ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        February 9, 2010                                                                                        
                           3:08 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Bob Herron, Co-Chair                                                                                             
Representative Wes Keller, Co-Chair                                                                                             
Representative Tammie Wilson, Vice Chair                                                                                        
Representative Bob Lynn                                                                                                         
Representative Paul Seaton                                                                                                      
Representative Sharon Cissna                                                                                                    
Representative Lindsey Holmes                                                                                                   
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
PRESENTATION BY THE MAT-SU SUBSTANCE ABUSE PREVENTION COALITION.                                                                
                                                                                                                                
     - HEARD                                                                                                                    
                                                                                                                                
HOUSE JOINT RESOLUTION NO. 35                                                                                                   
Proposing amendments  to the Constitution  of the State  of Alaska                                                              
prohibiting passage  of laws that  interfere with  direct payments                                                              
for health  care services  and the right  to purchase  health care                                                              
insurance  from  a privately  owned  company,  and that  compel  a                                                              
person to participate in a health care system.                                                                                  
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 168                                                                                                              
"An  Act  relating  to  state  certification  and  designation  of                                                              
trauma centers;  creating  the uncompensated  trauma care  fund to                                                              
offset  uncompensated  trauma  care   provided  at  certified  and                                                              
designated trauma centers; and providing for an effective date."                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HJR 35                                                                                                                  
SHORT TITLE: CONST AM: HEALTH CARE                                                                                              
SPONSOR(s): REPRESENTATIVE(s) KELLY, KELLER, P.WILSON, GATTO                                                                    
                                                                                                                                
01/08/10       (H)       PREFILE RELEASED 1/8/10                                                                                
01/19/10       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/10       (H)       HSS, JUD, FIN                                                                                          
02/09/10       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 168                                                                                                                  
SHORT TITLE: TRAUMA CARE CENTERS/FUND                                                                                           
SPONSOR(s): REPRESENTATIVE(s) COGHILL                                                                                           
                                                                                                                                
03/09/09       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/09/09       (H)       HSS, FIN                                                                                               
04/09/09       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/09/09       (H)       Heard & Held                                                                                           
04/09/09       (H)       MINUTE(HSS)                                                                                            
02/09/10       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ELIZABETH RIPLEY, Executive Director                                                                                            
Mat-Su Health Foundation;                                                                                                       
Chair, Mat-Su Substance Abuse Prevention Coalition                                                                              
Wasilla, Alaska                                                                                                                 
POSITION  STATEMENT:     Presented   a  PowerPoint   and  answered                                                            
questions   about  substance   abuse   in  the   Matanuska-Susitna                                                              
Borough.                                                                                                                        
                                                                                                                                
STEPHANIE ALLEN, Executive Director                                                                                             
United Way of Mat-Su                                                                                                            
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:   Testified and answered questions  during the                                                            
presentation.                                                                                                                   
                                                                                                                                
NICOLE JEFFRIES, Student                                                                                                        
Wasilla High School                                                                                                             
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
ROBYN HILLMAN, Student                                                                                                        
Wasilla High School                                                                                                             
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
JESSICA TRUMAINE, Student                                                                                                       
Valley Pathways School                                                                                                          
Sutton, Alaska                                                                                                                  
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
HANNAH SMITH, Student                                                                                                           
Wasilla High School                                                                                                             
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
PATRICK GONZER, Student                                                                                                         
Wasilla High School                                                                                                             
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
DEB HAYNES, Teacher                                                                                                             
Wasilla High School                                                                                                             
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
DESIREE COMPTON                                                                                                                 
United Way of Mat-Su                                                                                                            
Wasilla, Alaska                                                                                                                 
POSITION STATEMENT:   Testified  and answered questions  about the                                                            
Mat-Su  Substance  Abuse  Prevention   Coalition  and  the  Alaska                                                              
Healthy Kids Survey.                                                                                                            
                                                                                                                                
REPRESENTATIVE MIKE KELLY                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:     As  the  prime  sponsor,   presented  and                                                            
answered questions for HJR 35.                                                                                                  
                                                                                                                                
MIKE PRAX                                                                                                                       
North Pole, Alaska                                                                                                              
POSITION STATEMENT:  Testified in support of HJR 35.                                                                          
                                                                                                                                
PEGGY ANN MCCONNOCHIE                                                                                                           
National Federation of Independent Business (NFIB)                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HJR 35.                                                                          
                                                                                                                                
CHRISTIE HERRERA, Director                                                                                                      
Health and Human Services Task Force                                                                                            
American Legislative Exchange Council (ALEC)                                                                                    
Washington, DC                                                                                                                  
POSITION STATEMENT:  Testified and answered questions in support                                                              
of HJR 35.                                                                                                                      
                                                                                                                                
SENATOR JOHN COGHILL                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified and answered questions as the                                                                  
prime sponsor of HB 168.                                                                                                        
                                                                                                                                
DAVID HULL, Chair                                                                                                               
Alaska Council on Emergency Medical Services (ACEMS)                                                                            
Ketchikan, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 168.                                                                          
                                                                                                                                
DR. FRANK SACCO, Trauma Director                                                                                                
Alaska Native Medical Center;                                                                                                   
Chair                                                                                                                           
Alaska State Trauma Systems Review Committee                                                                                    
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 168.                                                                          
                                                                                                                                
DR. REGINA CHENNAULT, Chair                                                                                                     
American College of Surgeons Committee on Trauma                                                                                
Alaska Trauma System Review Committee                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 168.                                                                   
                                                                                                                                
MARK JOHNSON                                                                                                                    
Alaska Trauma System Review Committee                                                                                           
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 168.                                                                          
                                                                                                                                
WARD HURLBURT, Chief Medical Officer;                                                                                           
Director                                                                                                                        
Division of Public Health                                                                                                       
Office of the Commissioner                                                                                                      
Department of Health and Social Services (DHSS)                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 168.                                                                   
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:08:23 PM                                                                                                                    
                                                                                                                                
