HOUSE FINANCE COMMITTEE APRIL 9, 1996 1:45 P.M. TAPE HFC 96 - 105, Side 1, #000 - end. TAPE HFC 96 - 105, Side 2, #000 - end. TAPE HFC 96 - 106, Side 1, #000 - end. TAPE HFC 96 - 106, Side 2, #000 - #012. CALL TO ORDER Co-Chair Mark Hanley called the House Finance Committee meeting to order at 1:45 P.M. PRESENT Co-Chair Hanley Representative Martin Co-Chair Foster Representative Mulder Representative Brown Representative Navarre Representative Kohring Representative Therriault Representative Kelly Representatives Grussendorf and Parnell were not present for the meeting. ALSO PRESENT Representative John Davies; Representative Ivan Ivan; Eleanor Roser, Staff, Representative Ramona Barnes; Juanita Hensley, Chief, Driver Services, Division of Motor Vehicles, Department of Public Safety; Jayne Andreen, Executive Director, Council on Domestic Violence and Sexual Assault, Juneau; Dr. Gilbert Sanders, (Testified via teleconference), Director, Chemical Dependency Unit, Mt. Edgecumbe Hospital, Sitka; Donald Dapcevich, Executive Director, Governor's Advisory Board on Alcoholism & Drug Abuse, Office of the Commissioner, Department of Health and Social Services; Elmer Lindstrom, Special Assistant, Office of the Commissioner, Department of Health and Social Services; Barbara Craver, Assistant City Attorney, City and Borough of Juneau, Juneau; Shannon O'Fallon, Assistant Attorney General, Department of Law; Arthur Snowden, Administrative Director, Alaska Court System; Karen Perdue, Commissioner, Department of Health and Social Services; John Middaugh, MD., Chief, Epidemiology Section, Division of Public Health, Department of Health and Social Services; Gregory Hayes, PHD., Chief, Laboratories, Division of Public Health, Department of Health and Social Services; Russ Webb, Health Programs Manager, Division of Public Health, Department of Health and Social Services; Tom Lane, Juneau Facilities Manager, Division of Administrative Services, Department of 1 Health and Social Services. SUMMARY HB 110 An Act relating to the confidentiality of certain information in motor vehicle records; and providing for an effective date. CS HB 110 (STA) was reported out of Committee with a "no recommendation" and with a fiscal note by the Department of Public Safety dated 3/18/96. HB 493 An Act relating to involuntary commitment for alcoholism or drug abuse. CS HB 493 (JUD) was reported out of Committee with a "no recommendation" and with (2) fiscal notes by the Department of Administration dated 3/19/96, the Alaska Court System dated 3/19/96 and the Department of Health and Social Services dated 3/19/96 and a zero fiscal notes by the Department of Public Safety dated 3/19/96 and the Department of Law. HB 529 An Act giving notice of and approving the entry into, and the issuance of certificates of participation in, a lease-purchase agreement for a centralized public health laboratory. HB 529 was HELD in Committee for further consideration. HB 543 An Act establishing a preference when entering into state airport land leases. HB 543 was rescheduled for April 10, 1996 A.M. meeting. HCR 26 Relating to creation of the Public Inebriate Task Force. HCR 26 was rescheduled for April 10, 1996 A.M. meeting. HOUSE BILL 110 "An Act relating to the confidentiality of certain information in motor vehicle records; and providing for an effective date." ELEANOR ROSER, STAFF, REPRESENTATIVE RAMONA BARNES, testified in support of HB 110. She pointed out that the 2 legislation was introduced at the request of two constituents who had experienced stalking by persons who had obtained their addresses from the Division of Motor Vehicles through license plate information. In 1994, confidentiality of license plate information was included in the President's Crime Package. The intent of the federal legislation was to protect the personal privacy of persons licensed by states to drive a motor vehicle or persons who register a motor vehicle and would prohibit disclosure of information on drivers maintained by the state. That information is only to be disclosed under permissible uses. If Alaska is not in compliance with federal law by September 13, 1997, Division of Motor Vehicles (DMV) would be liable for civil fines in the amount of $2.5 thousand dollars per day and the State could be subject to fines in the amount of $5 thousand dollars per day until compliance was reached. Ms. Roser pointed out that the bill is supported by the Council on Domestic Violence and Sexual Assault and the Anchorage Police Department. Representative Brown asked about federal requirements not included in the bill. Ms. Roser replied that Alaska does not license private investigators, consequently, that section was removed. JUANITA HENSLEY, CHIEF, DRIVER SERVICES, DIVISION OF MOTOR VEHICLES, DEPARTMENT OF PUBLIC SAFETY, explained that the version before the Committee had been prepared by attorney general offices throughout the nation and the American Association of Motor Vehicle administrators in order to meet the standards of compliance with federal law. In response to Representative Brown, Ms. Hensley informed members that there are private investigative agencies in Alaska. Representative Brown asked if those agencies would have access to information referenced in the bill. Ms. Hensley