HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE February 25, 1993 3:00 p.m. MEMBERS PRESENT Rep. Cynthia Toohey, Co-Chair Rep. Con Bunde, Co-Chair Rep. Gary Davis, Vice Chair Rep. Al Vezey Rep. Pete Kott Rep. Harley Olberg Rep. Bettye Davis Rep. Irene Nicholia Rep. Tom Brice MEMBERS ABSENT None COMMITTEE CALENDAR *HB 136: "An Act relating to the offenses of driving while intoxicated and refusal to submit to a breath test; and providing for an effective date." HEARD AND HELD *HB 137: "An Act authorizing special medical parole for terminally ill prisoners." PASSED WITH INDIVIDUAL RECOMMENDATIONS HB 67: "An Act relating to eligibility for and payments of public assistance; and providing for an effective date." NOT HEARD - HELD TO TIME CERTAIN (* First public hearing.) WITNESS REGISTER LLOYD RUPP, Commissioner Designee Department of Corrections P.O. Box 112000 Juneau, Alaska 99811-2000 (907) 465-3376 Position Statement: Supported HB 136, HB 137 DANA LATOUR, Legislative Liaison Department of Corrections P.O. Box 112000 Juneau, Alaska 99811-2000 Phone: (907) 465-3454 Position Statement: Provided information on costs of HB 136 JUANITA HENSLEY, Chief of Driver Services Division of Motor Vehicles Department of Public Safety P.O. Box 20020 Juneau, Alaska 99802 Phone: (907) 465-4335 Position Statement: Explained reasons for HB 136 amendments JAY DULANY, Director Division of Motor Vehicles Department of Public Safety 5700 Tudor Road Anchorage, Alaska 99507 Phone: (907) 269-5559 Position Statement: Available to answer questions on HB 136 LORN CAMPBELL, Administrator Highway Safety Planning Agency Department of Public Safety P.O. Box 111200 Juneau, Alaska 99811-1200 Phone: (907) 465-4374 Position Statement: Available to answer questions on HB 136 MARGO WARING, Staff Alaska Mental Health Board 431 N. Franklin St., Suite 101 Juneau, Alaska 99801-1121 Phone: (907) 465-3071 Position Statement: Supported HB 137 GEORGE DOZIER Aide to Rep. Pete Kott Alaska State Legislature State Capitol Building, Room 409 Juneau, Alaska 99801-1182 Phone: (907) 465-3777 Position Statement: Questioned release conditions in HB 137 PREVIOUS ACTION BILL: HB 136 SHORT TITLE: DRUNK DRIVING & BREATH TEST OFFENSES SPONSOR(S): REPRESENTATIVE(S) MULDER TITLE: "An Act relating to the offenses of driving while intoxicated and refusal to submit to a breath test; and providing for an effective date." JRN-DATE JRN-PG ACTION 02/05/93 238 (H) READ THE FIRST TIME/REFERRAL(S) 02/05/93 238 (H) HES, JUDICIARY, FINANCE 02/25/93 (H) HES AT 03:00 PM CAPITOL 106 BILL: HB 137 SHORT TITLE: PAROLE OF TERMINALLY ILL PRISONERS SPONSOR(S): REPRESENTATIVE(S) MULDER TITLE: "An Act authorizing special medical parole for terminally ill prisoners." JRN-DATE JRN-PG ACTION 02/05/93 238 (H) READ THE FIRST TIME/REFERRAL(S) 02/05/93 238 (H) HES, JUDICIARY, FINANCE 02/25/93 (H) HES AT 03:00 PM CAPITOL 106 BILL: HB 67 SHORT TITLE: ELIGIBILITY FOR PUBLIC ASSISTANCE SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR TITLE: "An Act relating to eligibility for and payments of public assistance; and providing for an effective date." JRN-DATE JRN-PG ACTION 01/15/93 86 (H) READ THE FIRST TIME/REFERRAL(S) 01/15/93 86 (H) HEALTH,EDUCATION & SS, JUDICIARY,FINANCE 01/15/93 86 (H) -6 FNS (6-DHSS) 1/15/93 01/15/93 86 (H) GOVERNOR'S TRANSMITTAL LETTER ACTION NARRATIVE TAPE 93-24, SIDE A Number 000 CHAIR BUNDE called the meeting to order at 3:08 p.m. and noted members present. He announced the calendar, noted that Anchorage was on-line via teleconference, and brought HB 136 to the table. HB 136: DRUNK DRIVING AND BREATH TEST OFFENSES Number 030 REP. ELDON MULDER, PRIME SPONSOR OF HB 136, introduced himself and read his sponsor statement, which is on file in the committee room. In summary, the statement said the bill is aimed at eliminating the backlog of 2,500 offenders waiting as long as a year before serving their mandatory 72 hours of imprisonment for driving while intoxicated (DWI). Under the bill, offenders and those who refuse to submit to a breath test for alcohol must: serve their 72-hour sentence in a Community Residential Center (CRC); pay the costs for such incarceration, if necessary through permanent fund dividend withholding; while incarcerated, perform 24 hours of community service in a halfway house if available, or in an alternative facility designated by the Department of Corrections; and forfeit their vehicle upon third or subsequent offenses. The intent of the bill is to curtail the number of DWIs by stiffening punishment, and to ease financial burdens on the Department of Corrections, he said. Number 084 REP. MULDER read through the sectional analysis of HB 136, noting the important provisions of the bill. (Rep. B. Davis arrived at 3:13 p.m. Rep. Brice arrived at 3:14 p.m.) Number 118 REP. MULDER asked the committee to consider amendments to the bill to create a working draft, instead of developing a committee substitute. He presented a list of amendments to HB 136, and described them, numbered as described. Number 181 REP. G. DAVIS moved passage of the first