HOUSE BILL NO. 361 "An Act requiring 911 dispatchers to be trained in cardiopulmonary resuscitation; and providing for an effective date." 10:20:06 AM Representative Fairclough informed the committee that Alaska was one of the few states that do not require Cardiopulmonary Resuscitation (CPR) training through statute for all 911 dispatchers. She believed the training should be required. She noted that the issue was complex. CRYSTAL KOENEMAN, STAFF, REPRESENTATIVE ANNA FAIRCLOUGH, SPONSOR, explained that HB 361 (version A) would request a 911 coordinator to monitor and facilitate the training of emergency dispatchers in CPR and require that dispatchers be trained in CPR. Alaska is one of 18 states that do not mandate the training. Ms. Koeneman reviewed background regarding the location of the 911 coordinator. In 2004, there was an omnibus bill stipulating that the coordinator be housed within the Department of Military and Veterans Affairs (DMVA) because federal grant money was anticipated that required a 911 coordinator within the state. There has been debate about whether DMVA or the Department of Public Safety (DPS) should house the position. Representative Fairclough added that the committee could choose under the proposed CS to include CPR training, which would put into state statute a standard already required through regulation in other forms of training throughout the state. She noted that DMVA had asked to move the coordinator position over to DPS and it was discovered that little had been done in coordinating, monitoring, and training dispatchers of emergency medical services throughout the state. The department provided a fiscal note. Ms. Koeneman interjected that there was no fiscal note for the new CS. The House Heath, Education, and Social Services Committee (HES) had adopted a blank CS that moved the position to DPS. Co-Chair Hawker queried the version of the bill being discussed. Ms. Koeneman replied that she was referring to Version R (blank CS) that was adopted in HES; that version did not move from committee because they were unable to get a fiscal note from the department even after the CS was adopted. The HES committee did not feel comfortable bringing the bill to the Finance Committee with an unknown fiscal note. Version A moved out of HES. Co-Chair Hawker summarized that the bill introduced to the committee was Version A; the differentiation was the housing location of the coordinator. He queried the language being proposed for amendment in the A version. The language was put into statute some years ago to establish the coordinator in DMVA. He asked whether there was a person filling the position at DMVA currently. MIKE O'HARE, DEPUTY DIRECTOR, DIVISION OF HOMELAND SECURITY/EMERGENCY MANAGEMENT, DEPARTMENT OF MILITARY AND VETERANS AFFAIRS (via teleconference), responded that there was not a person filling the position. He provided background. In 2004, a Senate bill was brought before the House Rules Committee that included the additional duties of the 911 coordinator to the DMVA Division of Homeland Security and Emergency Management in an effort to secure potential federal grant dollars for 911 enhancements. A prerequisite for receiving the grant funding was having a coordinator designation in place; the responsibilities were to coordinate 911 communications in communities around the state, set uniform standards for 911, look for federal grant monies for 911, and enhance capabilities. The position was an "other duties as assigned" position with no funding. The federal grants did not materialize. 10:27:45 AM Co-Chair Hawker summarized that the legislature had provided for the position in the 2004 legislation but had not funded the position with a fiscal note, and that the position has never been funded by the legislature; there was only the hope that federal grant money would be available. Mr. O'Hare agreed. Co-Chair Hawker summarized that the position existed, was not funded, and was not filled. He thought the next question proposed in the legislation was moving the coordinator to DPS and securing funding for it. The funding question in HES had resulted in reverting to the A version. He queried the perspective of DPS. SUE STANCLIFF, SPECIAL ASSISTANT, OFFICE OF THE COMMISSIONER, DEPARTMENT OF PUBLIC SAFETY, was uneasy about referring to a CS that had not yet been adopted by the Finance Committee. Co-Chair Hawker said she could answer the questions under the hypothetical that the position was moved from DMVA to DPS. Ms. Stancliff replied that DPS had worked with the bill sponsor and was willing to take the responsibility on. The department believed a real coordinator would be needed and had prepared a fiscal note to that effect. Co-Chair Hawker asked how much funding the agency would request. Ms. Stancliff replied that the fiscal note would require one full-time person to act as the 911 coordinator; the initial cost to set up the position for FY 11 would be $162,700; future years would require $151,000, which included the required CPA training. 10:31:45 AM Co-Chair Hawker asked whether the committee wanted more information about the coordinator position. Representative Kelly summarized that another state employee would be added at significant cost. He commented that most areas already had the certification and asked whether the issue was a local one. AUDIE HOLLOWAY, DIRECTOR, DIVISION OF ALASKA STATE TROOPERS, DEPARTMENT OF PUBLIC SAFETY, testified in support of the CPR qualifications, which the department thought were very important. He added that state troopers and about several thousand eighth-graders would be working with the American Heart Association to get more CPR training out to everyone. Mr. Holloway stated that the issue was the disparity between what is available in urban and rural areas. Currently, nearly any person with a cell phone or land line thinks they can call 911 and reach a live person; that is not the case in many Alaskan rural villages. He reported that the department had not been doing as much as they should with 911 because the coordinator position was expected to address the issue. Mr. Holloway informed the committee that the department had discovered that over 60 percent of business and 911 calls were made from cell phones. Most of the state trooper 911 centers are subcontracted through local agencies; they have a good working relationship that they want to maintain. Many of the 911 calls were going to many different places and not necessarily to a Public Safety Answering Point (PSAP) qualified to provide 911 services. Some of the calls were going to business offices within a village or city that could be closed, a village public safety officer's phone, or a recorder saying "call 911." He did not think the public was being served as well as it should be. 10:36:20 AM Mr. Holloway referenced changing technology