1:06:17 PM SENATE JOINT RESOLUTION NO. 19 Relating to creating the Task Force to Assess Public Reporting of Health Care Associated Infections. This was the first hearing for this bill in the Senate Finance Committee. 1:06:23 PM SENATOR GARY STEVENS, sponsor of the resolution, explained it would create a task force to make recommendations on the establishment of a reporting system. Approximately two million infections are acquired each year in hospitals and an estimated 90,000 people die as a result of these infections. The cost to consumers is between $4.5 and $11 billion a year. This problem must be addressed. Senator Gary Stevens outlined the interim task force that would be appointed to review experience to date with public reporting of hospital-associated infections. The task force would also be charged with drafting legislation for consideration during the next legislative session. Additionally the task force would provide a timeline for implantation of the recommendations and establish a reporting system. 1:09:05 PM Co-Chair Green asked whether the January 31, 2007 termination date of the task force would be appropriate. 1:09:17 PM Senator Gary Stevens answered the time allowed would be sufficient, as the work could be completed in three meetings. Co-Chair Green asked the process to determine membership on the task force. Senator Gary Stevens affirmed that in conjunction with the Department of Health and Social Services, it was determined that the membership of the task force would be comprised of professionals and legislators. 1:09:55 PM Co-Chair Wilken, citing the language of lines 15 through 17 on page 2, asked why the resolution specifically prohibited the public members of the task force from receiving reimbursement for travel expenses. He understood the decision to not provide compensation, but suggested that travel costs be reimbursed. Senator Gary Stevens agreed this would be appropriate. The intention was to secure membership from those willing to participate at their own expense. Such reimbursement by the State would incur some cost, but he was willing to support the proposal. The task force members representing the Alaska Native Tribal Health Consortium (ANTHC), the Alaska Chapter of the Association of Professionals in Infection Control and Epidemiology and the Alaska State Hospital and Nursing Home Association (ASHNHA) could also represent "a consumer of health care who resides in rural Alaska" or "a consumer of health care who resides in urban Alaska". 1:11:08 PM Co-Chair Wilken acknowledged this, but surmised that volunteers willing to participate in holding the seats designated for a consumer of health care residing in rural Alaska and the consumer of health care who resides in urban Alaska should receive reimbursement for at least their travel and lodging expenses. Co-Chair Green pointed out that legislators and State employees holding positions in similar commissions do not receive special compensation. Travel and lodging is paid however. Senator Gary Stevens suggested that the meetings be held in Anchorage, where most members would reside. 1:12:19 PM Amendment #1: This conceptual amendment would provide State reimbursement of travel and other expenses for the seats designated for "a consumer of health care who resides in rural Alaska" and "a consumer of health care who resides in urban Alaska". Co-Chair Wilken moved for adoption. He noted those holding the remaining designated seats would receive reimbursement from the agencies or organizations they represent. There was no objection and the amendment was ADOPTED. 1:14:42 PM ROD BETIT, President and Chief Executive Officer, Alaska State Hospital and Nursing Home Association, testified in support of the resolution. The issue is important and should be addressed in a timely manner. He agreed the number of hospital acquired infections could be reduced. 1:17:26 PM RICHARD MANDSAGER, MD, Director, Division of Public Health, Department of Health and Social Services, testified to his efforts with the sponsor to conceive the proposed task force. Six other states have reporting requirements for infectious diseases contracted in hospitals. The task force could review these systems and garner information from both the positive and negative aspects of the other states' programs. Dr. Mandsager informed that the state of Vermont formed a similar task force a year prior, which proposed legislation based in its findings. The resolution before this Committee would allow for the same process. Dr. Mandsager spoke to complexities of the issue in Alaska. Twenty-five years ago, only 30 percent of surgical care was performed as outpatient care; currently, almost 75 percent is done in this manner. Although the title of the resolution specifies "health care associated infections", he recommended the focus should be inclusive and consider all forms of surgical care delivery. This would make the task force progress more difficult. Dr. Mandsager further cautioned that data reporting would be problematic with smaller institutions. Because the volume of smaller institutions is low, the reported percentages of any infections could be misleading. 1:19:18 PM Senator Olson asked the hardship such reporting requirements would cause smaller health clinics that are not in-patient care facilities. Dr. Mandsager told of preliminary discussions held with the ASHNHA on this issue. The Association as well as the ANTHC would participate in the task force because of the potential impacts to its member health care providers. Recommendations of the task force would ultimately be determined by cost and value returned from investment. To be a "worthwhile exercise" the process must ensure that institutions could afford to participate so consumers could receive accurate information of value. Senator Olson asserted that accreditation is important for smaller hospitals, and asked whether this process would impact a clinic's efforts in achieving or maintaining accreditation. 1:20:33 PM Dr. Mandsager responded that a joint commission, which awards accreditation, was undertaking the same effort of reporting hospital surgical standards. The states that have already implemented reporting requirements of hospital acquired infectious diseases include the process in the licensure and certification of institutions allowed to operate in that state. The same would occur for Alaska if similar reporting requirements were instituted. 1:21:00 PM Senator Olson asked how less commonly known infections would be addressed under the proposal. Dr. Mandsager replied that the "scope" of which diseases would require reporting would be determined by the task force. The states that appear to have the most success with implementing a reporting system have opted to limit the number of infection types to be reported to those with higher frequency and have broad applicability. The size of the data system and the costs would be too large if reporting of all infection types were required. Once capacity and "learning" has been established for a limited number of types, the governing body could determine to require reporting of additional types of infections. 1:22:18 PM Senator Dyson commented on Dr. Mandsager's goal of achieving an extensive health education and information system for the State. This resolution represents "a step in the first portion" of accomplishing this. 1:23:32 PM Senator Dyson offered a motion to report SJR 19, 24-LS1657, as amended, from Committee with individual recommendations and a new fiscal note. Without objection, CS SJR 19 (FIN) was MOVED from Committee with a forthcoming fiscal note. The zero fiscal note, dated 4/24/06, from the Legislature, was submitted to the Senate Secretary. AT EASE 1:24:03 PM / 1:24:32 PM