HB 71 - ADVANCE HEALTH CARE DIRECTIVES REGISTRY  3:31:36 PM CHAIR RAMRAS announced that the final order of business would be HOUSE BILL NO. 71, "An Act relating to a registry for advance health care directives." [Before the committee was CSHB 71(HSS); adopted as a work draft on 2/24/10 was the proposed committee substitute (CS) for HB 71, Version 26-LS0289\T, Kurtz/Bannister, 1/21/10.] CHAIR RAMRAS stated that public testimony on HB 71 was closed, and indicated that he had concerns about the bill's fiscal impact. REPRESENTATIVE HOLMES, speaking as one of the bill's joint prime sponsors, explained that under Version T, the Department of Health and Social Services (DHSS) would be allowed to charge people for filing their advance health care directives with the proposed registry. She indicated that the DHSS's fiscal note in members' packets doesn't reflect that authorization. 3:32:32 PM JAMES WALDO, Staff, Representative Lindsey Holmes, Alaska State Legislature, on behalf of Representative Holmes, one of the bill's joint prime sponsors, added that that authorizing language can be found in proposed AS 13.52.310(h), which begins on page 3, line 3, and which in part reads: "(h) The department may charge a fee to file a directive in the registry or provide a copy of a directive filed in the registry under this section ...". 3:33:05 PM CHAIR RAMRAS made a motion to adopt Amendment 1, to replace the word "may", on page 3, line 3, with the word "shall". REPRESENTATIVE GRUENBERG objected. CHAIR RAMRAS, observing that the fiscal note reflects an annual cost of $111,400 to fund a Public Health Specialist II position, expressed disfavor with that cost, and indicated that merely giving the DHSS the flexibility to charge a fee but not mandating that it do so was not acceptable to him. REPRESENTATIVE HOLMES expressed a preference for leaving the language as is, adding that she would prefer for the DHSS to retain the discretion to charge a fee, particularly given that the proposed registry's costs are going to be reduced over time. CHAIR RAMRAS offered his understanding, however, that the personal services costs wouldn't ever be eliminated. He offered his belief that although the proposed registry could be helpful, the information that would be included in the registry is already available elsewhere. REPRESENTATIVE GRUENBERG pointed out that testimony at the bill's last hearing indicated that a number of people would have trouble affording a registry fee, and surmised that adoption of Amendment 1 could "chill" the ability of people to use the proposed registry, and that that could prove more costly in the end. He expressed a preference for instead simply encouraging as many people as possible to make use of the proposed registry. CHAIR RAMRAS pointed out that adoption of Amendment 1 wouldn't preclude anyone from using the proposed registry, and likened having to pay a fee for using the registry to having to pay a licensing fee in order to go fishing, for example. REPRESENTATIVE GRUENBERG argued, however, that people over a certain age don't have to pay a fee for a fishing license, and asked Chair Ramras whether he would be amenable to amending Amendment 1 [such that persons over a certain age wouldn't have to pay a fee for using the proposed registry]. CHAIR RAMRAS indicated that he would not be amenable to such a change. A roll call vote was taken. Representatives Dahlstrom, Herron, and Ramras voted in favor of Amendment 1. Representatives Holmes, Lynn, and Gruenberg voted against it. Therefore, Amendment 1 failed by a vote of 3-3. 3:37:14 PM REPRESENTATIVE GRUENBERG moved to report the proposed committee substitute (CS) for HB 71, Version 26-LS0289\T, Kurtz/Bannister, 1/21/10, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 71(JUD) was reported from the House Judiciary Standing Committee.