and believed the department should be prepared to collect information from more than just a phone call. He thought the 911 coordinator position was needed to set up the policies, procedures, education, and training necessary to meet the public's expectation of what services should be available. For instance, the public should be able to send text messages and photographs and be able to use a cell phone to call 911 and get somewhere productive. Currently, there are places in the state where it is not clear where the 911 call would end up, causing delays while the call is moved to the appropriate place. Mr. Holloway hoped for collaboration with local personnel so that when they could not provide a response there would be an ultimate PSAP number that would be able to offer assistance. He also hoped to know more about developing technology and work with communication providers (such as the Alaska Telephone Association) interested in helping the state with the issue. Providers are mandated by law to send 911 calls to someplace where the calls will be answered; there currently is a lot of confusion about where to send the calls. Mr. Holloway stressed that the priority was that a person dialing 911 would get an answer from a person. 10:39:11 AM Co-Chair Hawker queried funding sources for the position. He asked whether there was a way to access 911 surcharges. Mr. Holloway believed that the state did not get the surcharges; local organizations did. Co-Chair Hawker thought something was missing regarding the funding source. Representative Fairclough supported the fiscal note. She noted that the 911 system needed structure and that the lack of structure was putting communities at risk. She pointed out that requiring CPR could be put on statute, and that communities need to develop procedures for local protocol standards. The CS could allow the state to work with individual communities to set up a 911 structure and standardize training. Representative Kelly acknowledged that the idea was good, but pointed out differences in services in different areas of the state. He referred to law enforcement positions that had already been approved and stated concerns about another state employee position. He did not want to promise 911 services immediately, though he wanted that to be a goal. He also wanted to know how to get a person trained in any given remote location and what could happen if there was not such a person. He was concerned about liability as well as increased costs. 10:43:26 AM Mr. Holloway responded that the state troopers were expected to respond as quickly as possible to the calls, wherever they originated. He thought the choices were continuing the current practice of letting the system grow organically and chaotically, or acquiring a coordinator to organize a set of rules to provide statewide standards for at least minimal response. He acknowledged that it could take time to answer calls from remote areas, but thought it would be faster than the current system. He believed the state did well getting assistance to people in emergency situations in difficult circumstances. He pointed out that there were over 700 search-and-rescue calls each year; the process could go faster with a more organized system. Representative Kelly acknowledged the work already being done. He was concerned about giving the state troopers another set of conditions and wondered whether the task was more appropriately left with individual communities. He reiterated concerns with the fiscal note and an added employee. Representative Salmon spoke to challenges in rural communities. He provided an example of a woman in a village whose life was saved by a person trained in CPR. He wanted the system related to CPR training and 911 capability to be developed further. He stated that he supported the legislation. 10:48:05 AM Vice-Chair Thomas stated that he represented what he called "urban villages," with troopers in Haines, Hoonah, Cordova, and Craig. He asked who the dispatcher was for the locations. Mr. Holloway responded that calls for Southeast usually went through Ketchikan and then local municipalities. Vice-Chair Thomas asked how the positions and training would be funded in the smaller locations. He wondered whether the burden would be placed back on the municipalities. Mr. Holloway replied that he shared the concerns. He pointed out that most communities require CPR and that the training could be done effectively online. He hoped that the proposed coordinator position would be able to access grant funds to train people around the state. He believed that the state should assist [financially] if it requires standards. He noted that funds are available. Vice-Chair Thomas pointed out that volunteer fire departments in many smaller communities offer CPR training. He noted that 911 calls do not always go through trooper dispatch. Mr. Holloway agreed; the state troopers are the recipient of other people's initial 911 calls through locals, subcontractors, fire departments, and other local entities. Vice-Chair Thomas noted that most commercial fishermen's calls go through the Coast Guard. Representative Austerman commented that he wanted a more in-depth discussion regarding the larger policy issue of a state-wide 911 system. 10:52:00 AM CHRIS SHERWIN, VICE-PRESIDENT OF ADVOCACY, PACIFIC MOUNTAIN AFFILIATE, AMERICAN HEART ASSOCIATION (via teleconference), testified in support of HB 361. He reported that the American Heart Association (AHA) was strongly supportive of efforts to improve the state's 911 system and of filling the 911 coordinator position. He agreed that there were a lot of issues to be worked out and felt that the coordinator could oversee the process and work with entities like the AHA. The association specifically supported putting a system in place that would assure that a caller could reach a person trained in CPR and able to walk the caller through until help arrived. Mr. Sherwin spoke to concerns and possible improvements for the legislation. The association would like the CPR training provided to be based on science and have a hands- on practice component. He pointed out differences between a person trained in giving CPR and a person trained in how to provide the instruction to someone else over the phone (pre-arrival instruction). A standard part of training for a certified emergency medical dispatcher usually includes how to provide pre-arrival training over the phone. A person who is only trained in giving CPR may not be able to provide the information over the phone. He referred to screen protocol that can help a person walk a caller through the process. 10:57:05 AM Co-Chair Hawker closed public testimony. Co-Chair Hawker noted that the bill before the committee was still the original HES version. HB 361 was HEARD and HELD in Committee for further consideration. 10:59:26 AM