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CSSB 300(HES): "An Act establishing the Alaska Health Care Commission and the Alaska health care information office; relating to health care planning and information; relating to a certificate of need study; and providing for an effective date."

00 CS FOR SENATE BILL NO. 300(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; relating to a 03 certificate of need study; and providing for an effective date." 04 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 05 * Section 1. AS 18.05.010(b) is amended to read: 06 (b) In performing its duties under this chapter, AS 18.09, and AS 18.15.355 - 07 18.15.395, the department may 08 (1) flexibly use the broad range of powers set out in this title assigned 09 to the department to protect and promote the public health; 10 (2) provide public health information programs or messages to the 11 public that promote healthy behaviors or lifestyles or educate individuals about health 12 issues; 13 (3) promote efforts among public and private sector partners to 14 develop and finance programs or initiatives that identify and ameliorate health

01 problems; 02 (4) establish, finance, provide, or endorse performance management 03 standards for the public health system; 04 (5) develop, adopt, and implement 05 (A) a statewide health plan under AS 18.09 based on 06 recommendations of the Alaska Health Care Commission established in 07 AS 18.09.010; and 08 (B) public health plans and formal policies through regulations 09 adopted under AS 44.62 or collaborative recommendations that guide or 10 support individual and community public health efforts; 11 (6) establish formal or informal relationships with public or private 12 sector partners within the public health system; 13 (7) identify, assess, prevent, and ameliorate conditions of public health 14 importance through surveillance; epidemiological tracking, program evaluation, and 15 monitoring; testing and screening programs; treatment; administrative inspections; or 16 other techniques; 17 (8) promote the availability and accessibility of quality health care 18 services through health care facilities or providers; 19 (9) promote availability of and access to preventive and primary health 20 care when not otherwise available through the private sector, including acute and 21 episodic care, prenatal and postpartum care, child health, family planning, school 22 health, chronic disease prevention, child and adult immunization, testing and screening 23 services, dental health, nutrition, and health education and promotion services; 24 (10) systematically and regularly review the public health system and 25 recommend modifications in its structure or other features to improve public health 26 outcomes; and 27 (11) collaborate with public and private sector partners, including 28 municipalities, Alaska Native organizations, health care providers, and health insurers, 29 within the public health system to achieve the mission of public health. 30 * Sec. 2. AS 18.05.010(b), as amended by sec. 1 of this Act, is amended to read: 31 (b) In performing its duties under this chapter, AS 18.09, and AS 18.15.355 -

01 18.15.395, the department may 02 (1) flexibly use the broad range of powers set out in this title assigned 03 to the department to protect and promote the public health; 04 (2) provide public health information programs or messages to the 05 public that promote healthy behaviors or lifestyles or educate individuals about health 06 issues; 07 (3) promote efforts among public and private sector partners to 08 develop and finance programs or initiatives that identify and ameliorate health 09 problems; 10 (4) establish, finance, provide, or endorse performance management 11 standards for the public health system; 12 (5) develop, adopt, and implement 13 (A) a statewide health plan under AS 18.09 [BASED ON 14 RECOMMENDATIONS OF THE ALASKA HEALTH CARE 15 COMMISSION ESTABLISHED IN AS 18.09.010]; and 16 (B) public health plans and formal policies through regulations 17 adopted under AS 44.62 or collaborative recommendations that guide or 18 support individual and community public health efforts; 19 (6) establish formal or informal relationships with public or private 20 sector partners within the public health system; 21 (7) identify, assess, prevent, and ameliorate conditions of public health 22 importance through surveillance; epidemiological tracking, program evaluation, and 23 monitoring; testing and screening programs; treatment; administrative inspections; or 24 other techniques; 25 (8) promote the availability and accessibility of quality health care 26 services through health care facilities or providers; 27 (9) promote availability of and access to preventive and primary health 28 care when not otherwise available through the private sector, including acute and 29 episodic care, prenatal and postpartum care, child health, family planning, school 30 health, chronic disease prevention, child and adult immunization, testing and screening 31 services, dental health, nutrition, and health education and promotion services;