amendment, changing the definition of half-way house to CRC. Hearing no objection, Chair Bunde announced the AMENDMENT PASSED. REP. B. DAVIS moved passage of the second amendment, specifying that "appropriate facilities" under the bill are to be determined by the Department of Corrections. Hearing no objection, Chair Bunde announced the AMENDMENT PASSED. REP. NICHOLIA moved passage of the third amendment, put forth as a cost-savings measure at the suggestion of the Department of Corrections, to extend the requirement for half-way house incarceration to second offenders, as well as to first offenders. Hearing no objection, Chair Bunde announced the AMENDMENT PASSED. REP. BRICE moved passage of the fourth amendment, to include provisions for limited driver's licenses, put forth at the suggestion at the Division of Motor Vehicles. Hearing no objection, Chair Bunde announced the AMENDMENT PASSED. REP. G. DAVIS moved passage of the fifth amendment, eliminating Section 3 of the bill, relating to forfeiture of vehicles. Hearing no objection, Chair Bunde announced the AMENDMENT PASSED. (Rep. Olberg arrived at 3:17 p.m.) Number 191 CHAIR BUNDE asked for comment and questions about the first two amendments, and hearing none, turned to the third amendment. REP. NICHOLIA asked whether a person arrested for DWI in an area in which no half-way house was available would have to serve the sentence in a jail. REP. MULDER answered yes, if no other appropriate facility was available, the sentence would have to be served in jail. Number 210 REP. NICHOLIA asked if the Department of Corrections had a list of appropriate facilities in rural areas. REP. MULDER said such a question might be better answered by the Commissioner of the Department of Corrections. Number 236 REP. KOTT asked if the committee could assume the first and third amendments replaced the term "half-way house" with "community residential center." REP. MULDER said he felt he could not change terminology in mid-stream and so put forth those amendments to make the change in terminology clear in both sections. Number 256 REP. MULDER said the fourth amendment addresses the current ability of the court to allow those convicted for up to six drunken driving offenses to enjoy the use of a limited drivers license, allowing them to drive to and from work. The Department of Motor Vehicles has said such a provision is costly, ineffective, and in violation of federal directives, Rep. Mulder said. Number 271 REP. TOOHEY asked a clarifying question about the fourth amendment. REP. MULDER answered the question, saying the amendment would limit such licenses only to first offenders and would deny the limited license to those with subsequent offenses, he said. CHAIR BUNDE said he did not wish to rush the amendments through the committee, especially as members had not seen them before the meeting. He encouraged members to take their time and pose any questions they wished. REP. MULDER noted that, under the bill, those who refuse to take a breath test and are still convicted of drunken driving would not be eligible for a limited license. CHAIR BUNDE asked whether the fifth amendment merely deleted the option of confiscating the vehicle of a person convicted of DWI. REP. MULDER said the court has the ability to confiscate a vehicle after the first offense. He said that he had wanted to include strict sanctions to take away the vehicle of a person who committed multiple offenses and continued to drive drunk. However, he encountered many statutory problems relating to ownership, liens and titles, and so decided to abandon the amendment as unnecessarily burdensome. CHAIR BUNDE invited Department of Corrections Commissioner Rupp to testify, and asked him to limit his testimony to HB 136, even though the commissioner was also planning to testify on HB 137 as well. Number 322 LLOYD RUPP, COMMISSIONER OF THE DEPARTMENT OF CORRECTIONS, testified in Juneau in support of HB 136. He expressed concern with the problem with drunken drivers and the delays of up to a year between sentencing and incarceration, which he said defeats the purpose of the law. He also said that the state needs to assess whether those arrested for DWIs are functioning alcoholics who need treatment for their problem, while at the same time not excusing drunken behavior. He supported the bill's effort to make people accountable for their actions and responsible for the costs incurred by their offenses. Commissioner Rupp referred to the fiscal notes accompanying the bill and said the bill would collect as much revenue as it would cost after some initial expenses. He said he had read news accounts of third-time offenders' involvement in fatal car accidents and called such situations intolerable. Number 380 CHAIR BUNDE asked why, if the program would generate receipts equal to expenditures, there was no zero fiscal note. REP. MULDER answered that the fiscal notes displayed expenses in the top half of the page, and program receipts on the bottom side, and the two amounts balanced after the first year. CHAIR BUNDE apologized