Legislature(2017 - 2018)ADAMS ROOM 519

03/08/2018 01:00 PM FINANCE

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Audio Topic
12:59:01 PM Start
01:05:25 PM HB285 || HB286
01:05:30 PM Amendments
02:11:45 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 286 APPROP: OPERATING BUDGET/LOANS/FUNDS TELECONFERENCED
Heard & Held
+= HB 285 APPROP: MENTAL HEALTH BUDGET TELECONFERENCED
Heard & Held
Amendments
+ Bills Previously Heard/Scheduled TELECONFERENCED
HOUSE BILL NO. 285                                                                                                            
                                                                                                                                
     "An  Act making  appropriations for  the operating  and                                                                    
     capital    expenses   of    the   state's    integrated                                                                    
     comprehensive mental health  program; and providing for                                                                    
     an effective date."                                                                                                        
                                                                                                                                
HOUSE BILL NO. 286                                                                                                            
                                                                                                                                
     "An  Act making  appropriations for  the operating  and                                                                    
     loan  program  expenses  of state  government  and  for                                                                    
     certain   programs;    capitalizing   funds;   amending                                                                    
     appropriations;  making   supplemental  appropriations;                                                                    
     making  appropriations  under   art.  IX,  sec.  17(c),                                                                    
     Constitution  of   the  State   of  Alaska,   from  the                                                                    
     constitutional budget  reserve fund; and  providing for                                                                    
     an effective date."                                                                                                        
                                                                                                                                
1:05:25 PM                                                                                                                    
                                                                                                                                
^AMENDMENTS                                                                                                                   
                                                                                                                                
1:05:30 PM                                                                                                                    
                                                                                                                                
Co-Chair Seaton noted that the  committee would be taking up                                                                    
special  appropriations   amendments,  and   amendments  for                                                                    
Judiciary  (JUD),  the  University   of  Alaska  (UOA),  the                                                                    
Department of Revenue (DOR), and  the Department of Military                                                                    
and  Veterans Affairs  (DMVA). The  rest  of the  amendments                                                                    
would be addressed in the order  of the packet. He wanted to                                                                    
get through  all of the  language amendments in  the current                                                                    
day  because it  would  help Legislative  Legal Services  in                                                                    
drafting the final budget bills.                                                                                                
                                                                                                                                
Co-Chair Seaton  MOVED to ADOPT  Amendment L H SAP  25 (copy                                                                    
on file):                                                                                                                       
                                                                                                                                
     Language Amendments                                                                                                        
     L  H  SAP  25  - Increase  the  capitalization  of  the                                                                    
     Disaster Relief Fund                                                                                                       
     Offered by Representative Seaton                                                                                           
                                                                                                                                
     See 30-GH2564O.28                                                                                                          
                                                                                                                                
     The amendment  adds a new  sec. 19(d)  that capitalizes                                                                    
     the Disaster Relief Fund  with an estimated $6,154,862,                                                                    
     from the balances of several  funds. These sources were                                                                    
     identified as available funds  in the Governor's budget                                                                    
     amendments submitted February 13th.                                                                                        
                                                                                                                                
     Alternative  energy conservation  revolving loan  fund,                                                                    
     $2,744,400  (DGF)  Mining  loan  fund,  $200,900  (DGF)                                                                    
     Unincorporated   community  capital   project  matching                                                                    
     grant  fund, $646,200  (DGF) Municipal  capital project                                                                    
     matching  grant fund,  $253,500  (DGF) Investment  loss                                                                    
     trust fund,  $2,298,862 (UGF) From  FY 14  through FY18                                                                    
     to date,  $51.5 million has been  appropriated into the                                                                    
     Disaster  Relief  Fund. Over  the  four-and-a-half-year                                                                    
     period, the  average annual expenditure has  been $11.4                                                                    
     million.                                                                                                                   
                                                                                                                                
     This  amendment increases  the  FY19 capitalization  to                                                                    
     $8.2   million,   closer    to   the   average   annual                                                                    
     expenditure.                                                                                                               
     The current fund balance is  only $1.5 million. HB 321,                                                                    
     the  supplemental  bill,   includes  an  additional  $4                                                                    
     million of capitalization in FY18.                                                                                         
                                                                                                                                