01 (10) systematically and regularly review the public health system and 02 recommend modifications in its structure or other features to improve public health 03 outcomes; and 04 (11) collaborate with public and private sector partners, including 05 municipalities, Alaska Native organizations, health care providers, and health insurers, 06 within the public health system to achieve the mission of public health. 07 * Sec. 3. AS 18 is amended by adding a new chapter to read: 08 Chapter 09. Statewide Health Care Planning and Information. 09 Article 1. Alaska Health Care Commission; State Health Plan. 10 Sec. 18.09.010. Alaska Health Care Commission. The Alaska Health Care 11 Commission is established in the Department of Health and Social Services. The 12 purposes of the commission are 13 (1) to provide recommendations for and foster the development of a 14 statewide plan to address the quality, accessibility, and availability of health care for 15 all citizens of the state; 16 (2) to review and approve the department's plan for a reporting data 17 system, including the type of reporting entity or person, and the timing of reporting; 18 and 19 (3) to review and approve facility health care information for 20 placement on the department's Internet database established under AS 18.09.110. 21 Sec. 18.09.020. Composition; chair. (a) The commission consists of 15 22 members, as follows: 23 (1) the state officer assigned the duties of medical director for the 24 department; 25 (2) one member representing the governor and appointed by the 26 governor; 27 (3) one member who is a member of the Alaska Commission on 28 Aging; 29 (4) three public members, in addition to members appointed under (5), 30 (8), and (9) of this subsection, appointed by the governor; one of the members 31 appointed under this paragraph must be a small business owner in the state;

01 (5) three public members who are health care providers, appointed by 02 the governor, as follows: one representing hospitals, one representing physicians, and 03 one representing mental health; 04 (6) two members from the house of representatives appointed by the 05 speaker of the house of representatives; 06 (7) two members from the senate appointed by the president of the 07 senate; 08 (8) one public member representing the Alaska tribal health care 09 system appointed by the governor; and 10 (9) one public member representing health care insurers appointed by 11 the governor. 12 (b) The medical director appointed under (a)(1) of this section shall serve as 13 chair of the commission. 14 Sec. 18.09.030. Term of office. (a) Public members of the commission 15 appointed under AS 18.09.020(a)(4), (5), (8), and (9) serve for staggered terms of five 16 years. 17 (b) If a vacancy occurs in a public member's seat on the commission, the 18 governor shall make an appointment for the unexpired portion of that member's term. 19 (c) The governor may remove a public member of the commission from office 20 only for cause. 21 Sec. 18.09.040. Executive director. The commission shall employ an 22 executive director with appropriate health care policy experience who may not be a 23 member of the commission. The executive director serves at the pleasure of the 24 commission. The commission shall establish the duties of the executive director. The 25 executive director is in the partially exempt service under AS 39.25 (State Personnel 26 Act). 27 Sec. 18.09.050. Staff. The department may assign employees of the 28 department to serve as staff to the commission. The commission shall prescribe the 29 duties of the commission staff. 30 Sec. 18.09.060. Bylaws. The commission, on approval of a majority of its 31 membership and consistent with state law, shall adopt and amend bylaws governing

01 proceedings and other activities, including provisions concerning a quorum to transact 02 commission business and other aspects of procedure; frequency and location of 03 meetings; and establishment, functions, and membership of committees. 04 Sec. 18.09.070. Duties of the commission. (a) The commission shall serve as 05 the state health planning and coordinating body. Consistent with state and federal law, 06 the commission shall provide recommendations for and foster the development of a 07 statewide health plan containing the following: 08 (1) a comprehensive statewide health care policy; 09 (2) a strategy for 10 (A) encouraging personal responsibility in prevention and 11 healthy living for all residents of the state; 12 (B) reducing the rate of growth in health care costs for all 13 residents of the state; 14 (C) improving access in communities to safe water and 15 wastewater systems; 16 (D) developing a sustainable health care workforce in the state; 17 (E) improving access to quality health care for all residents of 18 the state and increasing the number of residents of the state who are covered by 19 insurance for health care services. 20 (b) The commission shall review and approve health care information for 21 placement on the department's database developed under AS 18.09.110 and establish a 22 schedule for implementation of the database and reporting requirements under 23 AS 18.09.120. 24 (c) The commission shall submit to the governor and the legislature by 25 January 15 of each year an annual report regarding the commission's 26 recommendations and activities. 27 Sec. 18.09.080. Compensation, per diem, and expenses. A public member 28 appointed to the commission under AS 18.09.020(a)(4), (5), (8), or (9) is not entitled 29 to a salary, but is entitled to per diem, reimbursement for travel, and other expenses 30 authorized by law for boards and commissions under AS 39.20.180. 31 Article 2. Alaska Health Care Information Office.