stated they would not under the proposed legislation. Federal law allows licensed private investigating firms to access that information. She reiterated that Alaska does not license private investigators. Representative Brown asked if the State could legally differ from federal law regarding that concern. Ms. Hensley stated the federal law lists regulations that must be included in order to meet compliance. Almost anyone with a legitimate business use, could obtain the record, although they would be restricted as to how they can use it. The federal law is less restrictive than state law. 3 Representative Brown voiced concern with Community Service Patrols (CSP) having access to the record information. Ms. Hensley commented that as the information was being used for a legitimate purpose, they would continue to be eligible to receive the record. Discussion followed regarding the security of information being released. Representative Brown questioned how the relationship with Mr. Motznik would be affected through passage of the legislation. Ms. Hensley replied that Mr. Motznik would receive the entire DMV file, continuing to get the information but would not be able release that information without knowing to whom and the purpose of that release. The list could not be sold for mail distribution. Representative Brown pointed out that Page 3, Line 6, (9) indicated that it could be available for distribution. Ms. Hensley countered that federal law prohibits release for that purpose. Discussion followed regarding Section (9). Ms. Hensley noted that at present time, if a person wanted to receive information on someones address, they could walk into the Anchorage field office and obtain a copy of the vehicle certificates. It is not difficult. Representative Mulder suggested that the legislation would provide an "additional hurdle" for someone wanting to receive that information. Ms. Hensley agreed, noting that under the proposed legislation, an individual would no longer be able to obtain this information from the DMV office. Discussion followed among Committee members and Ms. Hensley regarding Mr. Motznik's access to the files as written in HB 110. Representative Brown reminded members that the Permanent Fund Dividend list was available to the public which contains similar information. She strongly recommended that state government not intervene in state records management. Ms. Hensley advised that the Association of Motor Vehicle Administrators lobbied against the legislation as they thought it could be a "night mare" to monitor. Co-Chair Hanley asked the consequences if State law was not changed. Ms. Hensley replied that when the federal law takes effect in 1997, the State and the Division would be subject to fines due to violations. She added that the proposed legislation would be "minimum compliance" with federal law. JAYNE ANDREEN, EXECUTIVE DIRECTOR, COUNCIL ON DOMESTIC VIOLENCE AND SEXUAL ASSAULT, JUNEAU, testified that the Council supported the proposed legislation. Accessing DMV records is one way that batterers track their victims. She 4 added, the Council requests that private investigators be denied access to the records, as they are often hired by abusers to locate their victims. Representative Mulder MOVED to report CS HB 110 (STA) out of Committee with individual recommendations and with the accompanying fiscal note. There being NO OBJECTION, it was so ordered. CS HB 110 (STA) was reported out of Committee with a "no recommendation" and with a fiscal note by the Department of Public Safety dated 3/18/96. HOUSE BILL 493 "An Act relating to involuntary commitment for alcoholism or drug abuse." REPRESENTATIVE IVAN IVAN testified in support of HB 493, noting that he introduced the bill as a solution to assist with the public inebriate problem faced by many communities throughout the State. Under current statute, AS 47.37.190, provisions allow for the involuntary commitment of alcoholics. Those provisions allow for 30 day commitments followed by a recommitment length of 90 days. Current law has been found to be unwieldy, expensive and treatment options are not readily available. According to a community survey report by the City and Borough of Juneau (CBJ), communities use the commitment policy sparingly, if they use it at all. The report also emphasized that the current commitment process is not working. Representative Ivan continued, under HB 493, the involuntary commitment process would be similar to those found in the involuntary mental health commitments. Drug abusers were not included in the definitions of incapacitation or intoxication. According to the Division of Alcoholism and Drug Abuse, many public inebriates are ingesting not only alcohol but drugs. The bill would change the definition of intoxicated persons to include drugs which are defined under the controlled substances statutes in Title 11. DR. GILBERT SANDERS, (TESTIFIED VIA TELECONFERENCE), PSYCHOLOGIST, DIRECTOR, CHEMICAL DEPENDENCY UNIT, MT. EDGECUMBE HOSPITAL, SITKA, voiced concern with the legislation. Particularly in reference to language proposed on Page 2, Lines 5 & 6, "physician". He suggested that psychologists should have the same authority as the physicians. He requested Committee members make that change. 