Representative Wilson OBJECTED for discussion.                                                                                  
                                                                                                                                
Co-Chair Seaton read the amendment (see above).                                                                                 
                                                                                                                                
Representative Wilson  replied to  her objection.  She asked                                                                    
about  the   loan  transfers  and  whether   they  had  been                                                                    
stagnated. She did not see a  backup page in the packet. She                                                                    
asked for more information.                                                                                                     
                                                                                                                                
Co-Chair Seaton invited Lacey Sanders from the Division of                                                                      
Legislative Finance to the table.                                                                                               
                                                                                                                                
1:09:12 PM                                                                                                                    
                                                                                                                                
LACEY  SANDERS,   ANALYST,  LEGISLATIVE   FINANCE  DIVISION,                                                                    
responded  that there  should have  been an  attachment. The                                                                    
Legislative  Finance  Division  had  been  provided  with  a                                                                    
report from  the Office of  Economic Development on  each of                                                                    
the revolving  loan funds.  She could  provide a  summary on                                                                    
the  two  funds  that  had been  identified.  Regarding  the                                                                    
mining revolving  loan fund, there were  currently no active                                                                    
loans  in  the  fund.  There was  one  remaining  foreclosed                                                                    
property being  collected on and  it had been  identified as                                                                    
available.   She  reported   that  the   alternative  energy                                                                    
revolving  loan fund  had no  outstanding loans  either. The                                                                    
governor's office  had identified the fund  as available for                                                                    
use.                                                                                                                            
                                                                                                                                
Representative  Wilson  asked  if   the  accounts  would  be                                                                    
drained to zero or if money would remain in the accounts.                                                                       
                                                                                                                                
Co-Chair  Seaton  relayed  that  on February  13,  2018  the                                                                    
governor's amendments  were submitted and he  had identified                                                                    
the funds  as available.  Co-Chair Seaton asked  Ms. Sanders                                                                    
if she had  the ending balances for the  accounts or whether                                                                    
they had been zeroed out.                                                                                                       
                                                                                                                                
Ms. Sanders  responded that she  had the balances  and added                                                                    
that  the  language  was  to   utilize  the  unexpended  and                                                                    
unobligated  balance on  the loan  funds and  drain the  two                                                                    
funds -  the alternate  energy revolving  loan fund  and the                                                                    
mining revolving  loan fund. No  future loans would  be made                                                                    
from these two programs.                                                                                                        
                                                                                                                                
Representative Wilson  wondered if  the balances  could just                                                                    
be zeroed out or if it  would take a statutory change to get                                                                    
rid of the funds altogether.  Ms. Sanders responded that the                                                                    
language would  drain the loan  funds. She thought  it would                                                                    
take a statutory change to remove the accounts altogether.                                                                      
                                                                                                                                
Representative   Kawasaki   conveyed   that   it   was   his                                                                    
understanding that with  the $2 million increment  in the FY                                                                    
19 budget and the  supplemental request, the disaster relief                                                                    
fund would get to where it  needed to be. He wondered if the                                                                    
legislature  was  over-capitalizing  the fund.  Ms.  Sanders                                                                    
replied that  the administration's position was  to increase                                                                    
the fund  balance to $5  million. The amendment  would bring                                                                    
the  fund  balance  higher  than  that  amount.  Looking  at                                                                    
historical trends, it was a  very low balance. She continued                                                                    
that because disasters were  so unpredictable, the amendment                                                                    
put  forward  capitalized  it  further  in  anticipation  of                                                                    
spring disasters and future disasters.                                                                                          
                                                                                                                                
Co-Chair  Seaton  reiterated that  in  FY  14 the  fund  was                                                                    
capitalized  with $32.5  million, which  had been  used over                                                                    
time. He added that he  was trying to prevent supplementals.                                                                    
If  the  legislature  underfunded  the  fund,  supplementals                                                                    
would be necessary.                                                                                                             
                                                                                                                                
