SENATE BILL NO. 161 "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." 6:07:00 PM Co-Chair Kelly MOVED to ADOPT the proposed committee substitute for SB 161, Work Draft 28-LS 1405\N (Mischel 3/5/14) as a working document. There being NO OBJECTION, it was so ordered. 6:07:42 PM DAVID SCOTT, STAFF, SENATOR DONALD OLSON, stated that the legislation would make minor changes to the medical examiners duties in the effort to be more compassionate to in interactions with family members of the deceased. He provided one example of the way in which current practices were disrespectful to mourning families. He stressed that some of the forms currently available to families could be misleading; for example, offering unnecessary funeral home services that resulted in burdensome expense. He shared that in some cases families could not afford to ship the remains of loved ones home for burial. 6:10:47 PM Mr. Scott stated that Section 1 had been changed to reflect: * Section 1. AS 12.65.025(a) is amended to read: (a) The state medical examiner shall designate the facilities at which post mortem examinations and autopsies ordered under this chapter may be performed consistent with this section. The Department of Health and Social Services shall pay the costs of (1) post mortem examinations and autopsies ordered under this chapter; (2) related transportation to the location where the post mortem examination is conducted and then to the community closest to where the death occurred, except that transportation costs to another requested location shall [MAY] be paid to the extent that the costs do not exceed the costs that  would otherwise have been paid by the  department for [OF] returning the body to the community closest to where the death occurred; (3) embalming required by law; and (4) cosmetology necessary to make the head, face, neck, and hands of the deceased presentable if those parts of the body are disfigured by the post mortem examination. Mr. Scott spoke to the changes in Section 2: * Sec. 2. AS 12.65.025 is amended by adding new subsections to read: (f) The state medical examiner shall designate a location for conducting a post mortem examination that is in the community closest to where the death occurred if (1) the state medical examiner has verified that a facility with adequate technology, personnel, and training is available at the location to enable the state medical examiner to direct a remote examination; (2) the facility meets applicable standards, including inspection and accreditation, for conducting remote post mortem examinations established in the Forensic Autopsy Performance Standards by the National Association of Medical Examiners; and (3) the cost of conducting the examination in the community closest to where the death occurred is less than the cost of conducting the examination or autopsy at another location, including the cost of transporting the body to and from another location to conduct the examination. (g) The Department of Health and Social Services shall provide to a person responsible for the burial of a body written notice describing the duties and procedures of the state medical examiner and the department under this chapter; the notice must explain, in a form and language that is designed to be easy to understand, the availability of (1) an option to release the body after examination and autopsy to a location other than a mortuary without a recommendation or stated preference to do otherwise; (2) the department's coverage of costs associated with the examination or autopsy, transportation of the body, and necessary cosmetology as provided under (a) of this section; (3) clothing and a casket required under (b) of this section; (4) transportation to another location other than the location where the death occurred; (5) a burial-transit permit as provided under AS 18.50.250; and (6) a death certificate as provided under AS 18.50.230; Mr. Scott spoke to Sections 3 and 4 of the legislation: *Sec. 3. AS 18.50.250(a) is amended to read: (a) Except as provided in (e) of this section,  the [THE] funeral director or person acting as the funeral director who first assumes custody of a dead body or fetus shall obtain a burial- transit permit before final disposition or removal from the state of the body or fetus and within 72 hours after death, except as otherwise authorized by regulation for special problem cases. *Sec. 4. AS 18.50.250 is amended by adding a new subsection to read: (e) The state medical examiner shall obtain the burial-transit permit before a body is transported under AS 12.65.025(a)(2). 6:13:07 PM Co-Chair Meyer OPENED public testimony. 6:13:11 PM KERRI SHELTON, DIRECTOR, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, ANCHORAGE (via teleconference), testified that in 2013 the division processed 1630 cases that were reported to the state medical examiner's office, 850 of which jurisdiction was assumed by the medical examiner's office, meaning that the deaths required further investigation. She said that approximately 95 of the 850 cases required an external examination, the remaining cases required a full autopsy. She stated that the division was willing to work with the sponsor to support families in rural Alaska. She relayed that transporting bodies to a location other than the location of death was standard practice with the medical examiner's office; if the cost was more than shipping the body back to the location nearest death, the family was responsible for any extra cost. The division provided the burial transit permit as a courtesy. She agreed that the formerly used release of remains form was misleading and had been revised for clarity by the division. She mentioned that the current bill version was accompanied by a new fiscal note. The division believed that any cost incurred would be by local jurisdictions and not the state. 6:17:19 PM Co-Chair Meyer understood that the new fiscal note was a zero note. Ms. Shelton relied in the affirmative. 6:18:07 PM Co-Chair Meyer requested that the updated fiscal note be supplied to the committee so it could travel with the bill. 6:18:28 PM MARCIA DAVIS, GENERAL COUNSEL, CALISTA CORPORATION, ANCHORAGE (via teleconference), spoke in support the SB 161. She stated that the corporation had looked into issues involving funeral homes and the medical examiner's office pertaining to rural Alaska. She said that the non-profits would run out of money for trying to get the bodies from Anchorage back to her region for burial about midway through the year, which resulted in families going to great extent to get the bodies released for burial. With the help of other native corporations several problems were finally diagnosed. She believed that continuing discussions would result in cost savings to the state, maintenance of tribal justice standards and minimize harm to families. She highlighted that the form provided by the medical examiner's office was misunderstood by native families and was causing them to unnecessarily select funeral homes and once they were on that path the funeral homes would indicate that the families were legally required to embalm when that was not the case, or they would indicate that it was required by the airlines for transport. She believed that the form was being misinterpreted by funeral homes and air carriers, which lead to the changes in Section 1. She explained that embalming was not culturally at part if the natural burial process and that embalmed bodies posed environmental hazards because the bodies being buried in the region were exposed to water seepage and inundation, which resulted in the embalming chemicals getting into the ecosystem. She believed the bill would be greatly beneficial to the state and the people of Alaska. 6:25:13 PM Co-Chair Meyer CLOSED public testimony. 6:25:28 PM SB 161 was HEARD and HELD in committee for further consideration.