HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE February 14, 1995 3:06 p.m. MEMBERS PRESENT Representative Cynthia Toohey, Co-Chair Representative Con Bunde, Co-Chair Representative Al Vezey Representative Norman Rokeberg Representative Caren Robinson Representative Tom Brice MEMBERS ABSENT Representative Gary Davis COMMITTEE CALENDAR * HB 28:"An Act relating to the possession of weapons within the grounds of or on the parking lot of preschools, elementary, junior high, and secondary schools or while participating in a school-sponsored event; requiring the expulsion or suspension of students possessing deadly weapons on school grounds; and relating to school lockers and other containers provided in a public or private school by the school or the school district." SCHEDULED BUT NOT HEARD CONFIRMATION HEARINGS: Karen Perdue, Department of Health and Social Services Brian Carter, William McCain, Mary Lou Madden and Christine Niemi for the Professional Teaching Practices Commission. * HJR 18: "Relating to medical savings account legislation." PASSED OUT OF COMMITTEE WITNESS REGISTER KAREN PERDUE, Commissioner Designee Department of Health and Social Services 350 Main Street, Room 229 Juneau, AK 99801 Telephone: (907) 465-3030 CHRISTINE NIEMI, Administrator Teacher Education and Certification Alaska Department of Education 801 W. 10th Street, Suite 200 Juneau, AK 99801 Telephone: (907) 465-2857 BRIAN L. CARTER, Interim Principal/Teacher Salcha Elementary School 613 Pleasure Drive North Pole, AK 99705 Telephone: (907) 488-6684 Interviewed via teleconference from Salcha. WILLIAM A. McCAIN, Teacher Chugiak Elementary School P.O. Box 873042 Wasilla, AK 99687 Telephone: (907) 376-0653 Interviewed via teleconference from Chugiak. MARY LOU MADDEN, Provost/Vice President Sheldon Jackson College 801 Lincoln Street Sitka, AK 99835 Telephone: (907) 747-5215 Interviewed via teleconference from Sitka. ROD MOURANT, Administrative Assistant Representative Pete Kott's Office Room 432, State Capitol Juneau, AK 99801 Telephone: (907) 465-3777 POSITION STATEMENT: Provided sponsor statement for HJR 18. PREVIOUS ACTION BILL: HB 28 SHORT TITLE: POSSESSION OF GUNS ON SCHOOL PROPERTY BILL VERSION: SPONSOR(S): REPRESENTATIVE(S) BUNDE,Rokeberg,Green,Toohey,Kott,Elton JRN-DATE JRN-PG ACTION 01/06/95 28 (H) PREFILE RELEASED 01/16/95 28 (H) READ THE FIRST TIME - REFERRAL(S) 01/16/95 28 (H) HES, JUD, FIN 01/18/95 75 (H) COSPONSOR(S): GREEN 01/20/95 104 (H) COSPONSOR(S): TOOHEY 01/27/95 161 (H) COSPONSOR(S): KOTT, ELTON 02/14/95 (H) HES AT 03:00 PM CAPITOL 106 BILL: HJR 18 SHORT TITLE: SUPPORT MEDICAL SAVINGS ACCT LEGISLATION BILL VERSION: SPONSOR(S): REPRESENTATIVE(S) KOTT JRN-DATE JRN-PG ACTION 01/20/95 100 (H) READ THE FIRST TIME - REFERRAL(S) 01/20/95 100 (H) HEALTH, EDUCATION & SOCIAL SERVICES 02/14/95 (H) HES AT 03:00 PM CAPITOL 106 ACTION NARRATIVE TAPE 95-7, SIDE A Number 000 CO-CHAIR CON BUNDE called the meeting to order at 3:06 p.m. Members present at the call to order were Representatives Bunde, Toohey, Vezey and Robinson. Co-Chair Bunde announced that a quorum was present and read the calendar. HHES - 02/14/95 HB 28 - POSSESSION OF GUNS ON SCHOOL PROPERTY CO-CHAIR BUNDE stated that HB 28 would be held until February 21, 1995. HHES - 02/14/95 CONFIRMATION HEARING - COMMISSIONER DESIGNEE KAREN PERDUE Number 067 KAREN PERDUE, Commissioner Designee for the Department of Health and Social Services (DHSS), offered to answer any questions the HESS Committee members may have about her background. She said she was originally from Fairbanks and announced that the dean of students from her high school, and other members of her community, were present. Both Ms. Perdue and her husband have family members in the Fairbanks area. Number 160 MS. PERDUE said that she previously worked for the United States Congress under Senator Ted Stevens and learned how the governmental process works. She feels this was valuable experience, considering the federal changes which are pending in the area of Health and Social Services. Ms. Perdue also worked in the Alaska state government working for former Lt. Governor Terry Miller. She learned a lot about public service from that job. Number 192 MS. PERDUE stated that she has served under three governors in program management and administration. A number of years ago she left Juneau for Fairbanks and has been working as a consultant to human services agencies. She has learned a lot about human service delivery and making services more efficient. She comes back to Juneau with enthusiasm for new approaches. Number 240 CO-CHAIR BUNDE said that one of the issues that comes repeatedly before the legislature is that of welfare reform. He asked Ms. Perdue if she had any ideas to share about that topic and how to make the system more efficient. MS. PERDUE said she thought the state was about to get a major opportunity to fundamentally redesign the welfare system. She feels that Congress is about to give Alaska the opportunity to try some new ideas. Most people who are on welfare and those who administer the program are ready for changes that encourage work while a person is on welfare, and encourage people to get off welfare as quickly as possible. Welfare should be used basically only as a safety net. Number 295 MS. PERDUE continued that the aforementioned changes are of primary concern when looking at redesigning a short-term welfare reform package