HB 301-AUTOPSIES AND DEATH CERTIFICATES  3:04:56 PM CHAIR HIGGINS announced that the first order of business would be HOUSE BILL NO. 301, "An Act relating to duties and procedures of the state medical examiner and the Department of Health and Social Services; and relating to death certificates." REPRESENTATIVE KELLER moved to adopt the proposed committee substitute (CS) for HB 301, labeled 28-LS1196\P, Mischel, 2/27/14, as the working draft. There being no objection, it was so ordered. 3:05:43 PM LIZ CLEMENT, Staff, Representative Bob Herron, explained that the changes in Version P were mostly the result from questions raised by the committee and the Department of Health and Social Services. The first change was on page 2, line 3, paragraph (3), which removed from statute explicit reference for the state's responsibility to cover the cost of any embalming that transport carriers could require for the transport of human remains. She declared that this would allow the department to "stand strong with the families with which they work and find ways around the families being required to pay that additional cost" should the transport companies require embalming for transport. She directed attention to page 2, lines 28-29, a change of language to read "transportation to the community closest to where the death occurred or to another location," which now clarified both of these options in the written notice from DHSS to the family. She moved on to page 3, lines 2-3, which deleted the requirements for temperature controls, and limited the temperature control practice to those available for maintaining remains shipped by air. The requirement would no longer be in statute. She stated that Sections 3 and 4 from the original bill had been deleted, and that Sections 5 and 6 in the original bill were now renumbered as Sections 3 and 4. 3:11:24 PM RAEBELLE WHITCOMB, Director, Workforce Development Center, Bristol Bay Native Corporation, expressed her support for the proposed changes in Version P, and, regarding the requirement for embalming prior to transport, she declared that transportation carriers should not have the right of determination regarding the deceased over the rights of the family. She asked about the process for the issuance of the death certificate, asking for clarification that local health aides in a community could begin the process. She expressed appreciation for the proposed bill as it recognized "many factors that are a concern for both Bristol Bay Native Association and families." She pointed out that the costs associated with a death were still very high, and she noted that there were still concerns for funeral homes controlling the remains of the deceased until the family had the funds for release of the body. MARCIA DAVIS, General Council, Senior Vice President, Calista Corporation, echoed the sentiments of Ms. Whitcomb for the obligations of air transporters. She asked that it be clarified that, as the bodies were removed by the state, it was necessary for the bodies to be returned by the state, and it was incumbent for the state to deal with the air transporter. She expressed her confidence with the compassion of the Medical Examiner's office for not allowing a body to sit "in purgatory" while waiting for solutions. She stated the necessity for understanding that "the state takes the body, the state needs to return the body." Referring to the issuance of death certificates by local authorities, she reported that the system had worked well with birth certificates and that the systems were in place for death certificates. She noted that the Bureau of Vital Statistics was in support of the proposed program. REPRESENTATIVE SEATON, noting that the language on page 2, line 3 had been changing, asked that Ms. Davis contact the local air carriers to ensure they know that embalming was not required by law. MS. DAVIS said that this information would go out on the web pages, and that she would meet with the air carriers. 3:19:42 PM KERRE SHELTON, Director, Central Office, Division of Public Health, Department of Health and Social Services, pointed out that there was only one medical examiner in Alaska, located in Anchorage. As there were not enough cases for a second position, all bodies requiring an autopsy were transported to Anchorage, inspected, and then returned to the community. She stated that standard practice was for the return transport to any location the family requested, and that the family would pay any additional cost. She clarified that embalming was not required by law or by the air transfers, although there had been confusion regarding its requirement. She said that there was some temperature control for bodies, including freezing when necessary, although this was not done for all bodies. She shared that there had been discussions for a pilot project to study the feasibility of rural examinations via telemedicine, although there was still a lot of equipment, infrastructure, and training to be determined. She acknowledged the zero fiscal note for the proposed bill [Included in members' packets] and stated that the costs would be borne by the local jurisdictions. She explained that the electronic vital records system would soon distribute death certificates, which would greatly reduce the time delay for completion. 3:25:59 PM CHAIR HIGGINS closed public testimony. 3:26:20 PM The committee took a brief at-ease. 3:27:21 PM REPRESENTATIVE SEATON pointed to a large study by the United States military regarding suicides, as this was an issue in rural Alaska. He reported that a low Vitamin D level resulted in twice the at-risk for suicide. 3:29:01 PM CHAIR HIGGINS said that HB 301 would be held over.