SB 71: EMERGENCY MEDICAL SERVICES SYSTEM REP. TOOHEY asked if there were a committee substitute (CS) version of the bill, but then withdrew her question. Number 047 REP. TOOHEY asked which fiscal note the committee would use in considering the bill. She noted that various fiscal notes listed had put the cost of the bill at no money, at $40,000 and at $100,000. Number 054 MARK JOHNSON, CHIEF OF THE EMERGENCY MEDICAL SERVICES SECTION OF THE DIVISION OF PUBLIC HEALTH IN THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES, testified in Juneau on SB 71, saying his department supported the April 6, 1993, fiscal note and pointed out that the state Senate had passed the bill with a zero fiscal note. He said his division believed it needed money for the patient care information system, "which was changed from a shall to a may." He said the division would like money to pay the estimated cost for certification teams to visit Alaska hospitals to verify their qualifications as trauma centers. (Rep. Vezey arrived at approximately 3:11 p.m.) CHAIR BUNDE said there had been talk of removing the $40,000 from the grants line in the fiscal note and moving it to the general fund line. MR. JOHNSON said Ms. Kreitzer had made that suggestion. Number 081 ANNETTE KREITZER, LEGISLATIVE ASSISTANT TO SEN. LOREN LEMAN, PRIME SPONSOR OF SB 71, said Sen. Leman had recommended the change in funding in order to pay for the emergency room nurses who did the abstracting for the patient information system. She also recommended adding $100,000 in the grants line. She said that the sponsor would feel comfortable with amending the fiscal note in the House Finance Committee. Number 099 REP. G. DAVIS MOVED that CSSSSB 71 as amended be passed from committee with the HESS fiscal note. REP. KOTT OBJECTED and asked for an at-ease at 3:15 p.m. CHAIR BUNDE called an at-ease and returned the meeting to order two minutes later. Number 110 REP. KOTT distributed copies of a proposed amendment, which would have the effect of ensuring that the Alaska Council on Emergency Medical Services would have three consumer members, and that no more than one member would come from the same one of the four federal judicial districts, to ensure geographical distribution. REP. VEZEY pointed out that the judicial districts were archaic political boundaries and asked why the state would want to perpetuate the use of such obsolete and arbitrary boundaries. REP. KOTT said he was offering the amendment on behalf of the sponsor, and invited the sponsor's representative to address the question. MS. KREITZER said use of the judicial districts was a simple way to ensure representation from different areas of the state to address concerns by regional EMS offices that the council might over-represent Anchorage and under-represent Bush areas. Number 159 REP. VEZEY pointed out that the Second Judicial District included 12,000 people in Nome and Kotzebue, and asked why that district should be guaranteed a seat on a board representing half a million people. He said he did not like to perpetuate the use of obsolete political boundaries in state law, and said there were other ways to ensure geographical diversity. MS. KREITZER said the amendment resulted from requests from EMT organizations and regional Native corporations. She said Sen. Leman was responding to constituent concerns, and she believed the amendment would ensure effective representation from across the sate. MR. JOHNSON said he believed the judicial districts were used because similar language was in an emergency medical services law passed in 1977, and that the continued use of those boundaries reflected constituent concerns. REP. OLBERG said that regional representation was appropriate in many instances. Number 196 CHAIR BUNDE said the issue was not regional representation, but how such regions would be defined. REP. TOOHEY noted the requirements for the board's makeup; including two physicians with emergency room experience; one registered nurse; three members active in pre-emergency hospital emergency care, at least one of whom lived off the land or marine highway; one emergency medical service administrator; and one Native health care facility administrator. She said the makeup of the board already included sufficient opportunity for representation from non- urban areas. Number 216 REP. VEZEY noted that the existing statute once called for four of the board's members to each come from separate judicial districts, but that provision had been deleted. He repeated his opposition to using judicial districts for purposes of ensuring broad geographical distribution of council membership. REP. TOOHEY noted that the bill, starting at page 5, line 29, required the governor to consider geographical distribution in making appointments to the council. Number 235 MS. KREITZER repeated that regional EMS corporations still feared that a governor might not appoint members representing rural interests. She said broad representation had been important from the start. REP. VEZEY suggested looking at maps of the judicial districts. MS. KREITZER said that the wording of the amendment allowed lots of leeway for many services within those districts to have members on the board. She repeated that she believed judicial districts were a suitable way to accomplish the diversity. Number 265 REP. OLBERG noted that it was possible to interpret the bill such that the governor could appoint all members of the board from one area if he so desired, and that the amendment would prevent that from happening. CHAIR BUNDE suggested an amendment to include three consumer members to the board, one each from an area not connected by land or marine highway, an area not connected by land highway, and an area not connected by marine highway. However, he did not formally make such a motion and abandoned the attempt. REP. NICHOLIA voiced support for Rep. Olberg's comments. She said there were Alaska Native hospitals in Anchorage and Fairbanks, and the Bush areas needed ensured representation. She voiced support for the amendment. CHAIR BUNDE repeated that the issue was not regional representation, but how such regions would be defined. REP. VEZEY repeated his opposition to the amendment. CHAIR BUNDE called for a roll call vote on the amendment. Those voting yes were: Reps. G. Davis, Kott, Olberg, B. Davis, Nicholia, Toohey. Those voting no were: Reps. Vezey, Bunde. The motion PASSED 6-2. He announced that the committee was now considering the bill as amended. REP. TOOHEY asked whether, if CSSB 71 were passed, it would pass with a zero fiscal note. Number 328 CHAIR BUNDE answered that that would be up to the committee. REP. TOOHEY MOVED passage of the bill with a zero fiscal note. REP. B. DAVIS said there was already a motion on the floor. Number 328 CHAIR BUNDE said the motion on the floor included "a fiscal note with numbers on it," and that if Rep. Toohey wanted to pass the bill with a zero fiscal note, it would be necessary to vote down the current motion and then propose a different motion. Number 330 REP. G. DAVIS asked the routing of the bill. CHAIR BUNDE answered that once the bill left the HESS Committee it would move to the House Finance Committee. REP. G. DAVIS said, concerning the issue of fiscal notes for the bill, that the Finance Committee would protect the state's financial interest when the bill went to that committee. CHAIR BUNDE noted that the motion on the floor was to pass the bill with a fiscal note from the Department of Health and Social Services indicating a cost of $99,200 for FY94. He called for a roll call vote on the motion. Those voting yes were: Reps. Toohey, Bunde, G. Davis, Vezey, Kott, Olberg, B. Davis, Nicholia. Those voting no: None. The motion PASSED 8-0. Chair Bunde noted that the bill passed to the House Finance committee along with a letter of intent from the Senate. He then brought HB 85 to the table.