CSSB 245(HES): "An Act establishing the Alaska Health Care Commission and the Alaska health care information office; relating to health care planning and information; amending the certificate of need requirements to exclude expenditures for diagnostic imaging equipment in certain circumstances; providing for a study of the certificate of need program; and providing for an effective date."
00 CS FOR SENATE BILL NO. 245(HES) 01 "An Act establishing the Alaska Health Care Commission and the Alaska health care 02 information office; relating to health care planning and information; amending the 03 certificate of need requirements to exclude expenditures for diagnostic imaging 04 equipment in certain circumstances; providing for a study of the certificate of need 05 program; and providing for an effective date." 06 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 07 * Section 1. AS 18.05.010(b) is amended to read: 08 (b) In performing its duties under this chapter, AS 18.09, and AS 18.15.355 - 09 18.15.395, the department may 10 (1) flexibly use the broad range of powers set out in this title assigned 11 to the department to protect and promote the public health; 12 (2) provide public health information programs or messages to the 13 public that promote healthy behaviors or lifestyles or educate individuals about health
01 issues; 02 (3) promote efforts among public and private sector partners to 03 develop and finance programs or initiatives that identify and ameliorate health 04 problems; 05 (4) establish, finance, provide, or endorse performance management 06 standards for the public health system; 07 (5) develop, adopt, and implement 08 (A) a statewide health plan under AS 18.09 based on 09 recommendations of the Alaska Health Care Commission established in 10 AS 18.09.010; and 11 (B) public health plans and formal policies through regulations 12 adopted under AS 44.62 or collaborative recommendations that guide or 13 support individual and community public health efforts; 14 (6) establish formal or informal relationships with public or private 15 sector partners within the public health system; 16 (7) identify, assess, prevent, and ameliorate conditions of public health 17 importance through surveillance; epidemiological tracking, program evaluation, and 18 monitoring; testing and screening programs; treatment; administrative inspections; or 19 other techniques; 20 (8) promote the availability and accessibility of quality health care 21 services through health care facilities or providers; 22 (9) promote availability of and access to preventive and primary health 23 care when not otherwise available through the private sector, including acute and 24 episodic care, prenatal and postpartum care, child health, family planning, school 25 health, chronic disease prevention, child and adult immunization, testing and screening 26 services, dental health, nutrition, and health education and promotion services; 27 (10) systematically and regularly review the public health system and 28 recommend modifications in its structure or other features to improve public health 29 outcomes; and 30 (11) collaborate with public and private sector partners, including 31 municipalities, Alaska Native organizations, health care providers, and health insurers,
01 within the public health system to achieve the mission of public health. 02 * Sec. 2. AS 18.05.010(b), as amended by sec. 1 of this Act, is amended to read: 03 (b) In performing its duties under this chapter, AS 18.09, and AS 18.15.355 - 04 18.15.395, the department may 05 (1) flexibly use the broad range of powers set out in this title assigned 06 to the department to protect and promote the public health; 07 (2) provide public health information programs or messages to the 08 public that promote healthy behaviors or lifestyles or educate individuals about health 09 issues; 10 (3) promote efforts among public and private sector partners to 11 develop and finance programs or initiatives that identify and ameliorate health 12 problems; 13 (4) establish, finance, provide, or endorse performance management 14 standards for the public health system; 15 (5) develop, adopt, and implement 16 (A) a statewide health plan under AS 18.09 [BASED ON 17 RECOMMENDATIONS OF THE ALASKA HEALTH CARE 18 COMMISSION ESTABLISHED IN AS 18.09.010]; and 19 (B) public health plans