for misreading the fiscal notes. Number 394 REP. BRICE asked about the assumption in the fiscal note that the state could collect only 60 percent of the charges levied under the bill, when the bill gave the state the ability to attach permanent fund dividends. COMMISSIONER RUPP said that the department generally assumes it can collect 60 percent of the funds due it. Also, he said, the department could not assume everyone arrested for DWI receives a permanent fund dividend. He added that the state would eventually pay for itself. Number 414 REP. BRICE said the fiscal notes were probably conservative estimates and the state would eventually bring in more money than the program cost. COMMISSIONER RUPP said he would be pleased with the extra money and could easily put the funds to good use within the department. REP. NICHOLIA noted that many people in Alaska do not receive permanent fund dividends because they owe for child care (support). Number 432 REP. G. DAVIS asked if the fiscal notes reflected the provisions for half-way house sentencing for second offenders. COMMISSIONER RUPP said extending the CRC provision to second offenders meant the department was looking at 20 days, which left more options. He invited a staffer to testify with details. Number 444 DANA LATOUR, LEGISLATIVE LIAISON FOR THE DEPARTMENT OF CORRECTIONS, said 1,100 people were charged with a second DWI offense in 1992. The offense carries a 30-day sentence, with a third of the sentence, or 10 days, subtracted for "good time." Assuming 80 percent of those charged are convicted and serve their sentence, the second-offense CRC provision results in an additional 17,800 bed-days. She said HB 136 addresses first-time offenses, of which there were 3,261 in 1992. If each served a three-day sentence, that means 6,783 bed-days. At $60 per day, a 20-day sentence would cost an offender $1,200, she said. COMMISSIONER RUPP said that cost did not seem unreasonable given the permanent fund dividend and other assets that people would have. He said he felt the key was to say that people are responsible for the costs the state bears. Number 458 REP. KOTT asked if the term "imprisonment" should be used instead of "detention" when referring to a stay at a half- way house. COMMISSIONER RUPP answered that the term "half-way house" had been replaced in favor of "community residential center (CRC)," a more expressive and appropriate term. He added that some areas speak of community corrections, or community imprisonment, or house arrest. REP. KOTT asked if AS 28.35.03 also included other motorized vehicles, such as snowmobiles. COMMISSIONER RUPP responded affirmatively. Number 475 REP. KOTT asked what type of facility in rural Alaska might be deemed an "appropriate facility" by the Department of Corrections. COMMISSIONER RUPP said giving the department latitude would be appropriate. He noted the department would consider a community's resources for possible CRCs, including such facilities as a hotel, which would mean the prisoner would have to pay the cost of incarceration in a hotel. In other places, the department might deem an armory or other community facility an "appropriate facility." It is important to make sure a place of confinement was appropriate and safe, to address liability issues, he said. If the bill did not provide for CRC, requirements for imprisonment in jail might mitigate (sic) against it, he said. He stated he wanted to let the community respond to what it had. REP. KOTT said he would hate to tell constituents that a drunk driving conviction netted a person a three-day stay in Juneau's Westmark hotel. Number 475 COMMISSIONER RUPP said he was once sentenced in traffic court to a traffic school, which took place overnight in a hotel and which cost some participants both the cost of the traffic school and the costs of a night's lodgings at a hotel. He said it was a method that had been tried with success. Number 500 REP. BRICE asked what would happen if a first-time DWI offender was indigent and had their permanent fund dividend (PFD) already attached. COMMISSIONER RUPP said he would not mind attaching PFDs for future years. He also said offenders could borrow money from friends or relatives, credit cards or any method of payment to make sure that a person was held accountable for the cost to society of his actions. REP. BRICE said his major concern was not to see children neglected to pay costs of imprisonment. Number 515 CHAIR BUNDE announced that, in light of the length of discussion on HB 136, the committee was not likely to bring HB 67, Eligibility for Public Assistance, to the table that day. He said the committee would hold HB 67 over until the following week. Number 522 REP. NICHOLIA asked if the Department of Corrections knew how the cost of incarceration in a CRC would compare to the cost of incarceration in a jail. COMMISSIONER RUPP answered yes, and noted that such costs vary by region. He said the cost for jails range from a low of $68 to a high of almost $140 per day, for an average of about $100 per day. The costs for CRCs