ALASKA STATE LEGISLATURE
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
February 25, 2008
1:37 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Thomas, Vice Chair
Senator Kim Elton
Senator Fred Dyson
MEMBERS ABSENT
Senator John Cowdery
COMMITTEE CALENDAR
SENATE BILL NO. 267
"An Act requiring certain persons licensed by the State Medical
Board to document an infant's prenatal exposure to alcohol in
the infant's medical file."
HEARD AND HELD
SENATE BILL NO. 243
"An Act relating to the duties and powers of the Alaska
Commission on Aging and the Department of Health and Social
Services."
MOVED CSSB 243 (HES) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 267
SHORT TITLE: DOCUMENT PRENATAL ALCOHOL EXPOSURE
SPONSOR(s): SENATOR(s) DAVIS
02/13/08 (S) READ THE FIRST TIME - REFERRALS
02/13/08 (S) HES, FIN
02/25/08 (S) HES AT 1:30 PM BUTROVICH 205
BILL: SB 243
SHORT TITLE: COMMISSION ON AGING
SPONSOR(s): SENATOR(s) DAVIS
01/19/08 (S) READ THE FIRST TIME - REFERRALS
01/19/08 (S) HES, FIN
02/25/08 (S) HES AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
JANA KREOFSKY, Intern
To Senator Davis
Alaska State Capitol
Juneau, AK
POSITION STATEMENT: Presented an overview of SB 267.
THOMAS OBERMEYER, Staff
to Senator Davis
Alaska State Capitol
Juneau, AK
POSITION STATEMENT: Introduced SB 243.
DIANE CASTO, Manager
Prevention and Early Intervention Services
Division of Behavioral Health (DBH)
Department of Health and Social Services (DHSS)
Juneau, AK
POSITION STATEMENT: Supported SB 267.
PEGGY METCALF, representing herself
Juneau, AK
POSITION STATEMENT: Supported SB 267.
KJ METCALF, representing himself
Juneau, AK
POSITION STATEMENT: Supported SB 267.
RIC IANNALINO, Coordinator
FASD Diagnostic Clinic
Central Council of the Tlingit Haida Indian Tribes
Tribal Family Youth Services
Juneau, AK
POSITION STATEMENT: Supported SB 267.
GLADYS EVE RECKLEY, representing herself
Juneau, AK
POSITION STATEMENT: Supported SB 267.
JAN RUTHERDALE, Senior Assistant Attorney General
Civil Division
Child Protection Section
Alaska Department of Law
Juneau, AK
POSITION STATEMENT: Opposed SB 267.
GEORGE BROWN MD, representing himself
Douglas, AK
POSITION STATEMENT: Supported SB 267.
ALPHEUS BULLARD, Attorney at Law
Legislative Legal and Research Services Division
Legislative Affairs Agency
Alaska State Capitol
Juneau, AK
POSITION STATEMENT: Drafted the bill and answered questions
regarding legal aspects of SB 267.
JOANNE GIBBONS, Health Program Manager
Department of Health and Social Services (DHSS)
Division of Senior and Disability Services
Juneau, AK
POSITION STATEMENT: Supported SB 243.
DENISE DANIELLO, Executive Director
Alaska Commission on Aging
Department of Health and Social Services (DHSS)
Juneau, AK
POSITION STATEMENT: Supported SB 243.
ACTION NARRATIVE
CHAIR BETTYE DAVIS called the Senate Health, Education and
Social Services Standing Committee meeting to order at 1:37:43
PM . Present at the call to order were Senators Dyson and Davis.
Senators Thomas and Elton arrived soon thereafter.
SB 267-DOCUMENT PRENATAL ALCOHOL EXPOSURE
CHAIR DAVIS announced consideration of SB 267.