Representative  Wilson  was   concerned  with  having  $11.5                                                                    
million  by using  other funds,  rather than  addressing how                                                                    
the state would pay for it in the future.                                                                                       
                                                                                                                                
Representative Wilson WITHDREW her OBJECTION.                                                                                   
                                                                                                                                
There being NO  further OBJECTION, Amendment L H  SAP 25 was                                                                    
ADOPTED.                                                                                                                        
                                                                                                                                
1:14:46 PM                                                                                                                    
                                                                                                                                
Representative Pruitt  MOVED to ADOPT  Amendment L H  SAP 26                                                                    
(copy on file):                                                                                                                 
                                                                                                                                
     Language Amendments                                                                                                        
     L H SAP 26 - Reappropriating $416,060 from the Office                                                                      
     of the Governor to CACFA.                                                                                                  
     Offered by Representative Pruitt                                                                                           
                                                                                                                                
     Reappropriates  the  remaining unexpended,  unobligated                                                                    
     balance of  $416,060 from the  Office of  the Governor,                                                                    
     Arctic  Policy  Leadership   and  Economic  Development                                                                    
    Projects originally appropriated in FY14, to CACFA.                                                                         
                                                                                                                                
Representative Guttenberg OBJECTED for discussion.                                                                              
                                                                                                                                
Representative  Pruitt  MOVED   Conceptual  Amendment  1  to                                                                    
Amendment L H SAP 26.                                                                                                           
                                                                                                                                
Representative  Pruitt explained  the conceptual  amendment.                                                                    
It would  allow the balance  to be  used over the  course of                                                                    
FY 19 and FY 20, spreading  the $415,000 over 2 years rather                                                                    
than 1 year.                                                                                                                    
                                                                                                                                
1:15:37 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
1:17:44 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Co-Chair Seaton OBJECTED for discussion.                                                                                        
                                                                                                                                
Co-Chair Seaton  drew attention  to the  original amendment.                                                                    
He clarified that  on Page 1, Line 21 "June  30, 2020" would                                                                    
be inserted after June 30, 2019.                                                                                                
                                                                                                                                
Co-Chair Seaton WITHDREW his OBJECTION.                                                                                         
                                                                                                                                
There being NO further  OBJECTION, Conceptual Amendment 1 to                                                                    
Amendment L H SAP 26 was ADOPTED.                                                                                               
                                                                                                                                
Representative  Pruitt read  the amendment  (see above).  He                                                                    
explained that the intent of  the initial money that had not                                                                    
been utilized was for arctic  policy leadership and economic                                                                    
development  projects  including  oil and  gas  development.                                                                    
Essentially,  it  had  been  used  for  the  climate  change                                                                    
commission  that  the  governor  had been  involved  in.  He                                                                    
argued  that the  money had  been used  against oil  and gas                                                                    
development. He suggested that instead  of spending money on                                                                    
an issue  that was more  of a  federal, rather than  a state                                                                    
issue, the  money could  be used  for the  Citizens Advisory                                                                    
Commission  on   Federal  Areas  (CACFA).  He   thought  the                                                                    
commission should be out advocating  on behalf of Alaska. He                                                                    
asked for member support.                                                                                                       
                                                                                                                                
1:21:52 PM                                                                                                                    
                                                                                                                              
SHAWN HENDERSON, DIRECTOR  OF ADMINISTRATOR SERVICES, OFFICE                                                                    
OF  THE  GOVERNOR,  spoke  on  behalf  of  the  Governor  in                                                                    
opposition of  the amendment. He  explained that  the reason                                                                    
for  the governor's  opposition was  that the  arctic policy                                                                    
funding  was  the  primary funding  source  for  the  Alaska                                                                    
Climate  Change  Strategy  and  Climate  Action  for  Alaska                                                                    
Leadership Team.  On October 31,  2017, the  governor signed                                                                    
Administrative Order 289  establishing the Alaska leadership                                                                    
team to  advise the governor  on critical and  timely action                                                                    
to  address  climate   change  challenges  that  safeguarded                                                                    
Alaska.  The order  called for  state departments  to review                                                                    
previous work  on climate change  and to  identify immediate                                                                    
action responses  the state  could take.  The administrative                                                                    
order also zeroed  in on climate initiative  and addressed 4                                                                    
key  action  areas:   mitigation,  research,  response,  and                                                                    
adaptation. The initial action plan  was due to the governor                                                                    
on  September 1,  2018 and  following the  report submission                                                                    
additional work would transpire.  He respectfully asked that                                                                    
the funding remain part of the arctic funding policy.                                                                           
                                                                                                                                