range from a low of $38 per day to a high of almost $70 per day, he said. REP. NICHOLIA asked whether a person in an area without a CRC would have to serve their sentence in jail and incur the higher cost. COMMISSIONER RUPP answered yes. But he added that most communities are open to the idea of CRCs. He added that the department would be willing to contract with for- or non- profit corporations to provide the service. A church or a community association could provide the CRC service, as long as they met the core criteria for the state's core program. He said the state should make allowances for regional variations in CRC conditions or programs, especially to make allowances for Native issues. (Rep. Olberg departed at approximately 3:45 p.m.) REP. NICHOLIA asked which rural communities the department contacted concerning the CRC programs. COMMISSIONER RUPP said the department would not talk about contracting for CRCs until the legislature had its say on HB 136. But, he said, he had spoken with a representative of Saxman who was interested in doing a culture-relevant program in that area. Commissioner Rupp also noted that he had spoken with representatives of "two other areas that were associations," as well as with representatives from the Alaska Federation of Natives. He said the department's intent, if HB 136 were to pass, would be to sit down with people in various areas to see what types of facilities would make sense as CRCs. He said the department would promulgate its basic uniform requirements for certification, then talk with representatives from different areas to see how they might want to add to those basic requirements, then entertain proposals. Number 574 JUANITA HENSLEY, CHIEF OF DRIVER SERVICES FOR THE DIVISION OF MOTOR VEHICLES IN THE DEPARTMENT OF PUBLIC SAFETY, testified from Anchorage on HB 136. She addressed the bill's fourth amendment, to include provisions for limited driver's licenses. She said the division asked Rep. Mulder to include the amendment for two reasons. The first reason was that the existing 1990 statutes regarding limited licenses, allowing such licenses to be granted to those charged with their second to sixth drunken driving offenses, are extremely burdensome to the division and to the court system. She said there was no method included to allow the division to keep track of the limited license. Given Alaskans' transience of residence and employment, the existing statutes create a large burden of paperwork and recordkeeping on the division and on the license-holder's employers, Ms. Hensley said. (Rep. Brice departed at 3:50 p.m.) (Rep. Brice returned at 3:52 p.m.) MS. HENSLEY said the second reason the division sought Rep. Mulder's fourth amendment was that granting limited licenses under the statutes was a large factor and disqualified the state from receiving about $200,000 in annual alcohol education grants given by the National Highway Safety Traffic Administration and administered by the Division of Public Safety's planning agency. The grant requirements specify that a qualifying state must meet five of six qualifications, she said. The state does not comply with requirements for limited licenses, for minimum age drinking prevention programs, or for sobriety checkpoints. TAPE 93-24, SIDE B Number 000 JAY DULANY, DIRECTOR OF THE DIVISION OF MOTOR VEHICLES, IN THE DEPARTMENT OF PUBLIC SAFETY, testified from Anchorage, making himself available to answer questions on HB 136. (Rep. Olberg returned at 3:54 p.m.) LORN CAMPBELL, ADMINISTRATOR OF THE HIGHWAY SAFETY PLANNING AGENCY, IN THE DEPARTMENT OF PUBLIC SAFETY, testified via teleconference in Juneau, making himself available to answer questions on HB 136. REP. G. DAVIS noted the absence of a fiscal note from the Division of Motor Vehicles on the bill, and asked whether the bill would not require more work for the division. MR. DULANY answered that the bill would actually help the division. He said that when amendments were passed in 1990, the division was unable to place a fiscal note and obtain funding to do the work called for by the amendments. He said HB 136 would help the division's operations in the driver services area. Number 039 REP. NICHOLIA asked whether the Department of Corrections would work with tribal courts in villages, as most nonprofits do not have programs in all villages. COMMISSIONER RUPP answered yes. Number 050 CHAIR BUNDE closed public testimony on HB 136 and asked the will of the committee. REP. BRICE moved passage of HB 136 with individual recommendations, with amendments and fiscal notes attached. Number 070 REP. VEZEY expressed concern about the number of amendments to the bill and said he would like to see a full list of the amendments so that the bill could be read in one document. He also expressed concern about the fiscal note. He said if the Department of Corrections wanted to come back later and ask for more money to administer the program, he would be encouraged to refuse. He said the bill was supposed to reduce the cost of enforcing compliance, and if it did not achieve that