CO-CHAIR BOB  HERRON called the  House Health and  Social Services                                                            
Standing    Committee   meeting    to   order    at   3:08    p.m.                                                              
Representatives  Herron,  Keller,   T.  Wilson,  and  Cissna  were                                                              
present at the  call to order.  Representatives  Lynn, Seaton, and                                                              
Holmes arrived as the meeting was in progress.                                                                                  
                                                                                                                                
^Presentation   by   the   Mat-Su   substance   abuse   prevention                                                              
coalition.                                                                                                                      
 Presentation by the Mat-Su substance abuse prevention coalition.                                                           
                                                                                                                                
3:08:44 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON announced  that the first order  of business would                                                              
be  a  presentation  by  the  Mat-Su  Substance  Abuse  Prevention                                                              
Coalition.                                                                                                                      
                                                                                                                                
3:10:27 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER introduced the coalition.                                                                                       
                                                                                                                                
3:11:27 PM                                                                                                                    
                                                                                                                                
ELIZABETH RIPLEY,  Executive Director,  Mat-Su Health  Foundation;                                                              
Chair,  Mat-Su Substance  Abuse  Prevention  Coalition, said  that                                                              
substance  abuse impacts  every sector  of our  community and  our                                                              
economy.   She  pointed  to the  economic  and  emotional toll  on                                                              
families  and  individuals,   and  declared  that   the  cost  was                                                              
staggering.   She  directed  attention to  each  of the  coalition                                                              
members  and  the various  reasons  for  their involvement.    The                                                              
attending  members   included  Nicole  Jeffries,   Robyn  Hillman,                                                              
Jessica  Trumain, Hannah  Smith, Patrick  Gonzer, Desire  Compton,                                                              
Deb Haynes, and  Gretchen Geist, and each shared  their reason for                                                              
becoming involved with the Coalition.                                                                                           
                                                                                                                                
3:16:27 PM                                                                                                                    
                                                                                                                                
MS.  RIPLEY  endorsed  that  a   key  to  breaking  the  cycle  of                                                              
substance abuse  was to  engage youth, and  she commended  each of                                                              
the  people  who  contributed  to make  this  presentation.    She                                                              
directed  attention to  the  PowerPoint, "Mat-Su  Substance  Abuse                                                              
Prevention Coalition  Data Project."   [Included in  the committee                                                              
packet.]                                                                                                                        
                                                                                                                                
3:16:52 PM                                                                                                                    
                                                                                                                                
MS. RIPLEY  described slide  1, "Mission,"  and declared  that the                                                              
focus was on youth in the local community.                                                                                      
                                                                                                                                
3:17:13 PM                                                                                                                    
                                                                                                                                
MS.  RIPLEY introduced  slide 2,  "Overview" and  slide 3,  "Brief                                                              
History," and detailed  the history of the coalition.   She shared                                                              
that  United  Way of  America  had  tasked  the local  United  Way                                                              
groups  to become  community impact  organizations.   She  further                                                              
explained  that the  model of  engagement was  to determine  "what                                                              
hurts  your community,  or what  changes  could you  make at  your                                                              
local level  that you could measure  progress in to  effect change                                                              
in quality of life."   She stated that this affected  every member                                                              
agency of United  Way.  She reported that the first  step had been                                                              
to meet  with the local behavioral  health providers where  it was                                                              
agreed  that the  problem had  to  be addressed  at the  community                                                              
level  to  have  any  impact.    She  reported  that,  after  this                                                              
meeting,  a substance  abuse summit  was held  in December,  2006,                                                              
and  four goals  were  set: form  a  coalition  using tobacco  use                                                              
cessation as  a model,  be data  driven for measureable  progress,                                                              
coordinate  a community response,  and provide  leadership  at the                                                              
state level.                                                                                                                    
                                                                                                                                
3:22:26 PM                                                                                                                    
                                                                                                                                
MS.  RIPLEY moved  to slide  4,  "Method," and  reported that  the                                                              
council  had reviewed  the  existing data  on  substance abuse  in                                                              
Mat-Su; as  very little  data existed,  a five year  retrospective                                                              
study of  local data was commissioned,  with input from  the local                                                              
providers  to determine  meaningful  data.   She  stated that  the                                                              
Youth Risk Behavior  Survey (YRBS) data from 2005-06  reflected an                                                              
insufficient sample  size.  She  shared the importance of  the new                                                              
data survey,  both as a benchmark  and a measurement  of progress.                                                              
She  remarked that  the group  commissioned its  own survey,  "The                                                              
Alaska  Healthy   Kids  Survey,"  (AHKS)  and  tested   it  to  be                                                              
culturally  appropriate   and  valid  as  a  survey   tool.    She                                                              
clarified that  it was financed  by the Mat-Su Health  Foundation,                                                              
with no federal or state funds.                                                                                                 
                                                                                                                                
3:24:29 PM                                                                                                                    
                                                                                                                                
STEPHANIE  ALLEN,  Executive  Director,   United  Way  of  Mat-Su,                                                              
recognized  slide 5 "Alaska  Healthy Kids  Survey," and  explained                                                              
each  of  the   survey  components,  which   included  demographic                                                              
information,  and information  on the behaviors  and attitudes  of                                                              
substance  abuse.   She noted  the segments  on alcohol,  tobacco,                                                              
drug use,  violence, harassment,  safety, and  crime.   She talked                                                              
about  the External  Assets  component which  examined  resilience                                                              
factors, protective  factors, and positive assets  associated with                                                              
a decrease  in risky  behaviors.  She  presented slide  6, "Survey                                                              
Demographics,"  and shared  that  the survey  was administered  to                                                              
all seventh,  ninth, and  eleventh graders  throughout the  school                                                              
district,  which included  Christian  schools,  home schools,  and                                                              
homeless and  at-risk youth.  She  detailed that 2435 of  the 4000                                                              
surveys, 61 percent, were valid responses.                                                                                      
                                                                                                                                