5 He added, language in the bill references the individuals "health and safety". He recommended that reference clearly include the mental health as well as the physical health. He stressed that the problem of drug abuse is clearly a mental health disorder. (Tape Change, HFC 96-105, Side 2). DONALD DAPCEVICH, EXECUTIVE DIRECTOR, GOVERNOR'S ADVISORY BOARD ON ALCOHOLISM & DRUG ABUSE, OFFICE OF THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, noted that the Board was an advocate for the individuals who are subject to the provisions of the legislation and for services statewide with regard to substance abuse. He stated that the Board strongly supports the legislation. The current situation has created an unworkable law placing pressure on municipalities, courts, police and the medical facilities around the State. He stressed that current law is confusing. Mr. Dapcevich thought that the legislation could provide better treatment options. He pointed out that the "hope" is that the legislation could educate communities of the "clinical" rather than "social" definitions of those subject to the statute. Mr. Dapcevich spoke to the civil rights of involuntarily committing someone against their will. Current statute allows for involuntary commitment. The changes would create a longer time span for recommitment when the initial phase had been completed and more time is considered to be needed. He referenced the cost/benefit analysis. [Copy on file]. Mr. Dapcevich suggested that a cost savings could exist, pointing out that marginal costs differ from real costs. Mr. Dapcevich reiterated that over a long term "real cost savings" would exist. Representative Mulder asked Mr. Dapcevich if the definition on Page 7, Section #14, was adequate. Mr. Dapcevich stated that it was. Often times people get caught up in the definition of "intoxification" using is synonymously as it applies to motor vehicle accidents, whereas, in a law of involuntary commitment, very different issues are regarded for incapacitation. The statute as proposed is correct. Mr. Dapcevich interjected that he disagreed with Dr. Sanders request to add "mental health" issues to involuntary commitment. He pointed out that there exists a mental health commitment law for issues dealing with mental health 6 concerns. Mr. Dapcevich added, the fiscal note which had been submitted was too high. The Board supports reducing it. In response to Representative Martin's statement, Mr. Dapcevich explained that times are changing, people are realizing that involuntary commitment is not an evil process. Representative Martin asked if there has been discussion with the Native people throughout Alaska. Mr. Dapcevich stated that there has been constructive dialogue with the Alaska Federation of Natives (AFN). Representative Martin questioned how the proposed program would differ from the many alcohol programs that have preceded it. Mr. Dapcevich replied that for the referenced population, all treatment programs are effective on some level. Long term treatment is the only treatment that is effective for late stage chronic alcoholics or addicts. Representative Martin pointed out that HB 493 and HCR 26 address the same concern. Representative Brown inquired the rate of success of late stage alcoholics going through a treatment program. Mr. Dapcevich advised that the rate of success is measured in the cost benefit analysis. To measure long term sobriety, it would be far less effective. He added that most studies find a 12% - 15% recovery, a "good" rate of recovery for the late stage alcoholic. Representative Brown asked why the Board felt that it should be easier to commit someone with the proposed condition than the already existing standard used to commit someone with mental illness. Mr. Dapcevich replied, it was the intent to make the legislation consistent with the mental health commitment. Representative Brown asked if the municipalities would be involved in providing the treatment facilities. Mr. Dapcevich responded that all facilities currently used are joint State and municipality funded. Representative Brown questioned the fiscal impact to the municipalities. Mr. Dapcevich suggested that eventually there would be a fiscal savings to the municipalities. ELMER LINDSTROM, SPECIAL ASSISTANT, OFFICE OF THE COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES (DHSS), explained the fiscal note for the Department. The funds associated with the FY98 portion of the request would cover legal training and treatment programs for the municipalities. The out-year projections include an expected need for additional residential treatment beds. No treatment impact is expected for FY97. 