and formal policies through regulations 20 adopted under AS 44.62 or collaborative recommendations that guide or 21 support individual and community public health efforts; 22 (6) establish formal or informal relationships with public or private 23 sector partners within the public health system; 24 (7) identify, assess, prevent, and ameliorate conditions of public health 25 importance through surveillance; epidemiological tracking, program evaluation, and 26 monitoring; testing and screening programs; treatment; administrative inspections; or 27 other techniques; 28 (8) promote the availability and accessibility of quality health care 29 services through health care facilities or providers; 30 (9) promote availability of and access to preventive and primary health 31 care when not otherwise available through the private sector, including acute and
01 episodic care, prenatal and postpartum care, child health, family planning, school 02 health, chronic disease prevention, child and adult immunization, testing and screening 03 services, dental health, nutrition, and health education and promotion services; 04 (10) systematically and regularly review the public health system and 05 recommend modifications in its structure or other features to improve public health 06 outcomes; and 07 (11) collaborate with public and private sector partners, including 08 municipalities, Alaska Native organizations, health care providers, and health insurers, 09 within the public health system to achieve the mission of public health. 10 * Sec. 3. AS 18.07.031(a) is amended to read: 11 (a) Except as provided in (c), (d), and (f) [(c) AND (d)] of this section, a 12 person may not make an expenditure of $1,000,000 or more for any of the following 13 unless authorized under the terms of a certificate of need issued by the department: 14 (1) construction of a health care facility; 15 (2) alteration of the bed capacity of a health care facility; or 16 (3) addition of a category of health services provided by a health care 17 facility. 18 * Sec. 4. AS 18.07.031(e) is amended to read: 19 (e) In [(a) OF] this section, 20 (1) "expenditure" includes the purchase of property occupied by or the 21 equipment required for the health care facility and the net present value of a lease for 22 space occupied by or the equipment required for the health care facility; "expenditure" 23 does not include costs associated with routine maintenance and replacement of 24 equipment at an existing health care facility; 25 (2) "critical access hospital" means a facility designated as a 26 critical access hospital by the department by regulatory authority exercised 27 under AS 18.05 or AS 18.20. 28 * Sec. 5. AS 18.07.031 is amended by adding a new subsection to read: 29 (f) Notwithstanding the limitations in (a) of this section, a person may make 30 an expenditure of $1,000,000 or more for diagnostic imaging equipment without 31 authorization under the terms of a certificate of need issued by the department if the
01 equipment is used in a health care facility that 02 (1) is located in a 03 (A) borough with a population of 60,000 or more; and 04 (B) a city that does not have a facility designated by the 05 department as a critical access hospital; and 06 (2) has at least a 50 percent ownership by one or more physicians 07 licensed in the state who are qualified to interpret, and actually interpret, diagnostic 08 images produced by the equipment in the facility. 09 * Sec. 6. AS 18 is amended by adding a new chapter to read: 10 Chapter 09. Statewide Health Care Planning and Information. 11 Article 1. Alaska Health Care Commission; State Health Plan. 12 Sec. 18.09.010. Alaska Health Care Commission. The Alaska Health Care 13 Commission is established in the Department of Health and Social Services. The 14 purposes of the commission are 15 (1) to provide recommendations for and foster the development of a 16 statewide plan to address the quality, accessibility, and availability of health care for 17 all citizens of the state; 18 (2) to review and approve the department's plan for a reporting data 19 system, including the type of reporting entity or person, and the timing of reporting; 20 and 21 (3) to review and approve facility health care information for 22 placement on the department's Internet database established under AS 18.09.110. 23 Sec. 18.09.020. Composition; chair. (a) The commission consists of 15 24 members, as follows: 25 (1) the state officer assigned the duties of medical director for the 26 department; 27 (2) one member representing the governor and appointed by the 28 governor; 29 (3) one member who is a member of the Alaska Commission on 30 Aging; 31 (4) three public members, in addition to members appointed under (5),