JANA KREOFSKY, Intern, Senator Davis, presented an overview of
SB 267. She said it mandates that health care professionals
record an infant's exposure to prenatal alcohol in the infant's
medical file with the mother's consent. This information is
designed to assist with early diagnosis of Fetal Alcohol
Spectrum Disorders (FASD) when applicable. Early diagnosis and
intervention have been shown to reduce the risk of developing
secondary disabilities such as difficulty in school, trouble
maintaining employment, mental health problems, and drug and
alcohol addiction. Due to the ambiguous nature of many of the
symptoms of FASD, misdiagnosis is common. Documentation of
prenatal alcohol exposure in the infant's file could aid medical
professionals in making more accurate diagnoses. The bill would
limit use of information pertaining to prenatal alcohol use by
the mother to purposes of diagnosis, treatment, and care. It
comports with the FAS surveillance project recommendations found
in "Fetal Alcohol Syndrome Prevalence in Alaska." Health care
providers should be encouraged to document the details of
maternal alcohol use during pregnancy in the child's medical
chart.
THOMAS OBERMEYER, Staff, Senator Davis, drew the committee's
attention to the zero fiscal note.
1:40:51 PM
SENATOR DYSON asked if Diane Casto intended to testify and
lauded her for her hard work to create the state's current
program for FASD.
1:41:58 PM
DIANE CASTO, Manager, Prevention and Early Intervention
Services, Division of Behavioral Health (DBH), Department of
Health and Social Services, said she was a former Director of
the Office of Fetal Alcohol Syndrome. At that time, Alaska was
one of the only states that had an office dedicated to FAS. The
Department of Health and Social Services (DHSS) supported the
concept of this bill, but recognized that the Department of Law
had concerns.
MS. CASTO said Alaska was using a "Gold Standard" diagnostic
process called the four digit diagnostic code developed by
Doctors Susan J. Astley, [Ph.D., Professor of Epidemiology] and
Sterling K. Clarren of the University of Washington. It looks at
four specific areas of concern and rates them to come up with a
diagnosis.
° Facial features - There are specific facial
dismorphologies in someone with the full FAS
diagnosis.
° Growth deficiency
° Central nervous system
° Known maternal alcohol use - This is the most
difficult to assess.
MS. CASTO said diagnostic teams have access only to a child's
medical records, not the mother's, which is appropriate. They
did not want to create a system that would be perceived as
targeting women, but felt there should be some way to document
known maternal alcohol use in the child's record, in order to
get appropriate services to the child.
MS. CASTO said that, as a strong proponent of civil rights, she
felt a mother should have to give her consent to document that
information, but was afraid that many women would choose not to
allow it for fear of retribution. She suggested that line 13 [12
and 13] of the bill, which read "(b) Information received under
this section may not be used except for the purposes of
providing medical diagnosis, treatment, or care" Should be
amended to read:
12 (b) Information received under this section may not
be used except for the
13 purposes of providing medical diagnosis, treatment,
or care of the child.
MS. CASTO digressed to point out that the 12 month age limit is
not enforced with regard to reporting FAS to the Birth Defects
Registry. The State of Alaska mandates that, if a medical
provider knows a child has been prenatally exposed to alcohol,
the provider must report it to the Birth Defects Registry.
Unlike all other types of birth defects, prenatal exposure to
alcohol can be reported up to the age of six because the
information is not often discovered within the first year.
However, that information cannot be accessed to help in an FASD
diagnosis. She added that, at least 20 percent of the time,
diagnostic teams were unable to document maternal drinking
during pregnancy, which led to a lesser diagnosis or a diagnosis
that did not get the child the needed services.
1:49:28 PM
SENATOR DYSON said the last time he discussed this with Ms.
Casto, Alaska led the nation in prenatal alcohol poisoning of
children. He asked if she could tell the committee where she
sensed Alaska was in the ranking at the time of this meeting.