01 Sec. 18.09.100. Office. The Alaska health care information office is 02 established in the department. The purpose of the office is to improve access by 03 residents of the state to consistently updated 04 (1) information about health care services, price, and quality to aid 05 consumers in making health care decisions; and 06 (2) information to encourage personal responsibility in prevention and 07 healthy living. 08 Sec. 18.09.110. Dissemination of information. (a) The department shall 09 establish and maintain an information database on the Internet of information about 10 health care facilities in the state to provide objective, unbiased, and factually based 11 information on health care services in the state. The department may require those 12 health care facilities to provide information in a standard form or format to the 13 department for placement in the database. Before information is placed on the 14 database, the department shall review the information with the health care facility for 15 accuracy. 16 (b) The database developed under (a) of this section must include the 17 following: 18 (1) a list of preferred drugs approved by the department for 19 reimbursement by the department; 20 (2) a complete list, organized by region and address, of 21 (A) health care facilities located in the state; 22 (B) licensed pharmacists and pharmacies located in the state; 23 (C) emergency and urgent care facilities located in the state; 24 (D) health insurance companies offering coverage in the state; 25 (E) health care providers licensed in the state, including the 26 provider license number, type, and expiration date along with disciplinary 27 actions, if any; 28 (F) long-term, in-home, and hospice care providers located in 29 the state; 30 (G) public assistance offices of the department; 31 (3) a list of the 100 most commonly prescribed medications in the state

01 and the source and price, updated monthly, of the medications; 02 (4) a list of the 100 most commonly conducted medical procedures in 03 the state, organized by the cash and negotiated price of the procedure at available 04 providers and insurers, updated annually; the list must include medical procedures 05 covered by workers' compensation under AS 23.30; 06 (5) available hospital ratings, including the rates of hospital acquired 07 infections and mortality occurring at each hospital located in the state; 08 (6) consumer education information on topics that include body mass 09 index, diet and nutrition, exercise, smoking cessation, and alcohol and drug addictions, 10 that includes the location of available sites that provide care and treatment related to 11 those issues; 12 (7) a list of procedures approved by state agencies for emergency 13 response and treatment; 14 (8) disease management support information; 15 (9) insurance information that includes 16 (A) a navigator to determine insurance eligibility using a 17 matrix of available insurers; 18 (B) links to Internet websites for purchasing insurance policies; 19 (C) an explanation of mandatory and optional insurance 20 coverage; 21 (10) a list of primary care clinics that cater to uninsured and self-pay 22 patients; 23 (11) a list of physicians who accept patients with Medicare coverage; 24 and 25 (12) information on the quality of health care facilities, including any 26 actions taken by state or federal agencies related to 27 (A) licensure and accreditation of a health care facility; or 28 (B) a licensed professional practicing in a health care facility. 29 (c) The department may contract with a private entity to provide services and 30 information required under (a) of this section. 31 (d) The department shall develop and consistently update an Internet website

01 to provide residents of the state timely and accurate information regarding prevention 02 and healthy living. 03 (e) The department shall post and make available information related to the 04 commission, including the commission's annual reports under AS 18.09.070(c). 05 Sec. 18.09.120. Mandatory reporting. (a) Beginning July 1, 2009, a health 06 care facility shall provide to the department, based on a schedule set by the 07 department, the following information related to the facility's health care services for 08 placement in the database developed under AS 18.09.110: 09 (1) information on costs to and bills payable by the consumer for 10 health care services that include both facility and physician components of care; 11 (2) types and amounts of insurance and other payments accepted by 12 the health care facility for health care services, including cash and negotiated prices; 13 (3) each location where the health care facility operates, and the hours 14 of operation; 15 (4) the types and scope of health care services offered at the health 16 care facility; 17 (5) the Internet address of any Internet website of the health care 18 facility the purpose of which is to provide factual information to aid the consumer; 19 (6) any other readily accessible information that the department 20 determines would help the consumer to make informed decisions about the health care 21 facility's services. 22 (b) The department shall develop a standard form or format for reporting the 23 information required in (a) of this section. The department shall adopt regulations 24 specifying the timing and frequency of the reporting of the information required by (a) 25 of this section. 26 (c) The department shall notify the health care facility of a failure to report 27 under (a) of this section and give the health care facility an opportunity to contest or 28 cure the failure. If the health care facility does not promptly cure the failure, the 29 department shall post the notice of failure on the database developed under 30 AS 18.09.110. 31 Sec. 18.09.130. Coordination of departments. The Department of