01 (8), and (9) of this subsection, appointed by the governor; one of the members 02 appointed under this paragraph must be a small business owner in the state; 03 (5) three public members who are health care providers, appointed by 04 the governor, as follows: one representing hospitals, one representing physicians, and 05 one representing mental health; 06 (6) two members from the house of representatives appointed by the 07 speaker of the house of representatives; 08 (7) two members from the senate appointed by the president of the 09 senate; 10 (8) one public member representing the Alaska tribal health care 11 system appointed by the governor; and 12 (9) one public member representing health care insurers appointed by 13 the governor. 14 (b) The medical director appointed under (a)(1) of this section shall serve as 15 chair of the commission. 16 Sec. 18.09.030. Term of office. (a) Public members of the commission 17 appointed under AS 18.09.020(a)(4), (5), (8), and (9) serve for staggered terms of five 18 years. 19 (b) If a vacancy occurs in a public member's seat on the commission, the 20 governor shall make an appointment for the unexpired portion of that member's term. 21 (c) The governor may remove a public member of the commission from office 22 only for cause. 23 Sec. 18.09.040. Executive director. The commission shall employ an 24 executive director with appropriate health care policy experience who may not be a 25 member of the commission. The executive director serves at the pleasure of the 26 commission. The commission shall establish the duties of the executive director. The 27 executive director is in the partially exempt service under AS 39.25 (State Personnel 28 Act). 29 Sec. 18.09.050. Staff. The department may assign employees of the 30 department to serve as staff to the commission. The commission shall prescribe the 31 duties of the commission staff.
01 Sec. 18.09.060. Bylaws. The commission, on approval of a majority of its 02 membership and consistent with state law, shall adopt and amend bylaws governing 03 proceedings and other activities, including provisions concerning a quorum to transact 04 commission business and other aspects of procedure; frequency and location of 05 meetings; and establishment, functions, and membership of committees. 06 Sec. 18.09.070. Duties of the commission. (a) The commission shall serve as 07 the state health planning and coordinating body. Consistent with state and federal law, 08 the commission shall provide recommendations for and foster the development of a 09 statewide health plan containing the following: 10 (1) a comprehensive statewide health care policy; 11 (2) a strategy for 12 (A) encouraging personal responsibility in prevention and 13 healthy living for all residents of the state; 14 (B) reducing the rate of growth in health care costs for all 15 residents of the state; 16 (C) improving access in communities to safe water and 17 wastewater systems; 18 (D) developing a sustainable health care workforce in the state; 19 (E) improving access to quality health care for all residents of 20 the state and increasing the number of residents of the state who are covered by 21 insurance for health care services. 22 (b) The commission shall review and approve health care information for 23 placement on the department's database developed under AS 18.09.110 and establish a 24 schedule for posting of the database and reporting requirements under AS 18.09.120. 25 (c) The commission shall submit to the governor and the legislature by 26 January 15 of each year an annual report regarding the commission's 27 recommendations and activities. 28 Sec. 18.09.080. Compensation, per diem, and expenses. A public member 29 appointed to the commission under AS 18.09.020(a)(4), (5), (8), or (9) is not entitled 30 to a salary, but is entitled to per diem, reimbursement for travel, and other expenses 31 authorized by law for boards and commissions under AS 39.20.180.