and a long-term package. One of the major things that has happened to the state's Aid to Families with Dependent Children (AFDC) Program in the last several years is that in 1988 two-parent families were added to the AFDC rules. That was a federal congressional mandate to Alaska. Alaska, at that time, was one of the few states that did not cover two-parent families. The reasoning behind this mandate was that welfare was breaking up families, therefore, two-parent families should be added. MS. PERDUE said that currently, the majority of the case load increase is due to two-parent families. In the two-parent family, there is usually at least one person who is able-bodied. So Ms. Perdue feels that at least one of those parents should be working or in training, and taking advantage of state and federal government support to go out and improve themselves. Ms. Perdue thinks that will be a key feature in any reforms that the DHSS looks at. They want 100 percent participation from two-parent families in some sort of training program. Number 373 MS. PERDUE announced that currently DHSS is trying to collect short-term strategies for lowering the number of people on a case load, making sure that no one who is on a case load is cheating the system in any way, making sure that absent parents are paying child support so the state is not paying in their absence, and still trying to move ahead with some reform while not wasting resources so that programs will not have to be redone if the Congress passes fundamental welfare reforms in November. Number 240 CO-CHAIR BUNDE asked Ms. Perdue to speculate on the possibility of Congress passing the block grant idea and giving Alaska a large amount of money. He asked if she had ideas about restructuring Alaska's welfare program, specifically in the area of "Two years then out" (a two-year welfare assistance limit), and also in those areas in Alaska where welfare is a lifestyle. He asked if a block grant would involve a rate reduction considering Alaska's rate is higher than anywhere else in the United States. MS. PERDUE answered that Congress is looking into putting AFDC food stamps and the Women, Infants and Children (WIC) program in a block grant. Currently, there is a bill before the Federal Congressional House, the Clay Shaw bill, that caps the contribution for five years. That puts a lot of pressure on the states because the money is not an entitlement anymore. That is a fundamental shift in the way Alaska has been doing business in the past. That is currently the most active proposal, and the Alaska DHSS is analyzing what that proposal would mean in terms of Alaska's current program. Ms. Perdue said that one can only guess, if the AFDC federal funding grows three to six percent every year, that would mean less money to go around. MS. PERDUE said that in terms of the contribution limits, the Republicans have now revised their entitlement to five years with some credits for working, and then there is an absolute cutoff. There are other proposals that create a bank of a two-year time limit, and a person may buy back time if he or she goes to work. MS. PERDUE commended the number of creative ideas which have been proposed. However, the time limit concept is one which both Democratic and Republican governors have accepted at this point. Ms. Perdue felt that the time limit concept was going to be enacted. Number 546 CO-CHAIR BUNDE hoped that Ms. Perdue would address the problem of rural Alaska. Some feel that in rural Alaska there cannot be a time limit. Others say perhaps time limits should exist everywhere. Number 564 CO-CHAIR BUNDE announced that Representative Brice and Representative Rokeberg joined the meeting at 3:08 p.m. REPRESENTATIVE TOM BRICE inquired that considering Alaska has one of the lowest rates of welfare fraud in the nation, what does Ms. Perdue see Alaska doing in the future to decrease that number of welfare fraud cases even further. Number 593 MS. PERDUE replied that one of the biggest areas of welfare fraud is food stamps, because they are essentially cash and can be traded. Her understanding is that there is an active food stamp trade in Anchorage. One of the ways states are dealing with this fraud is by providing people with a "swipe card," which transfers benefits electronically. Alaska is actively exploring that option and is very interested in working with grocers in Fairbanks and Anchorage. The technology has seemed out of reach because Alaska has a comparatively small number of grocery stores. However, governors in the western states have put together an alliance with Wyoming, Idaho and other states which Alaska is looking to join and buy some off-the-shelf technology. REPRESENTATIVE BRICE said the very essence of welfare reform lies within child support - making those who have helped create the problem pay for the problem. He encouraged Ms. Perdue to look at a large number of state departments that provide not only benefits for poor people and children, but also make sure that those who abandon their children start paying more. REPRESENTATIVE BRICE concluded by saying that currently most of the discussion at the federal congressional level is that the creation of children is only the woman's responsibility, and this is not true. Number 753 CO-CHAIR CYNTHIA TOOHEY is pleased to see Ms. Perdue appointed for the position. She is confident with Ms. Perdue's knowledge of the system and