end, the legislature should try a different approach. REP. G. DAVIS expressed agreement with Rep. Vezey on the number of amendments and said the fiscal impact of the third amendment was not included in the fiscal note, which would be updated and included. REP. BRICE said he would be willing to withdraw his motion to pass the bill from the committee if it were the will of the committee. CHAIR BUNDE said he would be willing to have a vote on the motion. REP. B. DAVIS objected to the motion. CHAIR BUNDE said he understood the will of the committee to have a clean copy of HB 136, plus a revised fiscal note to allow for the impact of including second offenses. Chair Bunde closed discussion of HB 136 and announced his intention to turn the chair over to Rep. Toohey and to have the discussion turn to HB 137. REP. NICHOLIA asked whether the committee would be able to discuss HB 136 when the bill returned to the table with a clean copy. CHAIR BUNDE said yes, the committee would be able to continue discussing the bill until it was ready to vote. Chair Bunde announced he would have to leave the meeting at 4:30 p.m. for another commitment, at which time he would turn the chair over to Rep. Toohey. He noted the teleconferenced portion of the meeting was completed. He brought HB 137 to the table. (Rep. Kott departed at approximately 4:00 p.m.) HB 137: PAROLE FOR TERMINALLY ILL PRISONERS COMMISSIONER RUPP testified in Juneau on HB 137. He said the bill responds to a recommendation from the Alaska Sentencing Commission concerning special medical parole for terminally ill prisoners. He said the bill was prompted, at least in part, by concerns over HIV-positive prisoners. He said prisoners are dying in record numbers and the significant amounts of medical attention required of AIDS cases meant large medical expenses for dying prisoners. Commissioner Rupp said he believed the intention of Rep. Mulder, the sponsor, was to seek payment for such medical expenses not by the state, but by third parties, such as the federal government's Medicare or Medicaid programs. The state can furlough terminally ill prisoners, but retains responsibility for their medical treatment, he said. There are now eight to 10 prisoners who would qualify for terminal parole under HB 137, and medical expenses for one of those prisoners has already exceeded $500,000. The commissioner said he had attended a conference of state prison commissioners at which they shared ideas on how to fight increasing health care costs, costs fueled in large part by AIDS and HIV. COMMISSIONER RUPP said he would like to see the provisions for parole in HB 137 expanded to include prisoners suffering from chronic debilitating conditions, saying that prisoners whose condition confined them to bed could be better cared for in different facilities. He noted that the Department of Corrections did not have specialists in the care of the terminally ill on staff, nor did it have the funding or inclination to add them. The department therefore provides a patchwork of care for terminally ill prisoners that is not up to the standard of care provided by specialists in the area, and which therefore serves as another reason for the department's support of HB 137, he said. Number 193 COMMISSIONER RUPP said the bill would result in parole of some prisoners who would not otherwise be paroled, but there is no assurance such prisoners would be granted general parole, which is granted only at the discretion and independent authority of the Parole Board. The commissioner said he had asked the executive director of the Parole Board, Richard Collum, to be available to answer questions. He reminded the committee members that the Parole Board does not work for the Department of Corrections. Number 216 REP. TOOHEY asked whether terminally ill prisoners now are sent to a specific facility. Number 228 COMMISSIONER RUPP answered no, that the department did not have a specified facility or staff to deal with terminally ill prisoners. He said the department provides most care for such prisoners through contracted services. He added that the department is also responsible for the medical care of the prisoners it holds in jails, which can cause more problems than the population of terminally ill prisoners held in prisons. Current law holds the department responsible even if a prisoner is being held before trial, he said. In some cases, Commissioner Rupp said, people needing serious medical attention have committed offenses with the deliberate aim of being placed in jail and being provided medical care, though a third-party might have paid the medical costs had the person remained free. He called that practice a travesty perpetrated upon the Alaska public. He concluded by saying the points he had raised showed why the Department of Corrections supported HB 137. Number 246 CHAIR BUNDE, on behalf of Rep. G. Davis, asked how much it cost the department to care for a terminally ill prisoner, compared to the cost Medicare or other third-party payer. COMMISSIONER RUPP estimated that, as the department contracts