MS. CASTO agreed that the State of Alaska did lead the nation in
prenatal alcohol exposure. One reason was that the state in
general and the Alaska native health organizations specifically,
did an excellent job of tracking this disability. Another reason
was that many states do not keep this data. Of the states that
do keep the data however, we continued to be at the top of the
list, although she said they were starting to see a small
downward trend.
SENATOR DYSON asked if it was true that there was no sure way to
diagnose fetal alcohol effects unless they could document that
the mother drank during pregnancy.
MS. CASTO replied that was mostly true. In the diagnostic
process you could see static encephalopathy, which means
permanent damage to the brain, so you could document the
disability without knowing the cause.
SENATOR DYSON asked if it would be found in a brain scan of some
kind.
MS. CASTO responded that brain scans were coming, but currently
it was found most often through psychological testing, speech
and language, physical therapy etc.
SENATOR DYSON clarified that he meant in infants. He asked if
Ms. Casto would get together with legal to draft an amendment
regarding permissions.
CHAIR DAVIS advised the Senator that they had already worked
with legal on this issue.
1:53:59 PM
SENATOR ELTON and SENATOR THOMAS joined meeting.
SENATOR DYSON said it was his understanding that this was first
documented at the University of Washington Hospital, when a
doctor noticed that many children with similar symptoms also
displayed similar facial features.
SENATOR ELTON returned to line 13 and asked if this type of
information would be available to an insurance agent or company
that might not be willing to pay for the care.
MS. CASTO admitted that she did not know; it was something she
had not thought of.
SENATOR THOMAS expressed concern about the issue of maternal
permission to document the information.
MS. CASTO assured Senator Thomas that this is a critical issue
and one they have grappled with for some time. FASD is one
disability that is clearly caused by the mother, which makes it
different from other disabilities in that there is tremendous
guilt, and placing this in the child's record documents the fact
that mom caused the child's disability.
1:58:43 PM
MS. CASTO stressed that somehow we need to get away from blame
and work with the mothers. We need to do a better job of
educating mothers before they get pregnant; to make sure we have
treatment and services available for those who get pregnant and
are still drinking; to make sure we have services available for
the children who are disabled as a result of drinking during
pregnancy. This bill could lead to earlier identification and
screening and an earlier diagnosis so children could get
treatment early enough to eliminate the secondary diagnoses
Senator Davis' aid referred to earlier.
SENATOR THOMAS asked Ms. Casto to speak to other things that
should be done to reduce this expensive and unfortunate
situation.
2:02:11 PM
MS. CASTO assured Senator Thomas that there are things to be
done. She referred to a knowledge, attitude, beliefs and
behavior survey done in 1996 and repeated about five years
later. The category with the worst response was "Is it OK to
drink occasionally during pregnancy?" That questions was
answered wrong most often by OBGYN doctors. We could definitely
do a better job of education. She was not entirely opposed to
drinking alcohol, but felt that there were three areas of
intolerance where it was concerned: Children and teens should
not drink alcohol; people should not drink and drive; women
should not drink during pregnancy.
SENATOR THOMAS asked if they should be sure the curriculum for
health professionals at the University of Alaska is clear on the
dangers of alcohol during pregnancy to better inform the new
generation of doctors.
MS. CASTO answered "Absolutely!"
SENATOR DYSON commented to Senator Thomas that every bar has to
have a label on the bar and on the table; also package stores
that sell alcohol have to put a caution on their bags along with
their logo.
2:04:41 PM
PEGGY METCALF, mother and grandmother, supported SB 267, and
felt that children should be given every opportunity to be their
very best.
KJ METCALF supported SB 267 and expressed appreciation to
Senators Dyson and Elton for moving the bill forward. He said he
and his wife lived in Angoon for 18 years and saw generations of
women drink during pregnancy. FASD can be devastating to a small
community where there are no services; one of the best things
they can do to prevent FASD is to provide services to young
ladies of child bearing age, to help them through that period
without drinking so their children will be healthy.
