ALASKA STATE LEGISLATURE  HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE  April 11, 2013 3:03 p.m. MEMBERS PRESENT Representative Pete Higgins, Chair Representative Wes Keller, Vice Chair Representative Benjamin Nageak Representative Lora Reinbold Representative Paul Seaton Representative Geran Tarr MEMBERS ABSENT  Representative Lance Pruitt COMMITTEE CALENDAR  COMMITTEE SUBSTITUTE FOR SENATE BILL NO. 87(HSS) "An Act requiring screening of newborns for congenital heart defects; and providing for an effective date." - MOVED CSSB 87(HSS) OUT OF COMMITTEE PREVIOUS COMMITTEE ACTION  BILL: SB 87 SHORT TITLE: NEWBORN SCREENING FOR HEART DEFECTS SPONSOR(s): SENATOR(s) MICCICHE 03/27/13 (S) READ THE FIRST TIME - REFERRALS 03/27/13 (S) HSS, FIN 04/01/13 (S) HSS AT 1:30 PM BUTROVICH 205 04/01/13 (S) Heard & Held 04/01/13 (S) MINUTE(HSS) 04/06/13 (S) HSS RPT CS 3DP SAME TITLE 04/06/13 (S) DP: STEDMAN, MICCICHE, KELLY 04/06/13 (S) HSS AT 11:00 AM BUTROVICH 205 04/06/13 (S) Moved CSSB 87(HSS) Out of Committee 04/06/13 (S) MINUTE(HSS) 04/10/13 (S) FIN RPT CS(HSS) 6DP 04/10/13 (S) DP: MEYER, HOFFMAN, OLSON, BISHOP, FAIRCLOUGH, DUNLEAVY 04/10/13 (S) TRANSMITTED TO (H) 04/10/13 (S) VERSION: CSSB 87(HSS) 04/10/13 (S) FIN AT 9:00 AM SENATE FINANCE 532 04/10/13 (S) PFD ALLOWABLE ABSENCE 04/11/13 (H) HSS AT 3:00 PM CAPITOL 106 WITNESS REGISTER SENATOR PETE MICCICHE Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Introduced SB 87 as the sponsor of the bill. JILL LEWIS, Deputy Director-Juneau Division of Public Health Department of Health and Social Services Juneau, Alaska POSITION STATEMENT: Testified during discussion of SB 87. JENNA APP American Heart Association Anchorage, Alaska POSITION STATEMENT: Testified in support of SB 87. REPRESENTATIVE MAX GRUENBERG Alaska State Legislature Juneau, Alaska POSITION STATEMENT: Testified in support of SB 87. ACTION NARRATIVE 3:03:30 PM CHAIR PETE HIGGINS called the House Health and Social Services Standing Committee meeting to order at 3:03 p.m. Representatives Higgins, Nageak, Tarr, and Seaton were present at the call to order. Representatives Keller and Reinbold arrived as the meeting was in progress. SB 87-NEWBORN SCREENING FOR HEART DEFECTS  3:04:15 PM CHAIR HIGGINS announced that the only order of business would be CS FOR SENATE BILL NO. 87(HSS), "An Act requiring screening of newborns for congenital heart defects; and providing for an effective date." 3:04:28 PM SENATOR PETE MICCICHE, Alaska State Legislature, speaking as the sponsor of SB 87, shared an anecdote about his recently born niece, who had been born with three congenital heart defects. Fortunately, she was born in a hospital where this testing procedure was offered, and the defects were quickly discovered. He declared that an estimated one in every hundred children was born with congenital heart defects, and that this resulted in death for more children in the first year of life than any other birth defects. He announced that 13 states had already adopted laws for this testing with an additional 20 states considering legislation. He declared the necessity for testing newborns. He listed the hospitals that were already testing for congenital heart defects in Alaska. He explained that the procedure for testing was very simple, painless and non-invasive, using pulse oximetry, which measured the oxygen level of the blood. He reported that this screening detected more than 75 percent of critical heart defects, as well as other life threatening conditions in newborns, including pneumonia, and that the test cost less than $10 and was covered by most insurance. He reported that the equipment cost between $500 and $1000. He declared that there had not been any opposition to the proposed bill. 3:08:22 PM REPRESENTATIVE SEATON asked if the proposed bill would require those having home births to do the procedure, and, if so, was the equipment portable. SENATOR MICCICHE, in response, said that the smaller hospitals, clinics, midwives, and birthing centers had until January 2016 to arrange for testing. 