for such services, the cost would be approximately the same for each. CHAIR BUNDE asked whether the department anticipated saving money by moving prisoners needing intensive medical care out of the prisons into other public facilities where Medicaid could pay for the care. COMMISSIONER RUPP answered that if the prisoners were moved to a state-funded system, then the state would continue to bear some expense. He added that it was likely that the state would pay less money because other health care facilities might have better contracts and be able to provide service at lower costs. Number 269 REP. TOOHEY asked whether the prisons treat sick prisoners inside prisons or in hospitals. COMMISSIONER RUPP said the prisons rely on the advice of the institution's attending physician whether to treat a prisoner inside the prison dispensary or at a facility outside the prison. The prison bears the cost of either choice, Commissioner Rupp said. He said treatment at an outside hospital costs more in part due to the necessity of sending guards along with prisoners. Number 282 REP. NICHOLIA asked, "What if an individual contracted AIDS in the jail because it was beyond their control?" COMMISSIONER RUPP answered that he would have to consider the methods by which inmates contract AIDS, and such people are more often participants rather than victims in such circumstances. Nevertheless, the Department of Corrections would be liable for the medical care of prisoners, he said. REP. NICHOLIA said she raised the question because there are some instances in which inmates who contract AIDS while imprisoned are unwilling victims. Number 300 COMMISSIONER RUPP said he would be concerned about the quality of care available for inmates. He said the department does not have the facilities or trained personnel to provide as good of care for terminally ill patients as the Alaska Psychiatric Institute, the Alaska Native health care system, or other services. He said he believed people deserve to die with dignity, and that there was not much dignity dying in a jail cell of terminal AIDS. Number 310 REP. VEZEY asked who sets the standards for care of terminally ill people. COMMISSIONER RUPP answered that the department has a physician, a medical officer, on staff who would remain in consultation with whatever medical authority was present at any of the department's 14 facilities. The initial standard of care would be established by the care-giver at the facility, with discussion with the departmental medical officer. The commissioner also mentioned that there is a four-member medical board which meets routinely to review cases for appropriateness of treatment, and which has ultimate decision-making authority on maintaining appropriate medical treatment. The board is primarily there to consider the cost of care and make sure that only appropriate care is provided. He said it would also consider whether and when to move prisoners from one facility to another for medical reasons. He said moving prisoners also entails a cost, which will be even higher given the requirements to comply with the Americans with Disabilities Act (ADA). Number 335 REP. VEZEY asked whether ADA addressed illnesses. COMMISSIONER RUPP answered no, the concern with ADA was that it required the department to make allowances for inmates with disabilities. He said that upgrading all the state's prison facilities to meet ADA standards would be prohibitively expensive, prompting them instead to upgrade one or two at a time, then move prisoners with special needs to those facilities. He commented that ADA was informally known as a "full employment act for attorneys." Number 353 REP. VEZEY said, "Staying on the same line of questioning, I was wondering how you were tying the ADA into health care, but. What is, to kind of approach the question from a different angle, what's to prevent you from prescribing a terminally ill patient two aspirin and sending them back to their jail cell? I mean, half a million dollars in medical expenses on terminally ill patients is a rather difficult sum of money to imagine. I know it can be done." Number 375 COMMISSIONER RUPP said he might want to refer the question to Dr. Townsend, but said that doctors must provide care according to medical standards, as a condition of their medical licenses. He said such standards, which include medical review, would help guide the standard of care. He said he could not imagine giving a terminally ill patient two aspirin and sending him back to his cell to die. He repeated that such questions might be better left to his medical officer to answer. REP. OLBERG asked a clarifying question, namely, whether state prisoners were guaranteed full medical benefits while the public at large was not. COMMISSIONER RUPP answered that this was true, though ironic. He said court decisions, including Russ v. State, and Estelle v. Gambel, require the state to assume responsibility for the medical condition of those it imprisons. Number 390 MARGO WARING, AN ALASKA MENTAL HEALTH BOARD STAFFER, testified in Juneau in support of