RIC IANNALINO, Coordinator, FASD Diagnostic Clinic, Central
Council of the Tlingit Haida Indian Tribes, Tribal Family Youth
Services, said they had been in existence for a little over
three years and had seen about 120 individuals and their
families so far. He said this issue was very personal to him
because he had dealt with many people whose children could not
get into the clinic because they could not confirm a diagnosis
of FASD; they could not say with certainty that the children had
been exposed prenatally to alcohol. He explained that medical
personnel could be sued for making a diagnosis of FASD if
exposure could not be proven, but he and his team feel awful
when they cannot help these families. He felt it would be much
easier to get this information from a mother when the baby is
born birth, before it became evident the child was disabled, and
that would allow the child to get the early diagnosis and
treatment needed.
2:12:02 PM
GLADYS EVE RECKLEY, served on the council at Northern Lights
Church with KJ Metcalf during the past year. Mr. Metcalf put
together a conference that was endorsed by Northern Lights
Church, which brought together a number of professionals on
FASD. She supported SB 267 and felt strongly that educating the
public on the long-term effects of FASD was very important. She
provided a letter of support addressed to Chair Davis and
Representative Doll from Joy Lion, also from Northern Lights
Church.
JAN RUTHERDALE, Senior Assistant Attorney General, Civil
Division, Child Protective Section, Department of Law, worked in
the civil division of the child protection section for 20 years,
working primarily with children in need of aid. She was very
much aware of the devastating effects of FASD because many of
the children in state custody and their parents suffer from it.
She did not doubt the importance of getting the documentation in
order to make an accurate FASD diagnosis, but feared the bill
might actually hamper documentation because it would allow a
mother to veto inclusion of that information in her child's
record. She agreed with Ms. Casto's remarks that a mother might
feel very guilty about what she had done to her child, but since
drinking is not illegal, she would have no liability.
MS. RUTHERDALE pointed out that a new reporting statute was
passed two years ago, AS 47.17.024, which requires health care
practitioners to make a report to the Office of Children's
Services (OCS) if a practitioner determined an infant was
adversely affected by alcohol. It made sense to her that, since
doctors know they are required to make that report when dealing
with a mother and child under the age of 12, he or she would
note that in the record. This bill might create the false
impression that the doctor did not have to comply with the
reporting statute if the mother did not authorize it.
MS. RUTHERDALE mentioned parenthetically that she was passing
the following concern on for the assistant attorney general who
does licensing. AS 08.64 established licensure requirements for
doctors in Alaska; it did not set out how specific medical
conditions should be diagnosed or recorded. The medical board
adopted a regulation regarding general record keeping and
adopted ethical standards for doctors, but telling a doctor how
to document a specific potential medical issue is a departure
from the purpose of AS 08.64. She suggested that, if this bill
went forward it should be in title 18, which deals with DHSS
matters.
2:20:22 PM
MS. RUTHERDALE agreed with Ms. Casto that they should clarify on
line 13 that reporting was for treatment and diagnosis of the
child, and further suggested drafting something that would allow
the notation to be made at a later date. She recommended
removing the phrase on lines 9 and 10 of the bill "if the mother
provides her consent to the inclusion of the information in the
infant's medical file." She speculated that an educational
component might offer an alternative to legislation, but
wondered whether documentation was actually still a problem. Now
that doctors have been mandated to report under AS 47.17.024 and
OCS keeps all of their records, there would be a historical
record going forward for any child in the OCS system.
MS. RUTHERDALE asserted that most mothers, when asked whether
their child might have been exposed to prenatal alcohol, say
they did not drink from the time they knew they were pregnant,
but they might have been pregnant for several months by the time
they found out, so doctors would need to know how to ask the
question.
2:23:30 PM
SENATOR ELTON said, regarding line 13, he did not want this to
become a rationale for insurance companies to deny coverage and
was concerned the language "treatment or care" might give an
insurance company access to the report.
MS. RUTHERDALE did not know, but said she could get back to him
on it.