feels she will do a very good job. Co-Chair Toohey hopes Ms. Perdue is strong enough for the upcoming challenges. There are some major budget cuts coming for Health and Social Services as well as many other departments. The cuts are not going to be pretty and it will break everyone's heart but they must be done. CO-CHAIR TOOHEY discussed an article from the Washington Post. There is a county in New York that spends 62 cents from every dollar they collect on MedicAid. Co-Chair Toohey said that this is not a projected figure for ten years in the future, this is what this county is paying currently. She warned that this type of spending will be seen in Alaska if some major changes are not made. Number 807 MS. PERDUE felt the article to which Co-Chair Toohey referred was excellent because it showed how difficult decisions were for the government. CO-CHAIR TOOHEY said that the Alaska government will soon be making those decisions. Some were made last year and everybody blamed everybody--legislators did not make popular decisions. CO-CHAIR TOOHEY continued that the issue of unwed teenage pregnancy must be addressed, and she did not know how it would be dealt with. Co-Chair Toohey would like to see funding for unwed teenage mothers stopped. They should be encouraged to go back home to their families. Co-Chair Toohey hoped that with the help of Ms. Perdue and her staff, this problem will be stopped. Number 850 REPRESENTATIVE NORMAN ROKEBERG said that Representative Brice made a very good point when he said that the level of welfare fraud in Alaska is the lowest in the nation. However, Representative Rokeberg felt that represented the amount of reported fraud. He asked Ms. Perdue if she could comment on the fact whether the actual incidence of fraud is substantially greater than is reported, and what was being done within the DHSS. MS. PERDUE answered that initially, the fraud must be reported so DHSS can investigate it. Some of Ms. Perdue's relatives in Interior Alaska have reported suspected welfare fraud. There are DHSS people who do home visits, investigate and follow up on suspected fraud even in rural areas. It could be the DHSS is understaffed in this area, but maybe the DHSS needs to be more visible when they investigate fraud and more encouraging of public reports. It is essential that the public feel their money is being well-spent. Number 930 REPRESENTATIVE ROKEBERG understood that a film had been produced to help fraud investigation within the last few years. He heard this from DHSS fraud investigators who also told Representative Rokeberg that the incidence of fraud was much higher than what was being reported. Number 956 CO-CHAIR BUNDE encouraged the publicizing of fraud investigations. No matter what the regulations are, and no matter how diligent the DHSS investigators are, there will always be people clever enough to figure out how to fraud the system. Publicizing investigations and prosecutions would discourage the least ambitious. MS. PERDUE said that is called the "Sentinel Effect," and she feels that effect does have an impact. Such publicity should be done for MedicAid fraud and for public assistance fraud. It is important to publicize not only the $50 to $100 frauds, but also the bigger frauds. There are also cases of public assistance providers who fraud the system and those cases should also be publicized. CO-CHAIR BUNDE agreed with Ms. Perdue. Number 1053 CO-CHAIR BUNDE mentioned concerns that he shares with Co-Chair Toohey, such as STDs, fetal alcohol syndrome and teenage pregnancy. He encouraged Ms. Perdue to work on those problems. Co-Chair Bunde continued that some state departments and the legislature tend to diverge. The legislature has ideas, but somewhere along the line the policy changes don't reflect the legislative goals. Such a divergence would be unfortunate in this case, however Co-Chair Bunde does not anticipate these problems. He desires a working partnership between the HESS Committee members, Ms. Perdue and the DHSS. Number 1118 CO-CHAIR TOOHEY asked Ms. Perdue about the future of permanency planning for foster children. MS. PERDUE answered that she is not well informed on that topic, however, she will study that area. Number 1142 REPRESENTATIVE CAREN ROBINSON said that last week the HESS Committee passed HB 92, which extended the termination date of the Citizen's Review Panel for Permanency Planning. She said that due to some unfortunate circumstances the Panel was not implemented the first year it was supposed to be. Now the program is under funded. Representative Robinson hopes that Ms. Perdue will work with the Commissioner of the Department of Administration to encourage the implementation of the program. REPRESENTATIVE ROBINSON said that currently, the focus for Health and Social Service departments across the nation is on welfare reform. She asked Ms. Perdue about other priorities during her tenure as commissioner. Number 1186 MS. PERDUE answered that she has spoken with the HESS Committee about prevention and the need to change the collective attitude toward issues. Ms. Perdue strongly feels that most children in Alaska are healthy and that most parents are doing good jobs. In addition, the schools are doing well. But the tendency is to focus on the 10 percent of the children who are driving 90 percent of the costs. That attitude needs to be changed in the DHSS so the department has the ability to