Representative Wilson  mentioned that  CACFA had to  do with                                                                    
federal overreach.  She asked if federal  overreach was part                                                                    
of the problem with  climate change. Mr. Henderson responded                                                                    
that he did not know if it entailed overreach.                                                                                  
                                                                                                                                
Representative Wilson  asked how the $416,000  was currently                                                                    
allocated.  Mr. Henderson  indicated that  $416,000 was  the                                                                    
remaining balance  of the fund.  It had not  been designated                                                                    
for any particular purpose other  than for use of the Alaska                                                                    
leadership  team.  He  could provide  historical  detail  of                                                                    
where the money had been used.                                                                                                  
                                                                                                                                
Representative Wilson asked  how much had been  used and for                                                                    
what  purposes. Mr.  Henderson  responded  that the  initial                                                                    
appropriation was  $900,000. Representative Wilson  asked in                                                                    
which  year   the  initial  amount  was   appropriated.  Mr.                                                                    
Henderson replied in 2014. Since  that time, to-date $95,857                                                                    
had  been used  for personal  services, $71,633  for travel,                                                                    
$267,489 for services, and $5803  for commodities. The total                                                                    
amount spent to-date was $440,782.                                                                                              
                                                                                                                                
1:26:26 PM                                                                                                                    
                                                                                                                                
Representative Wilson  asked where  the FY  14 appropriation                                                                    
was  originally supposed  to be  spent. Mr.  Henderson would                                                                    
have  to  bring  detail  back to  the  committee.  He  could                                                                    
generally say that  it was intended for  arctic policies and                                                                    
project analyses.                                                                                                               
                                                                                                                                
Representative  Wilson  asked  about  using  the  governor's                                                                    
contingency  fund   to  make  up   the  difference   if  the                                                                    
legislature  were  to  use  the   $416,000  for  CACFA.  Mr.                                                                    
Henderson  could  not speak  to  how  the contingency  funds                                                                    
would be used.  The purpose of that fund  was for shortfalls                                                                    
in  certain areas  and to  be  used as  needed for  possible                                                                    
emergencies or  other actions. The money  was the governor's                                                                    
fund.                                                                                                                           
                                                                                                                                
Representative Wilson  asked if  the contingency  fund could                                                                    
be used to make up for  the amount of $416,000. She wondered                                                                    
if  there was  anything  that would  prevent  the fund  from                                                                    
being used  in this way.  Mr. Henderson replied, "Not  to my                                                                    
knowledge,  Representative  Wilson."  Representative  Wilson                                                                    
responded that that was her understanding as well.                                                                              
                                                                                                                                
Representative Pruitt  asked about  the membership  team and                                                                    
whether  they were  all  Alaskans.  Mr. Henderson  responded                                                                    
that all but one member of  the team was from Alaska. He was                                                                    
unsure about  the last person.  He could follow-up  with the                                                                    
information.                                                                                                                    
                                                                                                                                
Vice-Chair Gara did  not see the spending of  $416,000 on an                                                                    
agency that had  no power as a  wise use of money.  It was a                                                                    
state entity, rather than an  agency, created to look at and                                                                    
watch federal laws. Alaska had  two senators, a congressman,                                                                    
and  staff from  the Office  of the  Governor in  Washington                                                                    
D.C. He  suggested that it  was unreasonable to  spend money                                                                    
to watch federal  laws that the state  legislature could not                                                                    
change,  when Alaska  already  had  four representatives  in                                                                    
Washington  D.C.  who  could  affect  change.  He  would  be                                                                    
opposing the amendment.                                                                                                         
                                                                                                                                