MS. ALLEN,  in response  to Co-Chair  Herron,  said that the  YRBS                                                              
survey  was  very  broad  and  included  questions  about  health,                                                              
exercise,  sexual activity,  and substance  abuse behaviors.   She                                                              
explained that  this survey focused  on substance abuse  and youth                                                              
use.                                                                                                                            
                                                                                                                                
3:27:19 PM                                                                                                                    
                                                                                                                                
MS. ALLEN  noted that  slide 7,"Demographics,"  was a  demographic                                                              
breakdown of the students' surveyed.                                                                                            
                                                                                                                                
3:27:30 PM                                                                                                                    
                                                                                                                                
MS. RIPLEY,  in response to  Representative Seaton, said  that the                                                              
demographics  did correlate  to  the Mat-Su  families with  youth,                                                              
but was slightly different than the community as a whole.                                                                       
                                                                                                                                
MS. ALLEN considered  slide 8, "Results," and reported  that after                                                              
receiving  the data, the  Coalition met  with stakeholder  groups,                                                              
enlisted  feedback  from  more than  130  community  members,  and                                                              
developed the  priorities for  a strategic plan.   She  turned the                                                              
presentation over to the youth leaders.                                                                                         
                                                                                                                                
3:29:16 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  asked that each presenter detail  "what surprised                                                              
them and what did not surprise them."                                                                                           
                                                                                                                                
3:29:41 PM                                                                                                                    
                                                                                                                                
NICOLE  JEFFRIES,  Student,  Wasilla High  School,  explained  the                                                              
slide  format: the  question at  the  top, its  definition in  the                                                              
middle, and  the results from middle  and high school  students at                                                              
the bottom.   She referred  to slide 9, "Meaningful  participation                                                              
from  adults in  the  community," and  listed  the definitions  to                                                              
each  included involvement  outside  the home  and  school:   with                                                              
personal  interests, with  group activities,  and/or with  helping                                                              
other people.   She shared that  only 20 percent of  middle school                                                              
students and 18  percent of high school students  felt involvement                                                              
with adults in the community.                                                                                                   
                                                                                                                                
MS. JEFFRIES  moved to  slide 10,  "Meaningful participation  with                                                              
adults at  home," which  included doing  fun things with  parents,                                                              
doing  things  at   home  that  made  a  difference,   and  making                                                              
decisions with the  family.  She reported that only  25 percent of                                                              
middle  school students  and 21  percent of  high school  students                                                              
felt involved with adults at home.                                                                                              
                                                                                                                                
3:31:15 PM                                                                                                                    
                                                                                                                                
MS.  JEFFRIES provided  slide 11,  "Meaningful participation  with                                                              
adults at  school," which  included doing interesting  activities,                                                              
deciding  things  like  class  activities  and  rules,  and  doing                                                              
things  at school  that make  a  difference.   She disclosed  that                                                              
only 6.4 percent  of middle school and 5.5 percent  of high school                                                              
students felt engaged with adults at school.                                                                                    
                                                                                                                                
3:31:43 PM                                                                                                                    
                                                                                                                                
MS. JEFFRIES  furnished slide  12, "Recommendation  1," and  noted                                                              
that data suggested  youth turn to substances because  of boredom.                                                              
She  recommended  that  providing  meaningful  relationships  with                                                              
youth would result in their stronger resilience to challenges.                                                                  
                                                                                                                                
3:32:14 PM                                                                                                                    
                                                                                                                                
ROBYN HILLMAN,  Student, Wasilla  High School, supplied  slide 13,                                                              
"Are  parents talking  to  their kids  about  substance use?"  and                                                              
ascertained from  the pie graph  that 36 percent of  middle school                                                              
and 42  percent of high  school students  did not talk  with their                                                              
parents about substance use.                                                                                                    
                                                                                                                                
3:32:39 PM                                                                                                                    
                                                                                                                                
MS.  HILLMAN reviewed  slide  14,  "What age  do  our youth  start                                                              
using?"  and  slide  15,  "Age   at  first  use,"  and  noted  the                                                              
comparative  use   of  alcohol,  cigarettes,   smokeless  tobacco,                                                              
marijuana, and  other illegal  drugs by youth  ages 10  and under,                                                              
14 and under, and 15 - 18.                                                                                                      
                                                                                                                                
3:33:21 PM                                                                                                                    
                                                                                                                                
MS.  HILLMAN introduced  slide 16,  slide  17, and  slide 18,  all                                                              
entitled "Parent  Perception of  Use."   The slides reflected  the                                                              
response  to  asking   how  parents  would  feel   about  drinking                                                              
regularly,  smoking   cigarettes,  or  smoking  marijuana.     She                                                              
acknowledged  that  one parent  could  supply many  students  with                                                              
cigarettes,  alcohol,   or  marijuana.    She  pointed   out  that                                                              
prevention needed to begin in the elementary schools.                                                                           
                                                                                                                                
3:34:33 PM                                                                                                                    
                                                                                                                                
MS. HILLMAN  continued on to  slide 19, "Recommendation  2," which                                                              
suggested  to "Increase  parental  involvement  in prevention  and                                                              
early intervention measures in the Mat-Su Community."                                                                           
                                                                                                                                
3:34:54 PM                                                                                                                    
                                                                                                                                
JESSICA  TRUMAINE,  Student,  Valley  Pathways  School,  explained                                                              
slides 20  - 22, all entitled  "Are substances difficult  to get?"                                                              
and  discussed the  access  to  tobacco, alcohol,  and  marijuana.                                                              
She referred  to the pie graphs  on each slide, and noted  that 54                                                              
percent  of  youth surveyed  deemed  tobacco  easy to  obtain,  56                                                              
percent  deemed alcohol  easy  to obtain,  and  47 percent  stated                                                              
marijuana was easy to obtain.                                                                                                   
                                                                                                                                
3:36:09 PM                                                                                                                    
                                                                                                                                
MS.  TRUMAINE shared  that slide  23, "Recommendation  3," was  to                                                              
reduce the  access to these substances.   She related  that Mat-Su                                                              
youth  were using  a variety  of  substances and  the majority  of                                                              
students reported  that alcohol, tobacco, and marijuana  were easy                                                              
to obtain.                                                                                                                      
                                                                                                                                