01 Administration, the Department of Commerce, Community, and Economic 02 Development, the Department of Labor and Workforce Development, and the 03 Department of Law shall 04 (1) provide to the department for placement on the database developed 05 under AS 18.09.110 information regarding an adverse action taken against a health 06 care facility in the state or against a licensed professional practicing in a health care 07 facility in the state; and 08 (2) cooperate with the commission in the performance of its duties. 09 Article 3. General Provisions. 10 Sec. 18.09.900. Regulations. The department may adopt regulations under 11 AS 44.62 (Administrative Procedure Act) to carry out the purposes of this chapter. 12 Sec. 18.09.990. Definitions. In this chapter, 13 (1) "commission" means the Alaska Health Care Commission 14 established in AS 18.09.010; 15 (2) "costs to the consumer" means actual price paid by the consumer 16 for health care services; 17 (3) "department" means the Department of Health and Social Services; 18 (4) "health care facility" means 19 (A) a facility licensed under AS 47.32; 20 (B) an independent diagnostic testing facility providing 21 services in the state; 22 (C) a provider of a home and community based waiver service 23 that is certified under regulations adopted by the department; 24 (D) a provider of personal care services that is certified under 25 regulations adopted by the department; 26 (E) a licensed pharmacy; and 27 (F) a physician's office. 28 * Sec. 4. AS 39.25.120(c)(7) is amended to read: 29 (7) the principal executive officer of the following boards, councils, or 30 commissions: 31 (A) Alaska Public Broadcasting Commission;

01 (B) Professional Teaching Practices Commission; 02 (C) Parole Board; 03 (D) Board of Nursing; 04 (E) Real Estate Commission; 05 (F) Alaska Royalty Oil and Gas Development Advisory Board; 06 (G) Alaska State Council on the Arts; 07 (H) Alaska Police Standards Council; 08 (I) Alaska Commission on Aging; 09 (J) Alaska Mental Health Board; 10 (K) State Medical Board; 11 (L) Governor's Council on Disabilities and Special Education; 12 (M) Advisory Board on Alcoholism and Drug Abuse; 13 (N) Statewide Suicide Prevention Council; 14 (O) the State Board of Registration for Architect, Engineers, 15 and Land Surveyors; 16 (P) Alaska Health Care Commission; 17 * Sec. 5. AS 18.09.010, 18.09.020, 18.09.030, 18.09.040, 18.09.050, 18.09.060, 18.09.070, 18 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 19 July 1, 2013. 20 * Sec. 6. The uncodified law of the State of Alaska is amended by adding a new section to 21 read: 22 TRANSITION: REGULATIONS. The Department of Health and Social Services may 23 proceed to adopt regulations necessary to implement the changes made by this Act. The 24 regulations take effect under AS 44.62 (Administrative Procedure Act), but not before the 25 effective date of the statutory change. 26 * Sec. 7. The uncodified law of the State of Alaska is amended by adding a new section to 27 read: 28 CERTIFICATE OF NEED STUDY. The Department of Health and Social Services 29 shall contract with an entity that has no financial interest in providing health care services to 30 conduct a comprehensive study of the effects of the certificate of need program in the state. 31 The department shall provide a copy of the study to the legislature.

01 * Sec. 8. Section 2 of this Act takes effect July 1, 2013. 02 * Sec. 9. Section 6 of this Act takes effect immediately under AS 01.10.070(c). 03 * Sec. 10. Except as provided in secs. 8 and 9 of this Act, this Act takes effect July 1, 2008.