3:09:29 PM CHAIR HIGGINS reported that a pulse oximeter was not expensive, was battery operated, and offered printable read outs, noting that he had paid $400 - $600. He declared that it was difficult to believe that any medical facility did not already have this piece of equipment, and he recommended that all facilities have one. 3:10:20 PM SENATOR MICCICHE clarified that the effective date allowed three years for the smaller facilities to comply. CHAIR HIGGINS emphasized the importance of the first 24 - 48 hours, noting that this procedure could not be administered until after the first 24 hours. 3:12:35 PM CHAIR HIGGINS opened public testimony. 3:12:42 PM JILL LEWIS, Deputy Director-Juneau, Division of Public Health, Department of Health and Social Services, clarified that she was an administrator, not a medical professional, and that there were other members of the department available to testify. She offered to answer any questions about the fiscal note, or other items. 3:13:32 PM REPRESENTATIVE TARR, referring to the fiscal note [Included in members' packets], asked about the cost to Medicaid enrollees being already included in global fees paid for delivery services. She asked about any other services included in this same category. 3:13:55 PM MS. LEWIS replied that recipients paid a flat rate, and that this procedure would be included. She said that she did not know of the other services which were included. 3:14:29 PM REPRESENTATIVE SEATON asked if the Division of Public Health had any qualms about including midwives and other small providers outside hospitals in the proposed bill. MS. LEWIS replied that the time frame was adequate for compliance by the smaller providers. 3:15:11 PM JENNA APP, American Heart Association, declared that the American Heart Association supported proposed SB 87, as it would ensure that newborns in Alaska were screened, prior to discharge, for critical congenital heart disease using a low cost, non-invasive screening tool. She explained that these common, but critical, congenital heart defects, were a leading cause of death in infants, if not treated. She reported that the test measured the pulse rate and the amount of oxygen in a baby's blood. It was quick and effective. She noted that the pulse oximetry test would catch many diagnosis missed by health care professionals and would save lives. 3:17:11 PM REPRESENTATIVE MAX GRUENBERG, Alaska State Legislature, said that this procedure had saved a baby's life on the first day that legislation had been passed for this in New Jersey. He declared that many other states had now adopted this legislation. He stated his support for the bill and the lives it would save. 3:19:22 PM The committee took an at-ease from 3:19 p.m. to 3:21 p.m. 3:21:00 PM REPRESENTATIVE TARR expressed her appreciation for the proposed bill, and said that this was "a life and death kind of decision." 3:21:42 PM REPRESENTATIVE SEATON pointed out that there was an effective date of January 1, 2014, which he opined would allow enough time for compliance. 3:22:13 PM CHAIR HIGGINS reported that many of his medical colleagues were already performing this test. REPRESENTATIVE REINBOLD offered a personal anecdote regarding a congenital heart defect in her family. 3:23:02 PM CHAIR HIGGINS closed public testimony. 3:23:15 PM REPRESENTATIVE REINBOLD moved to report CSSB 87(HSS), as amended, out of committee with individual recommendations and the accompanying zero fiscal notes. No objection was stated. The committee took an at-ease from 3:23 p.m. to 3:27 p.m. 3:27:41 PM REPRESENTATIVE KELLER moved to rescind the committee's action in moving the bill out of committee. There being no objection, it was so ordered. 3:27:45 PM REPRESENTATIVE REINBOLD moved to report CSSB 87(HSS) out of committee with individual recommendations and the accompanying zero fiscal notes. There being no objection, CSSB 87(HSS) was moved from the House Health and Social Services Standing Committee. 3:28:04 PM The committee took a brief at-ease. 3:29:05 PM CHAIR HIGGINS brought the committee back to order. 3:29:28 PM ADJOURNMENT  There being no further business before the committee, the House Health and Social Services Standing Committee meeting was adjourned at 3:29 p.m.