3:36:43 PM                                                                                                                    
                                                                                                                                
HANNAH  SMITH, Student,  Wasilla High  School, directed  attention                                                              
to  slide 24,  "Data  comparisons," and  explained  that the  next                                                              
series  of slides  would show  graphs comparing  data of  tobacco,                                                              
alcohol,  and marijuana use  from three  separate surveys:  Alaska                                                              
Healthy  Kids Survey  (AHKS),  Monitoring  the Future  (MTF),  and                                                              
Youth  Risk Behavior  Survey  (YRBS).   She  summarized slide  26,                                                              
"Tobacco  Lifetime  Cigarette  Use,"  slide 27,  "Tobacco  30  Day                                                              
Cigarette  Use," slide  28,  "Tobacco Lifetime  Smokeless  Tobacco                                                              
Use,"  and slide  29, "Tobacco  30 Day  Smokeless Tobacco  [Use]."                                                              
She  pointed out  that each  graph illustrated  the percentage  of                                                              
use by study and by school grade.                                                                                               
                                                                                                                                
MS. SMITH,  in response to  Representative Seaton,  explained that                                                              
MTF was a national survey, but was not conducted in Alaska.                                                                     
                                                                                                                                
MS. SMITH,  referring to  slide 28,  opined that  "we have  a very                                                              
large issue  with smokeless tobacco."   She pointed out  that high                                                              
school  use  of smokeless  tobacco  in  the Mat-Su  community  was                                                              
higher than  in the  nation.   She offered  her belief  that young                                                              
students were  using smokeless  tobacco and that  "if we  wait, we                                                              
are missing the  train, we are completely missing them  if we wait                                                              
until middle  school and  high school  to talk  to them,  they are                                                              
already doing it, they have already tried it."                                                                                  
                                                                                                                                
MS.  TRUMAINE,  in response  to  Co-Chair  Herron, said  that  the                                                              
substances, especially  alcohol and cigarettes, were  in the homes                                                              
and easy to  get.  She said  that older friends were  also able to                                                              
provide these.                                                                                                                  
                                                                                                                                
MS.  SMITH  added   that  prescription  pills  are   often  easily                                                              
accessible in home medicine cabinets.                                                                                           
                                                                                                                                
MS. SMITH, in  response to Co-Chair Herron, said  that tobacco use                                                              
was "not a big  deal."  She disclosed that only  a handful of kids                                                              
felt that  tobacco was  not good for  you, and strongly  advocated                                                              
against the use.                                                                                                                
                                                                                                                                
3:44:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LYNN  asked if both use and increase  was equal for                                                              
both sexes.                                                                                                                     
                                                                                                                                
MS. SMITH replied that she would supply that data.                                                                              
                                                                                                                                
3:45:17 PM                                                                                                                    
                                                                                                                                
PATRICK  GONZER, Student,  Wasilla High  School, introduced  slide                                                              
30,  "Alcohol,"  listing the  negative  effects of  alcohol  which                                                              
included   impaired   judgment,   liver   disease,   cancer,   and                                                              
dependence.   He summarized  slide 31,  "Alcohol Lifetime  Alcohol                                                              
Use,"  slide 32,  "Alcohol  30 Day  Alcohol  Use,"  and slide  33,                                                              
"Alcohol 30  Day Binge  Drinking."  He  directed attention  to the                                                              
AHKS  survey,  and  noted  that  68 percent  of  his  peers  drink                                                              
alcohol.   He expressed  his surprise  to the  high percentage  of                                                              
alcohol use  among seventh graders.   He described  binge drinking                                                              
as "the  typical party scene" and  shared that the  survey defined                                                              
it as five or more drinks in one sitting.                                                                                       
                                                                                                                                
3:47:15 PM                                                                                                                    
                                                                                                                                
MR.  GONZER  discussed  slide  34,   "Marijuana,"  and  noted  the                                                              
negative   effects  to   be  impaired   judgment,  problems   with                                                              
intellectual functioning,  and a greater risk of  lung infections.                                                              
He indicated  slide 35,  "Lifetime Marijuana  Use," and  slide 36,                                                              
"30  Day  Marijuana  Use,"  and  expressed  his  concern  that  46                                                              
percent  of his peers  had used  marijuana.   He ascertained  that                                                              
almost  18  percent   of  seventh  and  ninth   graders  had  used                                                              
marijuana.                                                                                                                      
                                                                                                                                
3:48:24 PM                                                                                                                    
                                                                                                                                
MR. GONZER,  in response  to Co-Chair  Herron, declared  that more                                                              
than  2400 students  at  Houston,  Wasilla, Valley  Pathways,  and                                                              
Burchell High  Schools, as  well as  home schools, at-risk  youth,                                                              
and Christian school students, had participated in the survey.                                                                  
                                                                                                                                
3:49:03 PM                                                                                                                    
                                                                                                                                
MS. TRUMAINE observed  that the discussion to this  point had been                                                              
about  alcohol, tobacco,  and marijuana.   She  offered slide  37,                                                              
"Substance  Use Totals,"  and noted  that 68  percent of  eleventh                                                              
graders used  alcohol.  She moved  on to slide 38,  "Substance use                                                              
Totals,"  and  pointed  to meth,  cocaine,  heroin,  ecstacy,  and                                                              
hallucinogen  use for ninth  and eleventh  graders.  She  compared                                                              
that  although hallucinogens  had  a 13  percent  use by  eleventh                                                              
graders,  alcohol use  was substantially  higher.   She  expressed                                                              
her surprise that  so many under 14 youth were  using alcohol, and                                                              
determined  that the  focus [for  reduced use]  should begin  with                                                              
alcohol.   She  opined  that alcohol  was in  every  home and  was                                                              
easily accessible.                                                                                                              
                                                                                                                                
