWD.
3:47:25 PM
REPRESENTATIVE ROSES confirmed that the bill creates a situation
whereby the DLWD can not determine who qualifies for the loan
program.
MS. OSTNES concurred. She added that the statute has never been
used and the research and analysis to generate the needed list
is not available.
3:48:35 PM
REPRESENTATIVE ROSES pointed out that the critical need in the
field of education has been identified by individual school
districts on a year-to-year basis; in fact, retired teachers
have been re-hired by this procedure.
MS. OSTNES opined that the DLWD web site has two job posting
systems; however, private employers do not have the capability
to cite specific areas of need.
3:50:33 PM
CHAIR WILSON invited testimony by the representative from the
DLWD.
3:51:15 PM
BRYNN KEITH, Research & Analysis, Division of Administrative
Services, assumed that the lists the committee was familiar with
are those that reflect the professions that the DLWD predicts
will be in demand. In order to determine severe shortage
occupations, both supply and demand would need to be calculated
and the supply component is unknown.
3:52:01 PM
CHAIR WILSON suggested that the DLWD should determine how many
workers are produced in Alaska.
MS. KEITH provided examples of the complexity of the statistics
and the dynamics of Alaska's population. In response to a
comment, Ms. Keith noted that the seasonal nature of the state's
economy, the military, and other factors, contribute to the
complexity.
3:53:17 PM
REPRESENTATIVE CISSNA recalled visiting approximately 50
clinics, many that have vacancies for positions that are funded.
She asked whether the state could work to create a supply of
workers.
MS. KEITH said, "We could get close to it." However, it would
not be a definitive figure. She re-stated that there is no
definitive measure to determine a shortage. A national
unemployment rate by occupation and a vacancy survey are
possible; nevertheless, a vacancy may not indicate a shortage
of supply, as there are variables that create vacancies. Ms.
Keith acknowledged the availability of anecdotal information; in
fact, assessing shortages is a corroboration of anecdotal
information. However, it is possible for the DLWD to look at
high demand occupations and study the impediments to filling
those vacancies.
3:56:44 PM
CHAIR WILSON predicted continued vacancies as the pay scale in
the Lower 48 states rises to meet the pay scale in Alaska.
3:57:32 PM
MS. KEITH advised that a recession in the Lower 48 states would
increase the supply of workers to Alaska.
3:57:53 PM
REPRESENTATIVE GARDNER observed that shortages may go unfilled
for a variety of reasons.
3:58:30 PM
REPRESENTATIVE CISSNA opined that the state endures changing
conditions and the proposal in the bill would provide some
certainty for solving this problem. She suggested funding a
vacancy survey that would provide specific information and
identify regional trends.
4:00:18 PM
MS. KEITH agreed that a vacancy survey provides a source of
information; however, a survey would be very costly due to the
seasonal nature of the Alaskan economy. Ms. Keith expressed her
concern, based on the experience of other states, that three
years of quarterly surveys may not provide adequate data.
4:01:28 PM
REPRESENTATIVE CISSNA made a further suggestion on how a survey
might be conducted.
4:02:36 PM
MS. KEITH agreed that a collection of anecdotal information
would be less expensive, but cautioned against making informed
policy decisions based on anecdotal information.
4:03:07 PM
CHAIR WILSON observed that the teacher placement group has
complete information on teacher shortages.
4:03:32 PM
REPRESENTATIVE ROSES conveyed that the educational area is more
predictable due to school enrollments and trends. He pointed
out that the private sector, for example, the construction
field, is far more variable and dependent on economic factors.
4:04:48 PM
REPRESENTATIVE CISSNA drew a comparison to state funding for the
field of health.
4:05:55 PM
REPRESENTATIVE ROSES asked how the Postsecondary Education
Commission would implement the bill in its present from.
4:06:26 PM
DIANE BARRANS, Executive Director, Postsecondary Education
Commission, Department of Education and Early Development,
opined that to administer the bill her department would
concentrate on the areas of the bill that are clearly defined.
She listed the areas of shortage that are readily identified by
a variety of sources. Her concern, as the program
administrator, is the question of fairness between careers that
require specific levels of higher education.
4:07:50 PM
REPRESENTATIVE ROSES referred to the testimony given during the
hearing on a student grant bill and compared how the two bills
approach the issue of attracting and retaining a workforce for
Alaska. He requested further clarification prior to moving this
bill.
4:09:05 PM
CHAIR WILSON stated that she intends to hold the bill.
4:09:16 PM
MS. OSTNES stated that the sponsor is aware of the need for this
bill to be held.
4:10:00 PM
REPRESENTATIVE GARDNER stated that this bill creates a reward
for behavior that has already happened. She opined that, to
fill anticipated future needs in the state, the legislature
should provide incentives to high school graduates that
encourage them in a certain direction. Representative Gardner
then referred to page 3, line 1, of the bill, and read:
In awarding education loan repayment benefits, the
commission shall give priority to an eligible
individual who was awarded a benefit for a prior year.
REPRESENTATIVE GARDNER questioned why an additional benefit
would be paid to one individual for two years.
4:11:19 PM
MS. OSTNES explained that, once the program is enacted, a
beneficiary would have the expectation that up to 50 percent of
their total loan would be repaid.
4:11:58 PM
REPRESENTATIVE GARDNER clarified that this program is for an
individual that is working, has been out of school for a year,
and acquired the student loans without the expectation of
repayment.
4:12:19 PM
CHAIR WILSON pointed out that there would be an expectation once
one is approved for the repayment.
4:12:33 PM
REPRESENTATIVE ROSES gave an example of a certified classroom
teacher who earns a special education credential and thereby
enters an occupation of severe shortage. He suggested that the
bill should not exclude a person in this situation.
4:13:50 PM
MS. BARRANS affirmed that, by regulation, HB 234 would allow
loan repayment for a person in this situation.
REPRESENTATIVE ROSES advised that the language of the bill
should clearly define its purpose.
4:14:52 PM
MS. OSTNES added that special education teachers are needed in
the state.
4:15:05 PM
[HB 234 was held in committee.]
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 4:15 p.m.