cope with the problem better. The department needs the courage to focus on prevention. MS. PERDUE said that, using alcohol as an example, the answer to alcohol problems is not to do more treatment of the expensive cases at the community level to influence people's choices about their own lifestyles. Instead, the state must start with young children, and start with communities where people see pregnant women drinking. Ms. Perdue reminded HESS Committee members about the "Celebration of Life Project" in which women in a community surround a pregnant women who are in a situation where drinking is prevalent. Such programs do not cost a lot of money. These programs cost significantly less than the amount it will cost to take care of the baby if it is born with fetal alcohol effects or Fetal Alcohol Syndrome. However, few proactive programs like this are being used. MS. PERDUE said that the state talks about tough funding choices, but there might also be tough policy choices. This may be particularly true in relation to alcohol. Alcohol is driving most of the department's health costs. CO-CHAIR TOOHEY strongly agreed with Ms. Perdue that early education is where funding should go. Number 1275 CO-CHAIR BUNDE added his support to Ms. Perdue and expressed concern that the current system rewards the wrong people. The people who are the problem receive all the state's attention and resources. But the people who are in same circumstances and make something of their life, in spite of perhaps humble beginnings or challenges, receive little or no reward. He offered his assistance to Ms. Perdue in rectifying that situation. CO-CHAIR BUNDE continued that in Anchorage, there are about 50 people with alcohol problems who take up 80 to 90 percent of the community service patrol. Co-Chair Bunde asked if the state was doing a little more than simply delaying their death from alcoholism. He said it was a tough question as to whether or not their behavior is being changed. He said that such a question should be looked at by Ms. Perdue and the legislature. Number 1336 REPRESENTATIVE BRICE noticed that throughout the current session, there has been a lot of attention paid to prevention, children and public health issues. He wanted to remind HESS Committee members and audience members that those who have severe developmental or mental health disabilities must also be looked out for. He encouraged Ms. Perdue to continue the move toward appropriate community based services. He wanted that issue to remain a strong focus of the DHSS. CO-CHAIR BUNDE said there is a reasonable possibility that the hold harmless clause of the permanent fund dividend will not exists next year. One question is whether there should be a separation of welfare recipients between those who are disabled and those who are able-bodied. Co-Chair Bunde hopes that Ms. Perdue is preparing for the possibility that the Hold Harmless clause will not be part of the welfare system. Number 1410 MS. PERDUE said that the issue will warrant much administrative thought because each individual case will have to be looked at. That is where the expenses will lie. The hold harmless clause is one of the first waivers that DHSS negotiated with the federal government because the DHSS was looking at a nightmarish administrative process if they had to look at all 13,000 AFDC cases and all 12,000 public assistance cases. MS. PERDUE disagreed with the idea of not holding people harmless for that activity if they are not going to be held harmless for other state subsidies. However, that issue will be played out in the policy arena. The administrative issue is a real issue. The DHSS will have to have the resources to comply with the federal law. If it does not, the state will be paying error rates and penalties. This can get very expensive very quickly. MS. PERDUE explained that the federal government samples Alaska's cases. If there is one error in that sample, they will prevalence that error across the case load. So one small error of $100 can mean a penalty of $1 million. Currently, Alaska is a shining star because it does not make those errors. It has not paid penalties since the late 1970s, when Alaska had 28 percent error rates. Therefore, there could be some financial issues which arise if the state is not very careful beyond the policy issues of what dropping the hold harmless clause may mean to individuals. Number 1491 CO-CHAIR BUNDE felt it was safe to say that the vast majority of Alaskans have a philosophical difference about the hold harmless clause, and so those administrative issues may simply be a fact that must be dealt with. If all 12,000 must be studied individually, welfare may be put on less of an automatic cycle and more of an ongoing evaluation process. But those issues will have to be played out. REPRESENTATIVE ROBINSON said that in reference to those with able- bodies and those who are disabled, there is currently a direction in the legislature to possibly exempt those who are developmentally disabled from losing their PFDs. Representative Robinson said that many times there is a misunderstanding that a lot of people on welfare are not working. She asked if Ms. Perdue had statistics on how many people on military bases were receiving food stamps. Representative Robinson speculated that may be because of the low military pay. She asked Ms. Perdue how those people who are working would fit into the