3:51:17 PM                                                                                                                    
                                                                                                                                
MS.  TRUMAINE   summarized  slide  39,  "Recommendation   4,"  and                                                              
suggested that  it was necessary  to increase community  awareness                                                              
and get the  community more involved.   She pointed out  that on a                                                              
national scale,  Alaska ranked  second for  illicit drug  use, and                                                              
sixth for  binge drinking  among adults.   She offered  her belief                                                              
that binge  drinking was  the "very normal  party scene"  and that                                                              
it would continue.                                                                                                              
                                                                                                                                
3:52:03 PM                                                                                                                    
                                                                                                                                
DEB HAYNES, Teacher,  Wasilla High School, said that  she was also                                                              
a private  mental health practitioner.   She confirmed  that slide                                                              
40, "Experiences  from Alcohol and  Drugs," described  high school                                                              
students' reactions  when they used drugs and alcohol.   She noted                                                              
that about  25 percent said  that they  did not have  any problem,                                                              
but that  75 percent had  a variety of  experiences.   She pointed                                                              
to  the  small   number  of  students  who  needed   therapy,  and                                                              
reflected  that  these  were  the  "very high  end  users"  as  it                                                              
required  a lot  of use  to get  into  therapy.   She shared  that                                                              
students often confided  in her, as she was a  human relations and                                                              
psychology teacher.                                                                                                             
                                                                                                                                
3:55:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  HOLMES,  responding  to  a remark  by  Ms.  Haynes                                                              
during her  testimony, asked  if confidentiality  was allowed  for                                                              
high school athletes and who the athletes could speak with.                                                                     
                                                                                                                                
MS. HAYNES  replied that  that there  was not any  confidentiality                                                              
privilege  for  athletes,  as  teachers   and  counselors  had  an                                                              
obligation to report  knowledge that any athlete was  a user.  She                                                              
acknowledged,  in response  to  Representative  Holmes, that  this                                                              
was a state  rule.  She opined  that it was  extremely troublesome                                                              
for her to have  to report any athletes who confided  in her.  She                                                              
clarified  that  she  made  her  obligation  clear  before  anyone                                                              
confided in her.                                                                                                                
                                                                                                                                
3:57:08 PM                                                                                                                    
                                                                                                                                
MS. HAYNES  reported the  reason for the  collection of  this data                                                              
was because the YRBS data was not made available to them.                                                                       
                                                                                                                                
3:57:49 PM                                                                                                                    
                                                                                                                                
DESIREE  COMPTON,  United  Way   of  Mat-Su,  explained  that  the                                                              
community  had  set  up  the  Mat-Su  Substance  Abuse  Prevention                                                              
Coalition to address  issues at a community level  in a culturally                                                              
appropriate  and  cost-effective way.    She furnished  slide  41,                                                              
"Coalitions are  an effective solution"  and pointed to  the graph                                                              
which  reflected  that the  Drug  Free Coalition  (DFC)  coalition                                                              
areas  had  significantly  lower  substance  use  rates  than  the                                                              
national average.   She affirmed  that the Coalition  was applying                                                              
for DRC  grants to aid  its funding and  teaching.   She indicated                                                              
slide  42,  "Our  Coalition,"  and  detailed  that  the  Coalition                                                              
included leaders  from 12  sectors of  the community,  and focused                                                              
on  prevention by  identifying  the  risk factors  and  underlying                                                              
problems.    She shared  that  the  Coalitions utilized  data  and                                                              
information from  the community leaders, as well  as environmental                                                              
strategies, to  influence community  standards and policies.   She                                                              
emphasized  that the  direction  was to  change  the social  norms                                                              
about drinking.   She advocated for law and policy  changes, which                                                              
included  increasing  parental  awareness.   She  highlighted  its                                                              
effort  to  coincide  with  the  state  plan  to  reduce  underage                                                              
drinking   by  utilizing   youth  leaders   for  local   messaging                                                              
campaigns.                                                                                                                      
                                                                                                                                
4:01:30 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   T.  WILSON   asked   if   allowing  students   to                                                              
participate in surveys would effectively disconnect parents.                                                                    
                                                                                                                                
MS. COMPTON opined  that parents would still be able  to not allow                                                              
participation in any given survey.                                                                                              
                                                                                                                                
4:02:14 PM                                                                                                                    
                                                                                                                                
MS. COMPTON  remarked  on slide  43, "Call to  Action," and  urged                                                              
for an  understanding of  the law and  the powerful  messages that                                                              
it demonstrated,  involvement  with the  local coalition's  goals,                                                              
and support of funding for local research and prevention.                                                                       
                                                                                                                                
4:04:03 PM                                                                                                                    
                                                                                                                                
CO-CHAIR KELLER  lauded the efforts  of the Coalition.   He opined                                                              
that  the economic  cost of  substance  abuse was  "mind-blowing,"                                                              
and he issued a challenge for other communities to move forward.                                                                
                                                                                                                                
The committee took an at-ease from 4:05 p.m. to 4:08 p.m.                                                                       
                                                                                                                                
                  HJR 35-CONST AM: HEALTH CARE                                                                              
                                                                                                                                
4:08:26 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  announced that the  next order of  business would                                                              
be  HOUSE JOINT  RESOLUTION  NO. 35  Proposing  amendments to  the                                                              
Constitution of  the State of  Alaska prohibiting passage  of laws                                                              
that interfere with  direct payments for health  care services and                                                              
the  right to  purchase  health care  insurance  from a  privately                                                              
owned  company, and  that  compel  a person  to  participate in  a                                                              
health care system.                                                                                                             
                                                                                                                                
4:09:10 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MIKE KELLY,  Alaska  State Legislature,  discussed                                                              
the proposed national  health care system and the  backlash to the                                                              
mandated  single payer  system.   He  noted that  35 other  states                                                              
were  also in  opposition  to the  proposed  national health  care                                                              
system.   He  explained that  HJR 35  would protect  the right  to                                                              
choose participation  in any given  health care system,  and would                                                              
prohibit and  fines or  penalties for  failure to participate;  it                                                              
would  protect the  right to  purchase or  provide lawful  medical                                                              
services  without  government fines,  interference  or  penalties.                                                              
He  emphasized  that  HJR  35 would  place  these  rights  in  the                                                              
Constitution of the  State of Alaska.  He offered  his belief that                                                              
the majority  of Alaskans opposed  mandated health care,  and that                                                              
this mandate  could result in  a lawsuit.   He opined that  the U.                                                              
S.  Supreme Court  would lean  toward the  protection of  personal                                                              
choice of health care.                                                                                                          
                                                                                                                                
