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Health and Human Services Interim Committee

MINUTES OF THE

HEALTH AND HUMAN SERVICES INTERIM COMMITTEE

May 21, 1997 - 9:00 a.m. -- Room 405 State Capitol



Members Present:    
    Sen. Nathan C. Tanner, Senate Chair
    Rep. Nora B. Stephens, House Chair
    Sen. Robert F. Montgomery
    Sen. Millie M. Peterson
    Sen. Pete Suazo
    Rep. Loretta Baca
    Rep. Mary Carlson
    Rep. Gene Davis
    Rep. Margaret Dayton
    Rep. J. W. "Bill" Hickman
    Rep. Bryan D. Holladay
    Rep. Robert H.M. Killpack
    Rep. Carl R. Saunders
    Rep. Raymond W. Short



    
Members Absent:

    Sen. Craig L. Taylor
    
    
Staff Present:
    Mr. Mark D. Andrews
        Research Analyst
    Ms. Janetha W. Hancock
        Associate General Counsel
    Mr. R. Chet Loftis
        Associate General Counsel
    Ms. Karen E. Mecham
        Secretary


Note:    A list of others present and a copy of materials distributed in the meeting are on file in the Office of Legislative Research and General Counsel.
    

1.    Call to Order and Approval of Minutes -- Sen. Tanner called the meeting to order at 9:05 a.m. and welcomed members of the committee.

     MOTION: Rep. Holladay moved to approve the minutes of the April 23, 1997 meeting. The motion passed unanimously. Sen. Montgomery and Reps. Baca, Carlson, Davis, Dayton, and Hickman were absent for the vote.

2.    Tobacco Suit Update -- Mr. Loftis briefed the committee on major developments leading to negotiations taking place between the tobacco industry and 29 state attorneys general for damages related to the cost of treating smoking-related illnesses.

    Mr. Loftis said that Utah's Attorney General, through private counsel, filed suit against the tobacco industry in federal district court in September 1996. He explained that the tobacco companies have asked the federal district court to dismiss the state's lawsuit under various legal theories. The court has yet to rule on those motions. In March 1997, Liggett & Myers, Inc., a smaller tobacco company, reached a settlement agreement with 22 attorneys general, agreeing to pay $30 million annually for a total of about $750 million and conceding that tobacco is addictive and a causal factor in cancer and that tobacco companies have deliberately marketed tobacco products to those as young as 14.

    As a result of the settlement, Congress is considering a bill that would require the tobacco industry to list the ingredients in cigarettes and request congressional hearings on statements made by the industry that smoking is not addictive. He noted that news reports indicate that the Justice Department is investigating whether industry executives committed perjury at congressional hearings and withheld information from federal agencies.

    Mr. Loftis said that in April 1997, a federal district court judge in North Carolina upheld the authority of the FDA to regulate tobacco products, while striking certain bans on advertising on first amendment grounds. This decision has been appealed. If upheld, the FDA would be able to impose greater regulations on tobacco products short of taking cigarettes off the market as unsafe drugs. Mr. Loftis noted that in February 1997 a federal district court judge in Massachusetts upheld a state statute requiring cigarette manufacturers to give the state information about the ingredients and nicotine yield ratings of their cigarettes. He added that in March 1997, the Federal Trade Commission requested action be taken against R.J. Reynolds because new evidence shows the company's Joe Camel campaign targets children.

    Ms. Jan Graham, Utah Attorney General and Ms. Carol Clawson, Solicitor General, addressed the committee. Ms. Graham said pressure is mounting on the tobacco companies as other states continue to join the litigation. She noted that the first trial will begin in Mississippi on July 10. She explained that each of the states has filed separately within their state because each focus is different. She said Utah's case focuses on the return of funds to the welfare system that have been spent on tobacco-related illnesses.

    Ms. Graham outlined four objectives of all attorneys general including: 1) stopping the marketing of tobacco to children; 2) full disclosure to the public of the health effects of tobacco products; 3) reformed business practices to protect consumers; and 4) relief to states and individuals for tobacco-related health costs. She suggested that the industry cannot do business as it has in the past even if the product remains legal.

    Ms. Graham gave a brief history of the state's litigation. She noted that presently the tobacco companies are attempting to dismiss Utah's case. She added a hearing to make this determination will be held on July 11. Ms. Graham said there will continue to be changes to the law as these cases are litigated and the state needs to have a mechanism to enforce changes as they occur. Sen. Montgomery said he would present a bill in the next session for enforcement and would bring the bill to the committee for its review. Ms. Graham said that the attorneys general have never discussed immunity for tobacco companies from future lawsuits but have discussed the setting aside of funds to settle future claims. This set aside could possibly create a cap.

    Ms. Clawson discussed the law firms handling the state's case. There is a 25 percent contingency fee based on the amount the state is awarded but not returned to the federal

government. The firms are putting up their own money to prosecute the case -- no state money is being forwarded to them. Sen. Peterson said she hoped that the funds would be used for adult cessation programs.

3.    Coordination of Tobacco Programs -- Mr. Andrews reviewed the coordination of tobacco education, prevention, cessation, and control programs in the state. He also reviewed recent bills debated in the Legislature, including the recent cigarette tax bill which appropriates $250,000 to a tobacco prevention and control media campaign targeted towards children. The following speakers each addressed their roles in tobacco education, prevention, cessation, and control; how they coordinate with each other; and how service delivery can be improved through enhanced coordination and collaboration.