1:30:33 PM                                                                                                                    
                                                                                                                                
Representative Guttenberg  recalled that in FY  17 the House                                                                    
did not  fund the appropriation,  the Senate funded  it, and                                                                    
the governor vetoed  it. In FY 18 the  appropriation was not                                                                    
in the  budget. He commented  that the entity was  a citizen                                                                    
commission, and  there was nothing to  prevent citizens from                                                                    
continuing their activity as their own endeavor.                                                                                
                                                                                                                                
Representative  Wilson  remarked  that the  amendment  would                                                                    
provide an option  of leaving $416,000 as a fund  to be used                                                                    
as needed or  the legislature could put  the funding towards                                                                    
a purpose that Alaskans were  concerned about. She would not                                                                    
be supporting  the amendment if  a position was going  to be                                                                    
cut.  She spoke  of  a contingency  fund  that the  governor                                                                    
could use. She was in support of the amendment.                                                                                 
                                                                                                                                
Representative Tilton asked  how long the CACFA  had been in                                                                    
the budget prior to  2017. Representative Kawasaki responded                                                                    
that it was reinstated in 2009 by Senator Mike Kelly.                                                                           
                                                                                                                                
Representative  Tilton asked  if  it was  the governor  that                                                                    
removed the  amount in FY  17. Mr. Henderson  responded that                                                                    
the funding had been dormant  since 2016. The funding at the                                                                    
time was $262,000 UGF.                                                                                                          
                                                                                                                                
Representative Kawasaki would be  opposing the amendment. He                                                                    
indicated there  were three young  Alaskans in  the audience                                                                    
that were  representing the  Alaska Youth  for Environmental                                                                    
Action. They were  very concerned with the  things that went                                                                    
on in Washington  D.C. He thought it was  an appropriate use                                                                    
of state money  when it came to the  governor's office being                                                                    
able to advocate for arctic  policy and economic development                                                                    
projects.  It was  one of  the reasons  for their  visit. He                                                                    
thanked them for being in Juneau.                                                                                               
                                                                                                                                
1:34:58 PM                                                                                                                    
                                                                                                                                
Representative  Tilton  thought   the  committee  had  heard                                                                    
earlier from  Representative Wilson  that the project  was a                                                                    
good use  of the  fund, but there  was an  alternate funding                                                                    
source that  could be  used to fund  the CACFA.  She thought                                                                    
the  legislature should  be listening  to its  citizens. She                                                                    
reemphasized that  there was  an alternative  funding source                                                                    
that could be used. She was in support of the amendment.                                                                        
                                                                                                                                
Co-Chair  Seaton would  be opposing  the  amendment for  two                                                                    
reasons. First,  he thought the Artic  Policy Leadership and                                                                    
Economic Development  Projects were extremely  important. He                                                                    
opined  that  the  state  should be  focusing  on  that  and                                                                    
adapting to  climate change.  H also  argued that  CACFA was                                                                    
basically a  slush fund for  use in a most  ineffective way.                                                                    
Putting a large portion of  money into a private effort that                                                                    
had no  function to accomplish  anything other  than talking                                                                    
to the legislature was not  something he supported. He would                                                                    
be opposing the amendment.                                                                                                      
                                                                                                                                
1:37:03 PM                                                                                                                    
                                                                                                                                
Representative  Pruitt thought  one  of the  members of  the                                                                    
artic leadership  team was  from Seattle.  He did  not think                                                                    
Alaskans would  appreciate someone from  Seattle, Washington                                                                    
setting arctic  policy for Alaska. He  indicated that Alaska                                                                    
had a delegation from Alaska,  however, they basically lived                                                                    
in  Washington  DC.  He  argued that  Alaska  did  not  need                                                                    
another  group advising  the  state what  to  do in  federal                                                                    
areas. He thought  it was better to have  citizens of Alaska                                                                    
advising the  federal government  on what  to do  in federal                                                                    
areas. He asked for the committee's support.                                                                                    
                                                                                                                                
A roll call vote was taken on the motion.                                                                                       
                                                                                                                                