SENATOR ELTON went back to her point that the bill might create
confusion for doctors reporting to OCS under AS 47.17.024; he
understood the point but, given the testimony that OBGYNs were
not giving correct information to pregnant women, he did not see
it as a problem to include a provision under the licensing law.
2:26:54 PM
MS. RUTHERDALE said if he was truly concerned that doctors were
advising pregnant women it's OK to have a couple of glasses of
wine, this bill would not accomplish what he wanted because it
does not contain an educational requirement. She also reminded
him that the report Ms. Casto referred to was about 12 years old
and there might no longer be a problem.
SENATOR ELTON commented that tying good advice to licensing
would get doctors' attention.
SENATOR DYSON asked if Ms. Rutherdale meant to imply that the
current mandatory reporting law covered much of what they were
trying to accomplish and might be more efficacious because it
lacked the disclaimer about requiring maternal consent.
MS. RUTHERDALE answered that yes, but she recognized that the
existing reporting statute placed the report into a central
registry that is confidential; state police reports are
confidential; doctors' reports are confidential; ideally it
would appear in all these places, but this bill might result in
less documentation because a mother could refuse to allow it.
SENATOR DYSON asked if she meant they needed to do something
more to ensure the information would show up in the relevant
files.
2:30:39 PM
MS. RUTHERDALE did not know.
SENATOR THOMAS questioned whether existing statute required
doctors to obtain permission to document other forms of abuse.
MS. RUTHERDALE responded that they never have to get permission.
SENATOR THOMAS asked what she believed the outcome would be if
someone sued based on an accurate report that was included in
the file without her permission.
MS. RUTHERDALE did not believe she would get very far in such a
suit.
GEORGE BROWN MD drew an analogy between this and other public
health problems. He pointed to laws that require children to be
immunized and tested for tuberculosis; laws that require
reporting of certain illnesses such as sexually transmitted
diseases. He admitted that this issue became difficult with
regard to whether the intent was to catch someone and place
blame, or to stem the tide of an epidemic.
DR. BROWN opined that the beauty of the bill is it allows the
possibility of cooperation between clinical medicine and public
health. He was pretty sure that if they did another survey the
OBGYNs would score much higher than they did before and,
although he could not tell the committee what the Alaska State
Medical Association or his colleagues would say about the bill,
he was quite sure most physicians would want to do whatever
would provide better case-finding and allow early identification
and intervention.
As far as AS 18 and the requirement that doctors report harm,
most of the time they would not make a report of FASD unless it
was pretty obvious, which could be long after damage had been
done. Speaking to Senator Elton's concern about insurance
companies using it to deny coverage, if a doctor recorded the
possibility of FASD and there was an ICD9 code, the insurance
company would know about it. He contended however, that the
money FASD cost society made that a minor consideration. He
agreed with Ms. Casto that it would be good to add to section
(b) that it is for the good of the child.
2:37:15 PM
SENATOR ELTON asked Dr. Brown if he understood him to say a
doctor might not report to OCS that a mother was drinking while
pregnant, because the harm had already occurred and there was
not an instance of harm for the doctor to report.
DR. BROWN responded that the OCS requirement had to do with a
doctor having evidence that there really was abuse and in many
cases reporting occurs occur long after the opportunity for
early intervention has passed. It would not promote the early
case finding, the early delivery of services and the cost
savings that go with it.
2:39:03 PM
ALPHEUS BULLARD, Attorney, Legislative Legal and Research
Services Division, Legislative Affairs Agency, read from
existing statute AS 47.17.024, which already provides for
mandatory reporting.
"(a) A practitioner of the healing arts involved in
the delivery or care of an infant who the practitioner
determines has been adversely affected by, or is
withdrawing from exposure to, a controlled substance
or alcohol shall immediately notify the nearest office
of the department of the infant's condition."