    Dr. Joseph K. Miner, executive director, Utah County Health Department, and head of the Association of Local Health Officers, explained that substance abuse is the major preventable cause of disease. He noted that tax revenues provide education for youth. They also assist in random unannounced inspections to reduce sales to underage consumers. Dr. Miner did not have any recommendations for improving coordination of tobacco programs.

    Ms. Barbara Hardy, director, Division of Substance Abuse Services for Salt Lake County, explained that their services are subcontracted and focus on life and problem-solving skills. They target children in fourth grade and up. She said the programs are voluntary. She described the relationship between law enforcement, local departments of health and substance abuse authorities as a triangle -- law enforcement has the authority to enforce compliance with laws relating to sales to minors, local health departments train merchants to comply with these laws, and local substance abuse authorities are accountable for and receive funding based on the results. She recommended that the sale to minors law focus on education and that the emphasis be directed away from the store clerk to the store. Sen. Montgomery said his bill would address these issues.

    Mr. Verne Larsen, specialist, Services for At Risk Students, State Office of Education, distributed a handout titled "Putting the Pieces Together" outlining the coordination of substance abuse efforts in the education area. He said a survey has been done to determine if the prevention programs are working. He said that repetition among programs is alright but questioned whether there was too much of it. He said that the structure is in place for coordination of tobacco programs, but that it can be improved.

    Mr. Phil Bernal, Office of the Board of Regents, and Ms. Dianne Casher, Salt Lake Community College, addressed the committee. Ms. Casher said that there is a consortium to coordinate efforts on the college campuses. She noted there is a 4-percent increase in smoking on college campuses. She said that funds were needed to train more volunteers and provide more programs.

    Mr. Richard Schwermer, Assistant Court Administrator, Administrative Office of the Courts, explained that in the juvenile court system at least one judge has waived tobacco penalties for participation in cessation programs. This flexibility does not exist for individuals outside the juvenile court system. Mr. Schwermer indicated that judges would appreciate any additional tools that could be provided them for dealing with tobacco. He said that anecdotal evidence suggests waiving fines for participation in cessation programs is working.

    Captain Tom Paul, Pleasant Grove Police Department, said his organization is coordinating with the D.A.R.E. program and does sting operations. It also coordinates with parent/teen programs.

    Mr. Leon Povey, director, Division of Substance Abuse, Utah Department of Human Services, distributed a handout titled "Talking Points for Legislative Interim Committee." He said that the division's involvement in tobacco use is focused on primary prevention and early intervention targeted to underage use. He added that 85 percent of the division's funds goes to local substance abuse authorities. He added that there are studies done that confirm the success of the programs. Mr. Povey said that he would support the addition of health and substance abuse officials to the enforcement of the sales to minors law.

    Ms. Christine Chalkley, manager, Tobacco Prevention and Control Program, Utah Department of Health, distributed a packet and handout titled "Utah's Year 2000 Objectives for Tobacco Prevention and Control. She said that the department evaluates its success with its programs. She recommended an annually renewed license for the sale of tobacco. Ms. Chalkley recommended: (1) implementation of legislation that would require high school guidance counselors to use comprehensive guidance fundings for facilitating and evaluating Teen Tobacco Reduction Programs; and (2) requiring that retail tobacco license fees be issued annually and that suspension and revocation provisions be added to the law.

    Mr. Kevin Condra, Coalition for a Tobacco Free Utah, distributed a handout with background, mission, objectives, and recommendations. He said that there needs to be more collaboration between state/local health departments and state/local substance abuse providers. He suggested legislative action for an annual tobacco retailer permit that can be suspended or revoked when repeat sales of tobacco products occur. He also recommended legislative action may be required to put tobacco products behind the counter and made available only through clerk assisted sales.

    Ms. Mary Lou Bozich, Substance Abuse Coordinator, Utah Substance Abuse and Anti- violence Coordinating Council distributed two handouts on the duties of the coordinating council and use of the tobacco tax. She indicated that the council will be focusing on the coordination of tobacco programs this year.

    Chair Tanner suggested that all providers need to evaluate their programs and determine which ones are most effective and efficient.

4.    Utah Health Policy Commission -- Mr. Patrick Johnson, executive director, Utah Health Policy Commission, distributed the commission's 1997 study agenda. He outlined the technical advisory groups. He said that mental health issues are a priority along with long-term care, substance abuse, and health insurance/cost. Additionally, medical education allocations and rural health issues will be studied by study groups. He said the dieticians would like the commission to study nutritional services. He said he would provide updated copies of HealthPrint to the committee.

5.    Privatization of Services -- Mr. Doug West, deputy director, Department of Human Services, distributed a memo from Director Robin Arnold-Williams outlining questions the department would like answered and given direction on how to utilize privatization and how the committee would like to participate in the process.

6.    Adjournment--

     MOTION: Rep. Davis moved to adjourn the meeting at 11:50 a.m. The motion passed unanimously. Reps. Carson, Hickman and Saunders were absent for the vote.


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