01 Article 2. Alaska Health Care Information Office. 02 Sec. 18.09.100. Office. The Alaska health care information office is 03 established in the department. The purpose of the office is to improve access by 04 residents of the state to consistently updated 05 (1) information about health care services, price, and quality to aid 06 consumers in making health care decisions; and 07 (2) information to encourage personal responsibility in prevention and 08 healthy living. 09 Sec. 18.09.110. Dissemination of information. (a) The department shall 10 establish and maintain an information database on the Internet of information about 11 health care facilities in the state to provide objective, unbiased, and factually based 12 information on health care services in the state. The department may require those 13 health care facilities to provide information in a standard form or format to the 14 department for placement in the database. Before information is placed on the 15 database, the department shall review the information with the health care facility for 16 accuracy. 17 (b) The database developed under (a) of this section must include, as 18 available, the following: 19 (1) a list of preferred drugs approved by the department for 20 reimbursement by the department; 21 (2) a complete list, organized by region and address, of 22 (A) health care facilities located in the state; 23 (B) licensed pharmacists and pharmacies located in the state; 24 (C) emergency and urgent care facilities located in the state; 25 (D) health insurance companies offering coverage in the state; 26 (E) health care providers licensed in the state, including the 27 provider license number, type, and expiration date along with disciplinary 28 actions, if any; 29 (F) long-term, in-home, and hospice care providers located in 30 the state; 31 (G) public assistance offices of the department;
01 (3) a list of the 100 most commonly prescribed medications in the state 02 and the source and price, updated monthly, of the medications; 03 (4) a list of the 100 most commonly conducted medical procedures in 04 the state, organized by the cash and negotiated price of the procedure at available 05 providers and insurers, updated annually; the list must include medical procedures 06 covered by workers' compensation under AS 23.30; 07 (5) available hospital ratings, including the rates of hospital acquired 08 infections and mortality occurring at each hospital located in the state; 09 (6) consumer education information on topics that include body mass 10 index, diet and nutrition, exercise, smoking cessation, and alcohol and drug addictions, 11 that includes the location of available sites that provide care and treatment related to 12 those issues; 13 (7) a list of procedures approved by state agencies for emergency 14 response and treatment; 15 (8) disease management support information; 16 (9) insurance information that includes 17 (A) a navigator to determine insurance eligibility using a 18 matrix of available insurers; 19 (B) links to Internet websites for purchasing insurance policies; 20 (C) an explanation of mandatory and optional insurance 21 coverage; 22 (10) a list of primary care clinics that cater to uninsured and self-pay 23 patients; 24 (11) a list of physicians who accept patients with Medicare coverage; 25 and 26 (12) information on the quality of health care facilities, including any 27 actions taken by state or federal agencies related to 28 (A) licensure and accreditation of a health care facility; or 29 (B) a licensed professional practicing in a health care facility. 30 (c) The department may contract with a private entity to provide services and 31 information required under (a) of this section.
01 (d) The department shall develop and consistently update an Internet website 02 to provide residents of the state timely and accurate information regarding prevention 03 and healthy living. 04 (e) The department shall post and make available information related to the 05 commission, including the commission's annual reports under AS 18.09.070(c). 06 Sec. 18.09.120. Mandatory reporting. (a) Beginning July 1, 2009, a health 07 care facility shall provide to the department, based on a schedule set by the 08 department, the following information related to the facility's health care services for 09 placement in the database developed under AS 18.09.110: 10 (1) information on costs to and bills payable by the consumer for 11 health care services that include both facility and physician components of care; 12 (2) types and amounts of insurance and other payments accepted by 13 the health care facility for health care services, including cash and negotiated prices; 14 (3) each location where the health care facility operates, and the hours 15 of operation; 16 (4) the types and scope of health care services offered at the health 17 care facility; 18 (5) the Internet address of any Internet website of the health care 19 facility the purpose of which is to provide factual information to aid the consumer; 20 (6) any other readily accessible information that the department 21 determines would help the consumer to make informed decisions about the health care 22 facility's services. 23 (b) The department shall develop a standard form or format for reporting the 24 information required in (a) of this section. The department shall adopt regulations 25 specifying the timing and frequency of the reporting of the information required by (a) 26 of this section. 27 (c) The department shall notify the health care facility of a failure to report 28 under (a) of this section and give the health care facility an opportunity to contest or 29 cure the failure. If the health care facility does not promptly cure the failure, the 30 department shall post the notice of failure on the database developed under 31 AS 18.09.110.