HB 137. She said the board's executive committee was concerned about several cases in which prisoners suffering from Alzheimer's disease and other organic dementias, and therefore people of concern to the board, could have been better served had they been paroled to more appropriate facilities. Such parole would allow the families of such people to help select what facility to which the prisoner could be paroled. The board felt the demented should be released from prison when in the terminal stages of their illness, when continued incarceration would neither benefit them nor serve to protect the public. She said the issue was one of humane care. CHAIR BUNDE closed public testimony and asked the will of the committee. REP. VEZEY moved passage of HB 137 from the committee with individual recommendations. Number 422 REP. B. DAVIS asked about Commissioner Rupp's earlier statement that he would like to see the bill's provisions extend to prisoners with chronic, debilitating diseases. She said that such a provision would require a specific definition of that condition. COMMISSIONER RUPP said his medical people could have a definition drawn up quickly. Number 436 MS. LATOUR said she had asked Mike Stark, an attorney with the Department of Law's criminal division, whom she said has worked frequently with the Department of Corrections, whether a definition of terminally ill" had to be included in HB 137. She said Mr. Stark had answered no, the Department of Corrections had the authority through regulation to have its medical team determine a definition of terminally ill and to decide what chronic and debilitating illnesses would be. She said that while the department could set those guidelines, it would still be up to the Parole Board to determine whether a prisoner would win parole. REP. B. DAVIS said that while she appreciated Ms. LaTour's answer, she would have to have more than one person's answer before she was satisfied. Number 446 COMMISSIONER RUPP offered to have his medical people come up with a statement for inclusion in the bill. Number 450 GEORGE DOZIER, AIDE TO REP. PETE KOTT, testified on behalf of Rep. Kott. Mr. Dozier said he wanted to express concern over the lack of specific statutory standards and criteria for conditions of release. While it is important to be fiscally responsible, as was one goal of the bill, it is also important to protect the public health and safety, he said. CHAIR BUNDE said there was a motion on the floor to move HB 137 from the committee. REP. BRICE interrupted to say there was a motion to amend the bill. CHAIR BUNDE said he had not heard such a motion, but would entertain such a motion if offered. Number 464 REP. VEZEY said he was satisfied with the term "terminal illness," but he had reservations about "debilitating illness." He said it was too broad a term, encompassing too much, and would require specific a definition. Many illnesses, such as arthritis, are debilitating, he said. He expressed comfort with the term "terminal illness" and with the delegation to either the medical board or the Parole Board to define the term. Number 475 REP. TOOHEY expressed agreement with Rep. Kott's position on the question of "debilitating illness." A terminally ill person is not a danger to society and is debilitated to the point of inability to walk and probable inability to function without assistance. She said the committee could leave that discretion to the Corrections Department's medical (board). COMMISSIONER RUPP said that prisons are getting more geriatric prisoners, defined as inmates who are 55 years old and older. He said the growth of the age class of prisoners susceptible to Alzheimer's disease prompted concern over the disease relative to HB 137. He said prison authorities are concerned about how to deal with prisoners suffering from Alzheimer's disease and from mental illnesses. He said he has 700 mentally ill prisoners in his prison system, 350 of them acutely and chronically mentally ill. Some of them are approaching the condition in which they are not terminally ill, but might be considered debilitated. Number 497 REP. OLBERG asked whether the bill just provides the opportunity of parole to those who would not be eligible any other way. That is, a prisoner not eligible for parole, but terminally ill, becomes eligible for parole under the bill, he said. He shared the concern with over-broadening the bill to include debilitating diseases. Number 505 CHAIR BUNDE said he would oppose HB 137 if it were broadened to include prisoners suffering from Alzheimer's disease. It would be a shame to have such people in prison, but it would be even worse to have them on the street, he said. Number 510 CHAIR BUNDE repeated the motion to pass HB 137 from the committee with individual recommendations and without amendment to include debilitating illness. Hearing no objection to the motion, he declared the bill passed with individual recommendations. CHAIR BUNDE announced that the committee would hear HB 67 the following Tuesday, March 2, 1993. The meeting was ADJOURNED at 4:30 p.m.