discussion. Number 1554 MS. PERDUE said that if the 12,000 seniors, blind people and others with disabilities were exempted from the hold harmless repeal, those left are members of the AFDC population. This includes 13,000 families and 25,000 kids. About 50 percent of those families only have one child, so they receive a $2000 check each month. A small percentage of those AFDC families have many children. Two months of hold harmless is equal to their assistance check. A good majority of those families have children under six years old. That is a large issue that needs to be noticed. MS. PERDUE felt that the loss of the medical support included in the hold harmless clause is as dangerous as the loss of the cash. Ms. Perdue wondered what that would mean to a person who was in the process of receiving care. The cash will have to be spent immediately, and Ms. Perdue felt that was a very poor habit to teach people. The cut in the continuity of medical coverage is a very serious issue. Number 1633 CO-CHAIR BUNDE asked how many of the 12,000 to which Ms. Perdue referred were senior citizens and how many were disabled. MS. PERDUE answered that the numbers were basically split down the middle. Approximately 4,500 are seniors, roughly 4,500 are developmentally disabled, and there is a fairly stable caseload of individuals who are blind, about 200 to 300 people. She stated that those areas have the largest caseload growth. People in Alaska are living longer, particularly in rural areas. This is a testament to Alaska's health care system. Number 1669 MS. PERDUE wanted to discuss one more issue. There are rules built upon rules of the hold harmless clause. Right now if a person is a recipient of Indian Health Services (IHS), and they are currently receiving medical care through this service, they can bill MedicAid at 100 percent federal funds. The DHSS is working very hard to increase that so state money is saved--up to 50 cents on every dollar. Right now, that amount equals about $14 million saved. Plans are in the works to perhaps double that amount by next year through working with the travel corporations. MS. PERDUE said that if MedicAid eligibility is affected for that population, those people will be denied their federal claim for their care. The person would have to be actively receiving care, either in the hospital or using an outpatient service. Number 1718 CO-CHAIR BUNDE told the committee that a form would be passed around to HESS Committee members for them to sign to pass the appointment of Karen Perdue on to the Speaker of the House. He reminded the committee that signing the form does not reflect any intention to vote for or against Ms. Perdue during further confirmation sessions. He asked HESS Committee members if there were any objections to this appointment being sent to the Speaker. Hearing no objection, he thanked Ms. Perdue. HHES - 02/14/95 CONFIRMATION HEARINGS FOR THE PROFESSIONAL TEACHING PRACTICES COMMISSION Number 1756 CO-CHAIR BUNDE announced that the committee would move forward to the Professional Teaching Practices Commission (PTPC) appointments. CHRISTINE NIEMI, Administrator for Teacher Education and Certification in the Alaska Department of Education (DOE), said she has been at the DOE since 1983. She was formally in the Educational Program Support Division in the special education area until 16 months ago, when she was moved into her present position. About a year ago, she was appointed to the PTPC to fill a term for someone who was unable to complete their term. MS. NIEMI then offered to answer questions for the HESS Committee members. Number 1796 CO-CHAIR BUNDE said that he has had the good fortune to work with Ms. Niemi on a teacher certification project which spanned about three years. He expressed his confidence in her abilities and her professional contributions to that endeavor. REPRESENTATIVE ROBINSON asked what the PTPC does. Number 1820 MS. NIEMI answered that the PTPC is a group of professional educators who are appointed to represent different groups. There are five teacher representatives, a member representing institutions of higher education, a representative of the DOE (Ms. Niemi), a member of the Principals' Association and a member of the Superintendents' Association. This group acts in disciplinary cases for teachers and administrators. For example, at the last meeting, two teacher's certificates were revoked for individuals who were involved with child abuse-type circumstances. CO-CHAIR BUNDE said that working with the PTPC was an important but probably not the most enjoyable job in education. REPRESENTATIVE ROBINSON noted that the HESS Committee members always hear concerns regarding the tenure policies. One of the main issues people have concerns about is that there is no way to remove a teacher who is not doing his or her job. Number 1877 CO-CHAIR BUNDE thought that Representative Robinson was asking about the district's policy for the removal of teachers. The members of the PTPC revoke the license of a teacher. REPRESENTATIVE ROBINSON wondered if a parent who had serious problems with a teacher could contact the PTPC. MS. NIEMI answered that the PTPC hears complaints. The executive director of the PTPC does investigate complaints, and some complaints come before subcommittees of the PTPC. Decisions are made on those complaints as well. However, the PTPC tries not to get involved in the hiring and general