4:14:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  declared that  he recognized the  intent of                                                              
HJR  35, and  he directed  attention  to the  proposed Section  2,                                                              
which  stated in  part: "no  law shall  be passed  that compels  a                                                              
person,  employer, or  health care  provider to  participate  in a                                                              
health  care system..."   He  asked if  this would  not allow  the                                                              
state to initiate a new tier of the retirement system.                                                                          
                                                                                                                                
4:15:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   KELLY  replied  that   he  would  research   that                                                              
question.                                                                                                                       
                                                                                                                                
4:16:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   HOLMES  referred   to  Medicare,  Indian   Health                                                              
Services, and  other similar medical  plans, and pointed  out that                                                              
these  had limits  which violated  the language  of HJR  35.   She                                                              
expressed concern  that this  would tie  the hands of  legislators                                                              
for any  future changes and  pointed specifically to  the language                                                              
in Section  2 (b) which stated:  "prohibits a person from  or that                                                              
penalizes  a person  for making  direct payment  to a health  care                                                              
provider for tendering health care services."                                                                                   
                                                                                                                                
4:18:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLY  offered his belief that HJR 35  did not have                                                              
any effect  on programs already in  place.  He reiterated  that it                                                              
reinforced personal choice.                                                                                                     
                                                                                                                                
4:20:05 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  HERRON  asked  Representative   Kelly  where  the  House                                                              
Health and  Social Services  Standing Committee  should focus  its                                                              
policy  debate,  and  then  where   he  believed  that  the  House                                                              
Judiciary Standing Committee would focus.                                                                                       
                                                                                                                                
4:20:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLY suggested  that each  committee should  look                                                              
at whether  HJR 35 was "in  the best overall health  care interest                                                              
of the state."                                                                                                                  
                                                                                                                                
4:22:07 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  clarified that proposed  HJR 35 would be  held in                                                              
the  committee until  the following  week, and  he suggested  that                                                              
the House  Health and  Social Services  Standing Committee  debate                                                              
the health and social services aspect of it.                                                                                    
                                                                                                                                
4:22:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CISSNA  cited that  more than 100,000  Alaskans did                                                              
not have  health coverage.   She  shared that  there were  already                                                              
capacity problems  within the health  care system, and  she voiced                                                              
"that we are a  state that is addicted to addictions."   She asked                                                              
how HJR  35 addressed  the health  care problems  in Alaska.   She                                                              
noted the difficulty of access to health care for many Alaskans.                                                                
                                                                                                                                
4:25:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLY,  in  response   to  Representative  Cissna,                                                              
disclosed  that he  had served  on  a hospital  foundation for  20                                                              
years.   He  agreed that  the current  health care  system was  in                                                              
need of  improvement.  He opined  that the government  element was                                                              
a  disincentive  for  doctors  and that  the  more  separated  the                                                              
patient  was  from  the  provider  and the  cost,  the  worse  the                                                              
situation became.   He offered  his belief  that the heart  of the                                                              
problem  for the  health care  system  was government  centralized                                                              
control.                                                                                                                        
                                                                                                                                
4:28:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked for clarifications that  HJR 35 would                                                              
not prevent  the federal government  from passing a law,  but that                                                              
it  would  stop  future  legislatures   from  adopting  a  federal                                                              
program.                                                                                                                        
                                                                                                                                
4:30:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLY replied  that  the least  effect  of HJR  35                                                              
would be  to send a signal  to the federal government  that Alaska                                                              
was  against additional  federal  controls  over medical  choices.                                                              
He said  the strictest  application would  be Alaska's  refusal to                                                              
comply with a federal mandate.                                                                                                  
                                                                                                                                
4:32:43 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  asked  to  clarify  that  HJR  35  was  an                                                              
amendment to the  Constitution of the State of  Alaska to restrict                                                              
the legislature  from passing a law,  even if that law  was in the                                                              
public interest.   He questioned if the proposed  resolution would                                                              
prevent the  state from  adopting a  medical plan without  passing                                                              
or repealing a constitutional amendment.                                                                                        
                                                                                                                                
4:33:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLY agreed.                                                                                                    
                                                                                                                                
4:34:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE T.  WILSON asked if Representative  Kelly had heard                                                              
any concerns from the public.                                                                                                   
                                                                                                                                
4:34:25 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLY  replied that  worries  about  a "head  butt                                                              
with  the  federal  government"   and  complications  to  existing                                                              
programs were the two concerns.                                                                                                 
                                                                                                                                
4:34:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  T.  WILSON  asked   if  those  two  concerns  were                                                              
stronger than  the "fear that people  have with being  forced into                                                              
a program  that they  don't want  and us sitting  back as  a state                                                              
acting like we don't care."                                                                                                     
                                                                                                                                
4:35:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLY offered  his  belief  that the  overwhelming                                                              
response was in support of HJR 35.                                                                                              
                                                                                                                                
4:35:23 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  KELLER, as  a  prime co-sponsor  of  the bill,  reported                                                              
that Arizona  had vetted  this legislation, and  that most  of the                                                              
questions  had already  been answered.   He  said that  "precisely                                                              
what  the bill does,  it forbids  any  law that we  have would  be                                                              
unconstitutional that  would forbid an individual in  the State of                                                              
Alaska  from  securing  medical   care  outside  of  the  required                                                              
medical system  that is there."   He opined that  the constitution                                                              
was the law  of the land and  that this resolution would  be voted                                                              
on by the people.                                                                                                               
                                                                                                                                
4:37:19 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON  opened public  testimony and  said that  he would                                                              
hold it open.                                                                                                                   
                                                                                                                                