7 Representative Kohring asked why Juneau had been chosen as the pilot city for the program. BARBARA CRAVER, ASSISTANT CITY ATTORNEY, CITY AND BOROUGH OF JUNEAU (CBJ), JUNEAU, responded that Juneau was not the pilot program, but rather, Juneau has been using this system since the local treatment facility has been in operation. There will be no changes to the Juneau facility with passage of the legislation, although, it is anticipated that the bill would provide clinically based definitions which will make everything at that operation run more smoothly. Mr. Lindstrom reiterated, the Juneau facility was not a pilot program, instead a program that has been using the recommendations now put forth. Representative Brown asked the difference in Section #7, being incapacitated by alcohol and being at risk for serious illness. Ms. Craver stated that language had been added because involuntary commitments require serious harm of some kind. She continued, incapacitation is being redefined in the definition section, Section #14. CBJ does support the new definition and standard. Representative Brown asked if all heavy drinkers would be at risk of fitting into the category. She suggested that the definition of who was eligible for involuntary commitment was too broad. SHANNON O'FALLON, ASSISTANT ATTORNEY GENERAL, DEPARTMENT OF LAW, noted that the legislation was attempting to make the standard similar to the mental health commitment statute, AS 47.30.700. Under the mental health commitment statute, the person must be suffering from a mental illness and be of a danger to themselves and/or others, and/or gravely disabled. Representative Mulder referenced the Alaska Court System fiscal note and questioned the long term impact. (Tape Change, HFC 96-106, Side 1). ARTHUR SNOWDEN, ADMINISTRATIVE DIRECTOR, ALASKA COURT SYSTEM, stated that he would check with the administrative director for the Court System. He explained, when a bill is initiated under the context of addressing a person incapacitated due to alcohol or drugs and taken into possession by a police officer, the Court System assumes that most of these persons would be indigent. Thus, they will need an attorney and the Court System will be responsible for that cost. He remarked that the communities will stand by the statute. Mr. Snowden thought that the Court System fiscal note was correct, although volunteered to further research that information. 8 Representative Martin MOVED to report CS HB 493 (JUD) out of Committee with individual recommendations and with the accompanying fiscal notes. There being NO OBJECTION, it was so ordered. CS HB 493 (JUD) was reported out of Committee with a "no recommendation" and with fiscal notes by the Department of Administration dated 3/19/96, the Alaska Court System dated 3/19/96, the Department of Health and Social Services dated 3/19/96 and a zero fiscal note by the Department of Public Safety dated 3/19/96. HOUSE BILL 529 "An Act giving notice of and approving the entry into, and the issuance of certificates of participation in, a lease-purchase agreement for a centralized public health laboratory." KAREN PERDUE, COMMISSIONER, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, spoke in support of HB 529. The public health laboratories are an essential component of the public health system in each state and in the national public health system. Alaska must have sufficient public health laboratory capacity in order to identify, evaluate and control public health threats. She continued, Alaska has three public health laboratories. They were established as regional laboratories when transportation linkages and technology dictated that laboratory services could only be delivered effectively through a regional structure. Adequate facilities are critical to safe, effective and efficient laboratory operations. Because of the special nature of laboratory functions we must have facilities capable of supporting operations involving bio-hazards and accommodating specialized equipment and changing technologies. Commissioner Perdue added, in the future to maintain the facilities as laboratories would require specialized upgrades and some improvements that are not feasible at a reasonable cost. Alaska must develop a permanent facility to support the specialized activities of the State Medical Examiner program which also involves bio-hazards. The program supports law enforcement and public health efforts by determining the cause and manner of deaths that occur in suspicious or unexplained circumstances or which may present a public health threat. Objective analysis indicates that the most cost and 9 operationally efficient solution to these problems would be the construction of a new facility that centralizes laboratory operations in Anchorage. Centralization of the functions to a single facility would provide the most economical permanent solution to the critical facility problems, while improving overall accessibility, enhancing the Department's ability to perform disease surveillance, evaluation and control activities, and avoid unrecoverable costs related to current laboratories. Commissioner Perdue pointed out that HB 529 provides the mechanism to implement a solution, authorizing the issuance of certificates of participation for lease/purchase financing of a centralized laboratory total cost in the amount of $23.5 million dollars. A centralized facility would house public health laboratory staff from Anchorage, Fairbanks, and Juneau as well as the laboratory chief and the State Medical Examiner staff. Commissioner Perdue acknowledged how difficult it was to propose a project which would centralize services and at the same time could adversely affect the economies of Fairbanks and Juneau. She noted her belief in regional government, although, pointed out that the project was necessary for the state as a whole. She spoke to the transudation