The House will come to order. Members will take their seats. [SPEAKER CHANGES] meeting of the Commerce and Job Development Committee. First, a little bit of housekeeping. I'd like to recognize our Sergeant at Arms, we have Warren Hawkins, Doug Harris, and David Leighton. In addition, we have a page, Mr. Antonio Sims from Pitt County, he's sponsored by the Speaker. This morning we're going to take up one bill, House Bill 108, and I understand there's a PCS so we'll need to have the adoption of the PCS for discussion. Do I have a motion? Alright, Susan, thank you. Is there a second? Alright, got a second. Alright, all those in favor say aye, alright, PCS is adopted. We'll move to the PCS and Representative Stam. [SPEAKER CHANGES] Thank you, Mr. Chairman, and cosponsors, Representative Jeter, Representative Martin, and then Representative Waddell had to be absent unavoidably today but he has written each of you a letter in full support of this. Usually when I explain a bill I go through it line by line but what I'd like to do here is give more of the reasons for it and the philosophy beside it and then, of course, answer questions in details. And then we have four folks who would each like to speak a couple minutes each, all of whom are local economic developers or regional economic developers. About three years ago, I met about three times regionally and a couple of times in Raleigh with a total of about 20 economic developers from around the state, primarily those in rural and semi-rural areas to see what we could do to enhance the economy, and this was when we were still in the worst part of the recession, and one thing that they all agreed upon, unanimously, at least the ones I met, was that in these rural/semi-rural areas there was not enough product to show. And at that time I did not know what product was, I thought it was inventory on the shelf, but what they meant by that was either pad-ready sites or in some cases shell buildings. Well, we developed this bill, Representative Jeter and myself in the last session, it's changed quite a bit, but what it is and what it's not, it is a loan program from Department of Commerce to another level of government, cities, counties, or their alter egos, but it's a secured loan. It's not a giveaway and it's a concessionary loan. The terms are real easy, but it's not a loan to a business, it's a loan to another unit of local government, secured. The PCS does two things which I need to mention. One, for the State Treasurer's Office, deletes a section they didn't like but secondly the appropriations are stricken from the bill and it has what's called the Royal Amendment. That is, it will only go into effect if the General Assembly appropriates money to it, know that this bill itself doesn't do that, and the reason for that is so that hopefully we can debate on the floor the policy so it won't have to be in the budget. A lot of members of both parties don't like to see policy in the budget, so this gives us a mechanism to debate the policy first and then if the House passes the policy then it can perhaps be funded, primarily out of existing funds with Department of Commerce. This is not a big new money spending thing and in the meetings with these economic developers, basically what I was told by virtually all of them, is that this would be more productive of economic development in rural/semi-rural areas than some of the other funds they had. Also, it is, although this is called site and building development fund, it is not anything like the site infrastructure fund which has been in law for
In hospitals, it can be extremely difficult to find two witnesses who are non-family members or health care staff and a notary public, especially if the patient wants to complete the documents at night or during the weekend. In the 44 states that do not require a notary, there does not appear to be any pattern of abuse. I have received a number of letters from several states that basically say there have not been any real issues in the way they've handled this. I have a number of letters of support. I've got a list of those if you're interested. It has generated quite a lot of conversation around this bill even though, as I've said, this is a very simple change. House Bill 146 allows an individual to use a notary or two witnesses. By making advance directive forms accessible and easier to complete, individuals are better able to plan ahead for these difficult health care and end of life decisions. With that, Mr. Chairman, I'll be glad to answer any questions. [SPEAKER CHANGES] Yes, sir, Mr. Neil. [SPEAKER CHANGES] This doesn't change what a qualified witness is? [SPEAKER CHANGES] No. [SPEAKER CHANGES] I would like to make a comment from the standpoint of the legal ??. It's awfully hard to find two witnesses and a notary on many occasions. I have never understood why we needed all of that when you get a deed with just a notary. [SPEAKER CHANGES] Does anybody in the audience have anything they want to add? Yes, ma'am. State your name and who you represent. [SPEAKER CHANGES] Yes, sir. I am Charmaine Fuller Cooper, Government Affairs liaison for AARP North Carolina. We're receiving mixed reviews from both our partner organizations as well as members who have concerns about this legislation. We have not had the opportunity to properly vent and share these concerns with the bill sponsors, so I do apologize. We have requested information from the Attorney General's office as far as any complaints of fraud and abuse against elders based on current statutes. The mixed reviews that we're receiving, On one hand people are siding with the sponsors, saying that they want ease and accessibility so that people can complete these documents. But also on the other hand we're hearing that people have concerns about increases in fraud and abuse and elder exploitation. [SPEAKER CHANGES] Mr. Chairman, if I might add, we did reach out to a number of states, and we could not find any evidence that there had been any concerns about fraud and abuse. I certainly understand that concern. I've had a number of discussions with members myself, particularly lawyers who may be concerned. But we've tried to find patterns of abuse in these other states and we have not been able to find it yet. [SPEAKER CHANGES] Identify yourself and who you represent. [SPEAKER CHANGES] My name is Deborah Love. I am the corporate director of bioethics for ?? Health. Also adjunct faculty in the Department of Social Medicine at UNC, the other school. I am a member of the advisory board of the North Carolina Partnership for Compassionate Care. We are an organization that is formed to support advance care planning. I am also a founding member of the Clinical Ethics Network of North Carolina. What I do in my job, I'm at the bedside quite a bit when we have cases where there is a difference of opinion between the medical providers and families about what's in the best interest of the patient. Frequently these difference are within families, where we have some family members who want to have ?? and continue advanced measures of a breathing tube or feeding tube for a family members and other members who would like to allow a natural death. There's a lot of confusion. It creates a lot of problems within families. We had a case a couple of weeks ago where literally we had to have members come in and separate families who were in physical altercation over this disagreement. It was a second wife and children from the first marriage. We want to do what we can to help support people make these decisions before these crises arrive. What the data tell us are that at least 70% of people when asked would say that they would like to die at home, surrounded by loved ones. What happens in our state is that 74% of people actually die in a hospital
or in a facility, and that's in large part because there's a bias of treatment. That's what our system basically requires, is that we treat unless we have a refusal and it's ethically permissible for anyone to refuse care. So we really want to encourage that these conversations take place outside of a hospital setting, it's not an advance care plan when it's in the hospital, now we're at the crisis. So North Carolina Partnership for Compassionate Care [??] efforts to support this, in churches, in libraries, in the community. When you're trying to do this in the community it's very hard to get a notary. Sometimes in the hospital it's hard to get witnesses. Sometimes you can't get a notary. So if somebody's in isolation, a hospital employee who's a notary will go in and make that, will do the notarization, but you can't get a disinterested witness to go into an isolation setting. So sometimes it's easier to get one, sometimes it's easier to get others, we're just saying let's give us the option, let's make it easier, let's try and do this in the community, not when the crisis is happening. [SPEAKER CHANGES] So you support the bill? [SPEAKER CHANGES] Anyone else? Any questions of the bill sponsor? Representative Howard? [SPEAKER CHANGES] Mr. Chairman, if you're ready, I'd like to make a motion that we give the PCS a favorable report, unfavorable to the original bill. [SPEAKER CHANGES] You've heard the motion, all in favor say aye, opposed no, and the aye's have it and we're adjourned.