4:37:33 PM                                                                                                                    
                                                                                                                                
MIKE PRAX  offered his support  for HJR 35  as it "might set  up a                                                              
confrontation between  the state  and the federal  government over                                                              
this   particular   issue."      He  opined   that   the   federal                                                              
administration  assumed  it had  absolutely  authority and  power.                                                              
He  asked   that  the  resolution   be  passed  to   protect  "the                                                              
individual right to make decisions."                                                                                            
                                                                                                                                
4:39:21 PM                                                                                                                    
                                                                                                                                
PEGGY  ANN   MCCONNOCHIE,  National   Federation  of   Independent                                                              
Business  (NFIB),  shared that  she  and  her husband  were  small                                                              
business owners.   She  offered her belief  that the  single payer                                                              
health  care system  did  not  fit for  Alaskans,  as  it did  not                                                              
provide  lower  cost,  greater   availability,  or  choice.    She                                                              
emphasized  that   she  was  totally  against  what   the  federal                                                              
government was trying  to do.  She offered her  opinion that small                                                              
business owners  would easily go  out of business  with additional                                                              
federal fees.   She encouraged the protection of  small businesses                                                              
from unreasonable  taxation, and any mandates for  health care for                                                              
employees.                                                                                                                      
                                                                                                                                
4:42:25 PM                                                                                                                    
                                                                                                                                
CHRISTIE  HERRERA,  Director,  Health   and  Human  Services  Task                                                              
Force,  American Legislative  Exchange  Council (ALEC),  explained                                                              
that  ALEC was  a  non-partisan organization  of  lawmakers.   She                                                              
offered  support for  HJR  35.   She offered  the  belief that  it                                                              
would ensure  continued access  to health  services and  the right                                                              
to pay  directly for health  services.   She opined that  it would                                                              
stop mandates that  did not work, as a government  requirement for                                                              
health insurance  was ineffective, bureaucratic, and  costly.  She                                                              
summarized that the  cornerstone of any reform  was the protection                                                              
of patients' rights.                                                                                                            
                                                                                                                                
4:45:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  directed attention to the  proposed Section                                                              
2, which stated  in part: "no law  shall be passed that  compels a                                                              
person,  employer, or  health care  provider to  participate  in a                                                              
health care system..."   He asked if this issue had  arisen in any                                                              
other jurisdiction  and would it  restrict the state's  ability to                                                              
initiate a new tier of the state retirement system.                                                                             
                                                                                                                                
MS.  HERRERA agreed  with  Representative Kelly  that  this was  a                                                              
forward  looking  bill, and  would  not affect  current  programs.                                                              
She  stated that  there was  no intent  to affect  any safety  net                                                              
programs.   She  agreed  that it  would  preclude  the state  from                                                              
enacting an individual  or an employer mandate  to purchase health                                                              
coverage.                                                                                                                       
                                                                                                                                
4:47:07 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON stated that he would keep public testimony open.                                                                
                                                                                                                                
[HJR 35 was held over.]                                                                                                         
                                                                                                                                
                HB 168-TRAUMA CARE CENTERS/FUND                                                                             
                                                                                                                                
4:48:03 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON announced  that the final order  of business would                                                              
be HOUSE  BILL NO.  168, "An Act  relating to state  certification                                                              
and  designation of  trauma  centers; creating  the  uncompensated                                                              
trauma care fund  to offset uncompensated trauma  care provided at                                                              
certified  and designated  trauma  centers; and  providing for  an                                                              
effective date."                                                                                                                
                                                                                                                                
SENATOR  JOHN COGHILL,  Alaska State  Legislature, explained  that                                                              
HB  168 created  an account  for improving  trauma care  delivery.                                                              
He explained  that the  Department of  Health and Social  Services                                                              
(DHSS)  commissioner would  create regulations  based on  national                                                              
standards  for trauma  care, and  evaluate  each delivery  system.                                                              
He referenced  the packet,  "Alaska Trauma  Center," [Included  in                                                              
the members  packets] which the  information presented  during the                                                              
prior  year.    He  shared  that   this  was  just  one  incentive                                                              
suggested by the  College of Surgeons to the State  of Alaska.  He                                                              
reported  that   DHSS  had  created  a  trauma   response  systems                                                              
administrator.   He detailed  that he had  met with  the Emergency                                                              
Medical  Services Council,  and  was encouraged  by  its focus  on                                                              
response systems,  especially in remote  areas.  He  expressed the                                                              
need  to  better  coordinate  emergency   response  systems.    He                                                              
detailed the desire  to create a fund to incentivize  hospitals to                                                              
enhance  trauma   care.    He   suggested  putting   money  toward                                                              
uncompensated care  as it would  allow hospitals to  contract with                                                              
more  doctors for  emergency trauma  care.   He  pointed out  that                                                              
Alaska had  24 acute care hospitals,  but only 1 Level  Two trauma                                                              
center.   He requested a systemic  approach to emergency  response                                                              
systems, and opined  that creating incentives was a  good place to                                                              
begin.   He pointed  out that discussions  were taking  place with                                                              
military doctors for  a licensing structure to allow  them to work                                                              
with the  civilian  hospitals.   He summarized  that the two  most                                                              
critical  issues  were  equipping  the medical  personnel  in  the                                                              
remote parts  of Alaska,  and creating a  fund to incentivize  the                                                              
hospitals to enhance the trauma care.                                                                                           
                                                                                                                                
4:55:37 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON opened public testimony.                                                                                        
                                                                                                                                
4:55:52 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  HERRON  read  a  statement  from  Representative  Cissna                                                              
[original punctuation provided]:                                                                                                
                                                                                                                                
     "Mr. Chair:   I have  an unavoidable conflict  and won't                                                                   
     be  able to  remain  in this  meeting.   Broadening  the                                                                   
     discussion   with   all   stakeholders   would   be   an                                                                   
     improvement.   Increasing  other  incentives also  would                                                                   
     be beneficial.   I am in  favor of passage of  this bill                                                                 
     (as well as strengthening the bill.)"                                                                                      
                                                                                                                                