evaluation processes of teachers, administrators and school districts. REPRESENTATIVE ROBINSON surmised that there has probably been a criminal action before a case comes before the PTPC. The PTPC then determines whether or not an educator's license should be suspended. Number 1906 MS. NIEMI responded that was generally true, but the PTPC also hears. CO-CHAIR BUNDE asked if some disciplinary action has usually taken place before an educator would appear before the PTPC. MS. NIEMI said that generally, Co-Chair Bunde was correct. However, within the last year there was a case in which an individual was applying for a teacher's certificate and the PTPC investigated the individual. In this person's history was impropriety involving children. The PTPC subcommittee suggested that a certificate not be issued in this case. CO-CHAIR BUNDE asked how the PTPC knew this person had been involved in inappropriate activities with children. Number 1955 MS. NIEMI explained that in the code of ethics there is a statement which requires a person to report to the PTPC any knowledge of a teacher or individual in a teaching profession who has or is harming a child. Often the executive director of the PTPC will hear from a person who has such information. The reporting individual may call Ms. Niemi and she either reports the incident to the executive director or she encourages the reporting individual to contact the executive director. CO-CHAIR BUNDE asked for clarification on whether those reports are simply allegations or have they been investigated or looked at legally. He also asked if the PTPC was expected to act as a court of law. Number 2007 MS. NIEMI said that sometimes the report involves a conviction. In other cases, the PTPC has held a hearing in which evidence is submitted and a determination is made. A hearing officer is also there in such a situation to provide some guidance. The PTPC also has an attorney which advises the commission. REPRESENTATIVE BRICE asked in what other circumstances is a certificate pulled or revoked. MS. NIEMI answered that in one case, a police officer reported that an individual had a large marijuana garden, grown for more than personal use. REPRESENTATIVE BRICE asked if the police officer was unwilling to prosecute the individual for that offense. Ms. Niemi did not know such extenuating details. Representative Brice understood that there was a code of ethics to be enforced, and that a teacher's certificate could be revoked for statute violations. He asked what other information is used when determinations are made. He was unclear as to what processes were used to make allegations that brings the teacher before the PTPC, and under what instances does the PTPC act. Do they act only for ethics and statute violations, or are there other instances where the PTPC revokes a license. Number 2097 MS. NIEMI said that it was a very serious thing to revoke a license, so the allegations would have to be very serious, such as a conviction. In the case of person who grew marijuana, the evidence provided by the officer provided a preponderance of evidence. Therefore, the evidence must be substantial and substantiated. CO-CHAIR BUNDE stated that the discussion was straying from her qualifications for appointment. Representative Brice said that it was pertinent to know what Ms. Niemi's beliefs are, the role of the PTPC, and the process by which licenses are revoked. Co-Chair Bunde agreed that her beliefs are very pertinent, but he felt perhaps the process of the PTPC could be explored at anther time. Number 2139 BRIAN CARTER, Interim principal and teacher in the North Star School District, on teleconference from Salcha, said that he will still represent the PTPC in the role of teacher. He has served on the PTPC since fall, 1992. CO-CHAIR BUNDE asked Mr. Carter if he encountered a conflict between his roles as teacher and principal while representing teachers for the PTPC. MR. CARTER answered no, that experiences have allowed him to experience somewhat of an administrative internship for the last few years. He is still a legal representation of a teacher. Until the district hires him as an administrator he will represent teachers. Most of his experience has been as a teacher. He continued that his previous years' experiences have been very rewarding. MR. CARTER wanted to publicly commend the efforts of the executive director of the PTPC and her secretary. Number 2256 CO-CHAIR TOOHEY agreed with Mr. Carter on the capabilities of the executive director of the PTPC. She is a hero of Co-Chair Toohey's. REPRESENTATIVE ROBINSON prefaced her comments by saying that her question may be somewhat uncomfortable for Mr. Carter. She said that unfortunately, his name is not on the list that was given to the legislature by Governor Knowles. She asked Mr. Carter how he felt about that, and if he planned on keeping his name on the confirmation list although his name was not picked by the Governor. MR. CARTER answered that he wanted to remain on the list, and that this was the first he had heard of his absence from the list. He knew that there was a nontransmittal letter for all appointees when the hearings were before the Senate HESS Committee. TAPE 95-7, SIDE B Number 085 WILLIAM McCAIN, teacher, Chugiak Elementary School, made his statements via teleconference from Chugiak Elementary School. He has been in the Anchorage School District as a Physical Education