He explained that the reason that, in this particular bill, the
mother must provide her consent is because of privilege. When a
mother shares information with a doctor or other medical
personnel, there is the expectation that the information is
privileged. If it is placed in the child's file, that privilege
is challenged.
CHAIR DAVIS asked if they could remove the consent requirement
from line 10 the bill and still move forward.
MR. BULLARD stated that in his legal opinion they could run into
constitutional issues in terms of the confidentiality of the
information about the mother's behavior. If it is going to be
recorded anywhere other than in her own file, she needs to
provide her consent.
SENATOR ELTON proposed a hypothetical situation in which a child
arrives at the emergency room with a broken arm that medical
personnel suspect was inflicted intentionally, and wondered why
reporting a mother's alcohol consumption would be a
constitutional issue while the reporting of other forms of
potential abuse were not.
MR.BULLARD said that in the scenario he described, the need to
report is clear. Here there is no real consensus about how much
alcohol leads to adverse effects on a child, so if a mother
provided information about her consumption of alcohol during
pregnancy, the question of whether the machinery of the state
should go into gear in terms of mandatory reporting is very
different.
2:44:17 PM
SENATOR ELTON questioned whether Mr. Bullard was saying that the
issue of what causes FASD was still unsettled science. He said
he believed it was demonstrable that drinking while pregnant was
harmful, so he was struggling with the issue of harm and why one
type could be reported and one could not.
MR. BULLARD advised the difference is that drinking while
pregnant is not currently illegal.
CHAIR DAVIS asked for his opinion on moving age of the child for
reporting purposes to more than 12 months.
BULLARD SECTION responded that section (c), referencing (a) as a
postnatal mother and infant, could be removed; but the bill was
just meant to govern medical personnel attending after the
birth.
CHAIR DAVIS mused that they could consider an additional section
to cover reporting for children over 12 months, or leave it as
it is and focus on the earliest possible identification. She
asked whether the committee wanted to change the verbiage in
section (b) to specify that the treatment and care are only for
the child.
SENATOR DYSON was struggling with Ms. Rutherdale's testimony
that this bill would weaken existing reporting law.
CHAIR DAVIS did not feel there would be a conflict.
2:49:11 PM
SENATOR THOMAS saw the distinction between them in this bill's
attempt to get the mother's cooperation.
CHAIR DAVIS suggested they contact the medical board for comment
before proceeding, and asked the committee if they intended to
propose any additional amendments.
SENATOR ELTON said he did not have an amendment but wanted to
hear from the Department of Law regarding insurance company
access to this information. He did not want to create a system
that would allow an insurance company access to the medical
files for the purpose of deciding whether to pay for care.
CHAIR DAVIS held SB 267 in committee.
SB 243-COMMISSION ON AGING
CHAIR DAVIS announced consideration of SB 243.
2:53:38 PM
TOM OBERMEYER, Staff to Senator Davis, introduced the committee
substitute for SB 243, version C. He said this is an act
relating to duties and powers of the Alaska Commission on Aging
in the Department of Health and Social Services (DHSS). He
directed the committee's attention to a new fiscal note attached
to the bill and explained that the CS contained clarification on
the duties of the executive director who would take the lead
role in formulating and submitting a statewide plan to the
Department of Health and Social Services (DHSS).
He described this as a "cleanup bill" to align the mission and
activities of the Alaska Commission on Aging with state statutes
and bring into line the grant duties and responsibilities
previously given to DHSS when the Commission on Aging and
Division of Senior Services became part of the department. Any
fiscal impact from these changes was already realized and
assimilated into the grant process.
MR. OBERMEYER said the bill assigns authority for establishing
state policy related to older Americans, Act federal programs
and state programs for older Alaskans, to the Department of
Health and Social Services (DHSS) as the state unit on aging. It
transfers grant authority related to senior service grants,
adult daycare, and family respite care grants from the Alaska
Commission on Aging to the Department of Health and Social
Services (DHSS). The department assigned these administrative
duties to Senior and Disability Services.