plan. JOHN MIDDAUGH, MD., CHIEF, EPIDEMIOLOGY SECTION, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, echoed that the current facilities were no longer adequate. The laboratory function of a public health lab is the core building block of state's health department and a critical component of protection from infectious diseases. Alaska must keep their prevention efforts in the forefront. The State's ability to employ new technology in rapidly diagnosing infections and establishing diagnosis will enable the State to facilitate control measures as a critical component of the public health laboratory. A close relationship exists with physicians around the State who submit specimens causing illness among Alaskans. The State Medical Association has fully endorsed the central new lab in Anchorage and the co-located staff. On a scientific basis, the practice of housing facilities in various locations around the State is not a good, sound idea. DR. GREGORY HAYES, CHIEF, LABORATORIES, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, advised that the services for the public health laboratory are directed towards prevention and control of disease in the community. These services differ from the clinical laboratories directed at individual patient care. 10 The core functions of a centralized lab would include: * Support of disease control and prevention programs, maternal child and family health programs and epidemiological programs; * Support surveillance activities, outbreak investigations and monitor for, the emergence of new infectious agents or re-emergence of infectious agents; * Focus on the development of methods for testing when those tests are not readily available and transfer that technology to the private sector; * Perform diagnostic product evaluation; * Data collection; * Testing of high quality at a reasonable rate; * Provide training, laboratory expertise and reference services to the private laboratory community in the laboratory diagnosis of diseases of public health significance. Dr. Hayes continued, the Juneau and Anchorage laboratories perform primarily microbiological testing. Juneau specializes in Mycology and Water Bacteriology while in Anchorage the specialty is Tuberculosis (TB) testing. The Fairbanks laboratory performs almost exclusively Virology testing. The facilities are in urgent need of repair, having mechanical and structural inadequacies for conducting laboratory testing. All three laboratories have poor facility layouts and have space limitations for future growth. In order to operate, Alaska must meet Federal Regulations, under the Clinical Laboratory Improvement Amendments. During the last survey, Alaska was found out-of-compliance and given 90 days to correct some major ventilation deficiencies or face loss of license. The surveyors will be looking for resolutions in long range planning to address laboratories health and safety concerns. Representative Therriault voiced concern in closing the Fairbanks lab. Dr. Hayes advised that there are no major health and safety problems with the Fairbanks facility. That facility is very dated and the lab is spread out over several floors and poorly laid out. Commissioner Perdue added that the Anchorage facility must be replaced because 11 it is unsafe. She added that when purchasing property, it would be most cost effective to purchase one location and consolidate the services from that spot. The turn around time is also predictable in Anchorage. Co-Chair Hanley asked the costs of maintaining the current facilities. TOM LANE, JUNEAU FACILITIES MANAGER, DIVISION OF ADMINISTRATIVE SERVICES, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, replied that fiscal costs are included in the fiscal notes provided to the Committee. Lease and personnel costs would be saved, providing a total savings of $710 thousand dollars per year. If a new facility was built in Anchorage and the facility in Fairbanks continued operation, $210 thousand dollars would be saved in the long term. Operating costs would diminish through centralization. RUSS WEBB, HEALTH PROGRAMS MANAGER, DIVISION OF PUBLIC HEALTH, DEPARTMENT OF HEALTH AND SOCIAL SERVICES, stated that centralizing services would be scientifically sound management and would enable the lab to achieve more efficiency. Discussion followed between Representative Therriault and Dr. Hayes regarding continued use of the Fairbanks facility. Dr. Hayes stressed that the current Alaskan system does not work well nor benefit the citizens of Alaska. Mr. Lane noted that an analysis had been done indicating the benefits of building the facility in Anchorage. He pointed out that Anchorage is the hub of the transportation network. Representative Kohring voiced concern with the cost analysis of the legislation. Mr. Webb stressed that the Juneau and the Anchorage facility can not be added on too. The Fairbanks facility would be difficult to add to in a cost effective way. None of the current facilities would be able to support the long-term functions of the lab. Representative Martin supported passage of the legislation. (Tape Change, HFC 96-106, Side 2). REPRESENTATIVE JOHN DAVIES voiced support for the lab services continuing to be housed in Fairbanks. ADJOURNMENT The meeting adjourned at 3:50 P.M. 12