IN FAVOR: Pruitt, Thompson, Tilton, Wilson                                                                                      
OPPOSED:  Gara, Grenn, Guttenberg,  Kawasaki, Ortiz, Foster,                                                                    
Seaton                                                                                                                          
                                                                                                                                
The MOTION to  adopt Amendment L H SAP 26  as amended FAILED                                                                    
(4/7).                                                                                                                          
                                                                                                                                
1:41:04 PM                                                                                                                    
                                                                                                                                
Vice-Chair Gara  MOVED to ADOPT  Amendment H JUD 4  (copy on                                                                    
file):                                                                                                                          
                                                                                                                                
     Alaska Court System                                                                                                        
     Trial Courts                                                                                                               
     H JUD 4 - Delete 16 of 32 Unfunded Positions                                                                               
     Offered by Representative Gara Deletes                                                                                     
                                                                                                                                
     16 long  term vacant  positions for  which there  is no                                                                    
     funding. Although  16 unfunded positions remain  in the                                                                    
     budget, the  Alaska Court System  would like  to retain                                                                    
     them.                                                                                                                      
                                                                                                                                
Representative Wilson OBJECTED for discussion.                                                                                  
                                                                                                                                
Vice-Chair Gara explained the amendment.  He had worked with                                                                    
the court system. He opined  that Judiciary had been doing a                                                                    
good  job   at  cost  containment  for   the  constitutional                                                                    
function they  performed. The agency  had been  losing money                                                                    
to  inflation,  experiencing   budget  reductions  over  the                                                                    
previous  few  years, and  had  empty  positions that  would                                                                    
probably not  be filled in  the current budget  climate. He,                                                                    
along with  the court  system, identified 16  positions that                                                                    
were  unfunded  and would  likely  remain  unfunded for  the                                                                    
following few years.                                                                                                            
                                                                                                                                
Representative Wilson WITHDREW her OBJECTION.                                                                                   
                                                                                                                                
There being NO OBJECTION, Amendment H JUD 4 was ADOPTED.                                                                        
                                                                                                                                
Co-Chair Seaton MOVED to ADOPT Amendment  L H UOA 3 (copy on                                                                    
file):                                                                                                                          
                                                                                                                                
     University of Alaska                                                                                                       
     Anchorage Campus                                                                                                           
     L H UOA  3 - Alaska mother and baby  vitamin D research                                                                    
     Offered by Representative Seaton                                                                                           
                                                                                                                                
     See 30-GH2564O.2                                                                                                           
                                                                                                                                
     This adds $499.5 over FY19  and FY20 for research to be                                                                    
     conducted  by  the  Institute  for  Circumpolar  Health                                                                    
     Studies  to  establish  a  baseline  for  prenatal  and                                                                    
     newborn  vitamin   D  levels   for  Alaska   women  and                                                                    
     children,  to determine  the  prevalence  of vitamin  D                                                                    
     deficiency among  pregnant women  and newborns,  and to                                                                    
     consider  whether  prenatal  vitamin D  screenings  and                                                                    
     supplementation  guidelines  should   be  modified  for                                                                    
     Alaska women and children.                                                                                                 
                                                                                                                                
Representative Wilson OBJECTED for discussion.                                                                                  
                                                                                                                                
Co-Chair Seaton read the amendment (see above).                                                                                 
                                                                                                                                
Representative Wilson  asked if there was  someone available                                                                    
to  testify  from  the   Institute  for  Circumpolar  Health                                                                    
Studies.                                                                                                                        
                                                                                                                                
JEFF JESSEE,  DEAN, COLLEGE OF  HEALTH, UAA,  ANCHORAGE (via                                                                    
teleconference), introduced himself.                                                                                            
                                                                                                                                
1:44:14 PM                                                                                                                    
                                                                                                                                
Representative Wilson asked how  the institute established a                                                                    
baseline for  prenatal and newborns  for anything,  not just                                                                    
vitamin  D. Mr.  Jesse responded  that  it was  a matter  of                                                                    
taking blood  samples, having them analyzed,  gathering them                                                                    
together,  and looking  at the  values of  vitamin D  in the                                                                    
blood systems  of both the  mothers and their  newborns. One                                                                    
of the advantages of the  study being discussed was that the                                                                    
newborn  vitamin  D  levels could  be  obtained  through  an                                                                    
umbilical cord draw rather than sticking the baby.                                                                              
                                                                                                                                