MR. OBERMEYER explained that the Alaska Commission on Aging is
responsible for planning the advocacy and community education
activities related to the health and welfare of older Alaskans.
It has relationships with state departments and agencies across
the state including the Governor's office, Alaska Mental Health
Trust Authority, Alaska Housing Finance Corporation, and non-
governmental organizations. According to the state plan for
senior services for fiscal years 2008-2011, Alaska has the
largest proportion of baby boomers (32 percent) in the nation,
and the senior population is growing faster than almost any
other state. Projections indicate that by 2030, seniors 60 plus
will comprise 17 percent of Alaska's population and the number
of those over 65 will have doubled. This CS was designed to help
clarify state duties and responsibilities in this regard.
2:56:31 PM
JOANNE GIBBONS, Health Program Manager, Division of Senior and
Disability Services, Department of Health and Social Services
(DHSS), stated support for SB 243. She said the bill codified
what had been in place and working well since 2003 in terms of
the organizational structure, the commission and the department.
Executive order 108 issued by Governor Murkowski, moved the
Alaska Commission on Aging from the Department of Administration
to the Department of Health and Social Services (DHSS). As part
of that, responsibility for grants was also moved from the
commission to the department. The impetus for this bill was, in
part, a legislative audit performed as part of a sunset review
for the commission, which advised the law be brought in line
with the existing structure.
DENISE DANIELLO, Executive Director, Alaska Commission on Aging,
Department of Health and Social Services (DHSS), stated support
for SB 243. She submitted written testimony outlining the
history of events; the intent of this legislation as it was
presented by Joanne Gibbons; the partnership between the
commission on aging with Senior and Disability Services, and the
Department of Health and Social Services. The commission on
aging, along with the Department of Health and Social Services
partnered to assist the Department of Health and Social Services
to carry out its state unit on aging responsibilities:
administration of grant funds from the Older Americans Act to
community senior provider agencies, providing services for older
Alaskans, and planning for senior services. The commission
developed a state plan for senior services, a planning document
required by the US Administration on Aging to present the
state's plan on how Older Americans Act funds will be used. The
plan was completed in July of 2007 in collaboration with about
20 agencies. The commission is required by statute to provide
recommendations to the Governor and the legislature regarding
regulations, policies and appropriations that benefit older
Alaskans. It is also required to provide recommendations to the
Department of Health and Social Services and the Mental Health
Trust Authority regarding provisions of funds from the Mental
Health Trust Settlement Act to provide services for older
Alaskans affected by Alzheimer's disease and related dementia,
mental health and behavioral health conditions.
MS. DANIELLO added that the commission provides community
education in a variety of ways including public comment at each
of its quarterly meetings, rural outreach visits, visits with
senior provider agencies during those meetings, a quarterly
newsletter and a bi-weekly legislative teleconference during
sessions.
3:02:11 PM
SENATOR ELTON said he understood that they were bringing the
statute into compliance with what was already happening, but
felt he needed to better understand the role of the executive
director. He directed Ms. Daniello's attention to page 4,
section 3 and ventured that the executive director would
formulate and submit a comprehensive statewide plan to the
department, but would no longer administer those programs.
MS. DANIELLO replied that he was correct; the agency would be
responsible for administration.
3:04:10 PM
SENATOR ELTON moved to adopt the proposed committee substitute
(CS) for SB 243, version /C and asked for unanimous consent.
There being no objection, version \C was adopted.
CHAIR DAVIS expressed her desire to move this legislation out of
committee to Finance, unless there were other issues to be
addressed.
SENATOR ELTON moved to report committee substitute to SB 243,
version /C, from committee with individual recommendations,
attached zero fiscal note(s) and unanimous consent. There being
no objection, CSSB 243(HES) moved from committee.
There being no further business to come before the committee,
Chair Davis adjourned the meeting 3:05:42 PM.