teacher for 14 years. He has spent 24 years total in the education profession at all levels. He has taught kindergarten to high school. He taught in Washington state for many years and taught in Australia for three years. MR. McCAIN stated that he was on his second term with the PTPC. He joined the commission in the fall, 1992. Although the PTPC deals with some very troubling cases at times, the work is very interesting and satisfying because you do feel like you are "policing the ranks." With 30,000 certified teachers in Alaska, of which 8,000 are active, the job is formidable. MR. McCAIN also commended the executive secretary of the PTPC and her staff. He offered to answer questions on how cases are given to the PTPC. CO-CHAIR BUNDE declined the offer, and asked instead for responses to specific questions. He suggested, however, that Mr. McCain contact Representative Brice's office to answer questions that Representative Brice may have. Number 160 MARY LOU MADDEN, Provost and Vice President of Sheldon Jackson College, testified via teleconference from Sitka. She is a new appointee to the PTPC. She has 20 years of experience in Alaskan education, with everything from preschool to graduate work in both the public and private sector. She wants to be on the PTPC because she is interested in professional ethics. These issues are important not only for the teaching profession but also (indisc. - coughing). She is interested in being a part of holding teachers to the standards of professional behavior that benefit not only students but the educational system in general. CO-CHAIR BUNDE congratulated Ms. Madden on her appointment at Sheldon Jackson College. He asked if her work on the PTPC would interfere with her work as Provost and vice versa. Ms. Madden said there would be no interference. As a matter of fact, there is a teacher education program at the college which she feels will help her. Her positions can also help the teacher education program by her insuring that ethics are a part of teacher rating. She sees her two appointments as working hand in hand. Number 261 CO-CHAIR BUNDE thanked and commended the appointees for taking on the difficult task of cleansing the profession of those who would weaken it. Co-Chair Bunde then reiterated that if the names are passed forward it does not reflect the intent of any member to vote for or against a nomination. CO-CHAIR BUNDE asked if there were any objections to the appointments being sent to the speaker. REPRESENTATIVE ROBINSON asked if the individuals could be taken one at a time. CO-CHAIR BUNDE said yes. There were no objections to sending forth the names Christine Niemi, Mary Lou Madden or William McCain. Representative Robinson objected to Brian Carter. A roll call vote was asked for. Voting yes for the passage of Brian Carter were Representatives Bunde, Vezey, Rokeberg and Toohey. Voting no were Representatives Robinson and Brice. Number 381 REPRESENTATIVE ROBINSON wanted Mr. Carter to know that the "no" votes had nothing to do with his qualifications, they only reflected dissatisfaction with the process and her beliefs that the appointments the HESS Committee members should be addressing are those that have been sent by Governor Knowles. CO-CHAIR BUNDE announced that all names will be sent to the Speaker of the House. HHES - 02/14/95 HJR 18 - SUPPORT MEDICAL SAVINGS ACCOUNT LEGISLATION Number 475 ROD MOURANT, Administrative Assistant to Representative Pete Kott, apologized on behalf of Representative Kott for his absence and thanked the committee for hearing HJR 18. Mr. Mourant said that all but two of the current members of the HESS Committee saw and voted on this exact legislation last session. The resolution passed unanimously from the House, but subsequently died in the Senate Rules Committee at adjournment. MR. MOURANT then read the sponsor statement: As medical costs nationally and in Alaska continue to rise, the need for innovative approaches to health care cost containment becomes more acute. The concept behind Medical Savings Accounts is to encourage employees to shop more carefully for medical services. It recommends the purchase of high deductible coverage by employers. The savings realized by this effort results in reduced health insurance premiums. These savings are then placed by the employers in individual employee Medical Savings Accounts. Employee Medical Savings Accounts then may be used by employees to purchase additional, more specific insurance coverage and to pay deductibles incurred under employer provided or employee purchased medical coverage plans. Medical Savings Accounts belong to the individual employee and move with the individual to purchase health insurance when between jobs or for coverage when re-employed, even when with a different employer. The additional benefit to Medical Savings Accounts is that they allow the individual to select and purchase coverage at reduced cost without a new federal bureaucracy and would be revenue neutral to employers. It is compatible with the free market in that it protects individual freedom and rewards prudent decision making. HJR 18 urges Congress to enact legislation that will make Medical Savings Accounts a viable option in the national effort to reduce and contain health care costs. Number 620 CO-CHAIR BUNDE asked if there was any current legislation on the national level which would change the need for this