4:56:15 PM                                                                                                                    
                                                                                                                                
DAVID HULL,  Chair, Alaska Council  on Emergency  Medical Services                                                              
(ACEMS), testified  that he was speaking  on behalf of  ACEMS.  He                                                              
opined that trauma  calls were increasing every year.   He defined                                                              
trauma as any bodily  injury from an external source,  and that it                                                              
could  be accidental  or intentional.   He  quoted statistics  for                                                              
death  and hospitalizations.    He  shared that  a  study in  2004                                                              
revealed  that the  hospital  stay for  trauma  patients was  more                                                              
than $73 million,  and that 1 in  4 was not compensated  care.  He                                                              
defined a  trauma system as  a "pre-determined, organized,  multi-                                                              
disciplinary  response  to  managing  the care  and  treatment  of                                                              
severely  injured people,"  and that a  statewide system  provided                                                              
"a  framework  for  disaster  preparedness   and  response."    He                                                              
emphasized that  the most important  time frame for survival  of a                                                              
severely  injured   person  was   the  time  between   injury  and                                                              
definitive  care,  "the Golden  Hour."    He  opined that  it  was                                                              
necessary for increased  hospital participation for  the statewide                                                              
trauma system to  function optimally.  He shared that  the goal of                                                              
the statewide trauma  system was to ensure that  every hospital in                                                              
Alaska was  a designated trauma  center.  He testified  in support                                                              
of funding for  the development of trauma centers,  incentives for                                                              
trauma  care designation,  and  uncompensated  patient  care.   He                                                              
offered support for HB 168.                                                                                                     
                                                                                                                                
4:59:31 PM                                                                                                                    
                                                                                                                                
DR. FRANK  SACCO, Trauma Director,  Alaska Native  Medical Center;                                                              
Chair,  Alaska State  Trauma Systems  Review Committee,  explained                                                              
that trauma was  the leading cause of death for  Alaskans under 44                                                              
years  of age,  and that  Alaska had  the second  highest rate  of                                                              
trauma in  the U.S.   He opined  that a  good trauma system  would                                                              
decrease the  mortality by 15-25  percent.  He reflected  on prior                                                              
legislation  which  was only  voluntary  with no  incentives,  and                                                              
consequently,  there  was  only  one  Level  2  Trauma  Center  in                                                              
Alaska.   He  summarized an  American College  of Surgeons  review                                                              
that "the  achievements to date  have been largely  unplanned with                                                              
limited coordination;  as the result, incongruity  exists with the                                                              
current trauma  system."   He commended  the Alaska Native  health                                                              
facilities for working  toward trauma designation,  but he decried                                                              
the  lack  of  commitment  for  "achieving  nationally  recognized                                                              
standards  of  trauma  care"  from most  health  facilities.    He                                                              
stated that  Alaska was the  only state  without a Level  2 Trauma                                                              
Center  for the  majority of  the population,  and that  Anchorage                                                              
was the  largest city  in the United  States without  a designated                                                              
Level  1  or  Level  2 trauma  center  for  the  majority  of  the                                                              
population.   He expressed support  for HB 168, and  declared that                                                              
it was not a partisan issue.                                                                                                    
                                                                                                                                
5:04:06 PM                                                                                                                    
                                                                                                                                
DR.  REGINA   CHENNAULT,  Chair,  American  College   of  Surgeons                                                              
Committee  on  Trauma,  Alaska  Trauma  System  Review  Committee,                                                              
expressed concern  that Alaska  did not  have a designated  trauma                                                              
hospital for the  general public.  She reported that  Alaska had a                                                              
lot of  trauma, with a  lot of domestic  violence.   She requested                                                              
that   an  organized,   systems   approach  to   trauma  care   be                                                              
implemented as soon as possible.                                                                                                
                                                                                                                                
5:05:30 PM                                                                                                                    
                                                                                                                                
MARK JOHNSON, Alaska  Trauma System Review Committee,  opined that                                                              
[trauma]  care  would  be  improved  if  more  hospitals  met  the                                                              
national standards.   He referred to the 2008  American College of                                                              
Surgeons   review   of   Alaska  hospitals   which   included   70                                                              
recommendations,  of  which  16  were  listed  as  priority.    He                                                              
supported the incentives within HB 168.                                                                                         
                                                                                                                                
5:07:30 PM                                                                                                                    
                                                                                                                                
WARD  HURLBURT,  Chief  Medical  Officer;  Director,  Division  of                                                              
Public Health,  Office of the  Commissioner, Department  of Health                                                              
and Social  Services (DHSS), shared  his personal experience  as a                                                              
trauma physician.   He  shared that trauma  was the  third highest                                                              
cause of  death in Alaska,  and the highest  cause for ages  up to                                                              
44  years.   He  reflected on  the  American  College of  Surgeons                                                              
trauma  system review  and  noted with  concern  that the  "trauma                                                              
infrastructure's  unplanned,  under  developed,  under  resources,                                                              
and  lacks sufficient  coordination  and  integration."   He  also                                                              
expressed  the administration's  concern  that  Anchorage was  the                                                              
largest city  in the  U.S. without  Level 1  or 2 trauma  centers.                                                              
He shared that  the administration encouraged  collaboration among                                                              
the health  care systems  and the  development  of a "more  mature                                                              
trauma system."   He  stated that  the administration  was neutral                                                              
on HB 168.                                                                                                                      
                                                                                                                                
5:11:55 PM                                                                                                                    
                                                                                                                                
CO-CHAIR HERRON noted a proposed amendment for funding.                                                                         
                                                                                                                                
5:12:23 PM                                                                                                                    
                                                                                                                                
SENATOR COGHILL  replied that  it was a  good amendment,  but that                                                              
the funding would be drawn from the general fund.                                                                               
                                                                                                                                
5:12:48 PM                                                                                                                    
                                                                                                                                
[HB 168 was held over.]                                                                                                         
                                                                                                                                
                                                                                                                                
5:13:28 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 5:13 p.m.