01 Sec. 18.09.130. Coordination of departments. The Department of 02 Administration, the Department of Commerce, Community, and Economic 03 Development, the Department of Labor and Workforce Development, and the 04 Department of Law shall 05 (1) provide to the department for placement on the database developed 06 under AS 18.09.110 information regarding an adverse action taken against a health 07 care facility in the state or against a licensed professional practicing in a health care 08 facility in the state; and 09 (2) cooperate with the commission in the performance of its duties. 10 Article 3. General Provisions. 11 Sec. 18.09.900. Regulations. The department may adopt regulations under 12 AS 44.62 (Administrative Procedure Act) to carry out the purposes of this chapter. 13 Sec. 18.09.990. Definitions. In this chapter, 14 (1) "commission" means the Alaska Health Care Commission 15 established in AS 18.09.010; 16 (2) "costs to the consumer" means actual price paid by the consumer 17 for health care services; 18 (3) "department" means the Department of Health and Social Services; 19 (4) "health care facility" means 20 (A) a facility licensed under AS 47.32; 21 (B) an independent diagnostic testing facility providing 22 services in the state; 23 (C) a provider of a home and community based waiver service 24 that is certified under regulations adopted by the department; 25 (D) a provider of personal care services that is certified under 26 regulations adopted by the department; 27 (E) a licensed pharmacy; and 28 (F) a physician's office. 29 * Sec. 7. AS 39.25.120(c)(7) is amended to read: 30 (7) the principal executive officer of the following boards, councils, or 31 commissions:
01 (A) Alaska Public Broadcasting Commission; 02 (B) Professional Teaching Practices Commission; 03 (C) Parole Board; 04 (D) Board of Nursing; 05 (E) Real Estate Commission; 06 (F) Alaska Royalty Oil and Gas Development Advisory Board; 07 (G) Alaska State Council on the Arts; 08 (H) Alaska Police Standards Council; 09 (I) Alaska Commission on Aging; 10 (J) Alaska Mental Health Board; 11 (K) State Medical Board; 12 (L) Governor's Council on Disabilities and Special Education; 13 (M) Advisory Board on Alcoholism and Drug Abuse; 14 (N) Statewide Suicide Prevention Council; 15 (O) the State Board of Registration for Architect, Engineers, 16 and Land Surveyors; 17 (P) Alaska Health Care Commission; 18 * Sec. 8. AS 18.09.010, 18.09.020, 18.09.030, 18.09.040, 18.09.050, 18.09.060, 18.09.070, 19 18.09.080, 18.09.110(e), 18.09.130(2), 18.09.990(1); and AS 39.25.120(c)(7)(P) are repealed 20 July 1, 2013. 21 * Sec. 9. The uncodified law of the State of Alaska is amended by adding a new section to 22 read: 23 APPLICABILITY. Sections 3 - 5 of this Act apply to health care facilities in existence 24 or proposed on or after the effective date of secs. 3 - 5 of this Act. A decision of the 25 Department of Health and Social Services made before the effective date of secs. 3 - 5 this 26 Act denying or granting a certificate of need that was applied for or issued for a health care 27 facility described in AS 18.07.031(f), added by sec. 5 of this Act, shall be void and 28 unnecessary. A pending application for a certificate of need for a health care facility described 29 in AS 18.07.031(f), added by sec. 5 of this Act, shall be returned to the applicant. 30 * Sec. 10. The uncodified law of the State of Alaska is amended by adding a new section to 31 read:
01 TRANSITION: REGULATIONS. The Department of Health and Social Services may 02 proceed to adopt regulations necessary to implement the changes made by this Act. The 03 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 04 effective date of the statutory change. 05 * Sec. 11. The uncodified law of the State of Alaska is amended by adding a new section to 06 read: 07 CERTIFICATE OF NEED STUDY. The Department of Health and Social Services 08 shall contract with an entity that has no financial interest in health care services to conduct a 09 comprehensive study of the effects of the certificate of need program in the state. The 10 department shall provide a copy of the study to the legislature not later than February 15, 11 2009. 12 * Sec. 12. Section 2 of this Act takes effect July 1, 2013. 13 * Sec. 13. Sections 3 - 5, 9, 10, and 11 of this Act take effect immediately under 14 AS 01.10.070(c). 15 * Sec. 14. Except as provided in secs. 12 and 13 of this Act, this Act takes effect July 1, 16 2008.