resolution. MR. MOURANT said that at this time he is not aware of any nationally introduced legislation. However, this certainly is a concept that has been discussed at the national level. In the resolution packets HESS Committee members could find a series of articles that describe medical savings accounts and their use. MR. MOURANT also pointed out that one recent article, from the Wall Street Journal, says that support for medical savings accounts is growing. Six states, Arizona, Colorado, Mississippi, Idaho, Missouri and Michigan, have changed their tax structure to accommodate medical savings accounts. The United Mine Workers Union has signed a new five year contract with a health plan that includes a $1,000 bonus that workers can use to pay their medical plan's $1,000 deductible. Mine workers still have first dollar coverage but the first $1,000 they now spend will be their own money, rather than the company's. MR. MOURANT concluded that Representative Kott believes that kind of incentive on the part of those covered is a good incentive to reducing the overall costs of health insurance in this country. Number 693 CO-CHAIR TOOHEY asked how Representative Kott will handle the welfare and MedicAid recipients of Alaska. MR. MOURANT answered that this legislation does not address that issue. It only addresses those who are employed and currently covered. Number 714 REPRESENTATIVE AL VEZEY felt that the resolution was excellent. Health care costs are a national problem, driven by the Internal Revenue Service's regulations. However, there have been a number of companies who provide health care insurance for their employees who have experimented with this. Those companies have experienced substantial reductions in medical costs as a result of allowing their employees to accrue a medical savings account which is income they can take if they don't use it. MR. MOURANT said that Representative Vezey makes a very valid point. The resolution seeks not only reduced expense in medical coverage and medical services, but, in addition, the money remains with the individual. If, at the time of retirement, the individual still has a positive balance in their account, they are able to take that to buy an annuity if they desire, or to help out in their retirement years. CO-CHAIR BUNDE said that a great deal of research shows that people with sick leave on a use-it or lose-it program are ill much more frequently. Number 791 REPRESENTATIVE ROBINSON asked Mr. Mourant to explain the process to her. She wondered how this would work for an interested individual and what exactly the steps would be. MR. MOURANT answered that a typical state employee pays about $465 dollars for health insurance on a monthly basis. The medical savings account would allow the employer, the state of Alaska, to purchase a major emergency medical coverage plan at a much reduced premium than the detailed coverage plan that exists today. Employees would still be covered for catastrophic injury and emergency care, but because of the reduced premium the state may save between $200 and $300 per employee per year. That money is placed into an individual account for the employee to use to shop for additional coverage if he or she chooses to have it. This is much like the option that exists right now for selecting dependent medical coverage. MR. MOURANT continued that the balance can be used to pay any deductible that might be present in the coverage that the employer buys for the employees. Number 870 MR. MOURANT said that if, through prudent use in health care coverage selection, the employee still has a savings account balance upon retirement, he or she can convert that into an annuity or other such account. Number 883 CO-CHAIR TOOHEY commended the bill. She said that most of us spend about $100 to $200 on medical coverage every year. Catastrophic coverage will take over if a person gets appendicitis or is hit by a car or some such tragedy. Number 914 REPRESENTATIVE BRICE asked Mr. Mourant if the accounts would be tax deductible. MR. MOURANT answered that he was not sure what Representative Brice was asking. He said they would be tax deductible for the employer because the account would be a payroll expense. For the employee, it would depend on how the code is structured. Mr. Mourant feels that the accounts are much like the employer match on the Supplemental Benefits System (SBS). When an employee starts to receive that employer match, Mr. Mourant assumes that would be taxable income. Number 954 REPRESENTATIVE ROKEBERG'S understanding was that the accounts are, in essence, tax neutral. The benefit in the end is the savings which is tax free money the employee can have. It would depend who would make the contribution of the up-front capital. That would be a taxable event. REPRESENTATIVE VEZEY commented that the plans he has seen would involve a change in Internal Revenue Service codes. The bank account is, as Representative Rokeberg said, tax deductible. Should the employee use it for medical services it is not tax liability. If the money is taken for personal income it would be taxable. Number 995 REPRESENTATIVE VEZEY moved that HJR 18 be passed from the committee with individual recommendations. There were no objections. CO-CHAIR BUNDE announced that HJR 18 had been moved from the HESS Committee to the next committee of referral. Number 1016 ADJOURNMENT CO-CHAIR BUNDE adjourned the meeting at 4:10 p.m.