Representative Wilson  asked if any  study had been  done in                                                                    
the United States  on women and children and  vitamin D. Mr.                                                                    
Jesse replied  not to his  knowledge. There might  have been                                                                    
some studies done in the United  states, but none done in an                                                                    
arctic or near-arctic geographic area.                                                                                          
                                                                                                                                
Co-Chair  Seaton   noted  there  was  a   4-page  supporting                                                                    
document   in  member   packets   from   the  Institute   of                                                                    
Circumpolar Health Studies,  University of Alaska, Anchorage                                                                    
(copy on  file). [Document  can be  found in  the supporting                                                                    
documents  section of  the amendment  packet.] He  indicated                                                                    
there had been a number  of studies done in different places                                                                    
around  the world  that had  looked at  vitamin D  levels in                                                                    
cord blood and in pregnant  mothers. There was a significant                                                                    
amount of data that showed that  if a person had low vitamin                                                                    
D during pregnancy,  they had 4 times the  level of moderate                                                                    
to severe  language impairment at  age 5 going  into school.                                                                    
He referred  to other  studies that  showed the  benefits of                                                                    
adequate  levels of  vitamin  D. He  explained  that he  was                                                                    
putting  forth the  amendment because  Alaska  had a  severe                                                                    
amount  of  health costs  that  could  be reduced  with  the                                                                    
intake of vitamin  D. He continued to speak  to the benefits                                                                    
of taking vitamin D.                                                                                                            
                                                                                                                                
1:47:53 PM                                                                                                                    
                                                                                                                                
Representative  Wilson indicated  that it  sounded like  the                                                                    
data  was  already available.  She  wondered  why the  state                                                                    
would spend  money on  a study to  confirm what  was already                                                                    
known.                                                                                                                          
                                                                                                                                
Co-Chair  Seaton  would  agree  with  Representative  Wilson                                                                    
except  that in  2011 the  legislature proposed  a volunteer                                                                    
study across  the state sampling all  newborns, about 10,000                                                                    
newborns. At the  time, the Department of  Health and Social                                                                    
Services  indicated it  did not  do research  in Alaska.  He                                                                    
referred to  the State of  Alaska Epidemiology  Bulletin No.                                                                    
27, dated  November 1, 2016  (copy on file).  He highlighted                                                                    
the conclusion of  a vitamin D deficiency  study in prenatal                                                                    
Alaska Native  women in  the upper right  column. He  read a                                                                    
portion of the bulletin:                                                                                                        
                                                                                                                                
     Data from  these three studies  suggest that  vitamin D                                                                    
     deficiency  appears  to  be  highly  prevalent  in  YKD                                                                    
     [Yukon Kuskokwim  Delta] prenatal women.  While current                                                                    
     evidence does  not support routine vitamin  D screening                                                                    
     and supplementation  for prenatal  women on  a national                                                                    
     level,  such screening  and supplementation  appears to                                                                    
     be warranted in YKD.                                                                                                       
                                                                                                                                
Co-Chair Seaton  concluded that DHSS was  admitting that the                                                                    
state needed  to worry  about the problem  of low  vitamin D                                                                    
levels in Alaskans. The department  was identifying that the                                                                    
only population  that had been  studied was native  women in                                                                    
the  YKD. Alaska  was the  only arctic  state. He  indicated                                                                    
that 90  percent of  vitamin D  was transmitted  through sun                                                                    
exposure  to  the skin  and  a  person's own  production  of                                                                    
vitamin D. For 7 months of the  year, a person in Alaska did                                                                    
not  produce any  vitamin  D. He  continued  to discuss  the                                                                    
importance of further study of  vitamin D. He indicated that                                                                    
the  chief medical  officer had  testified that  he did  not                                                                    
want to take any actions  until he saw research on Alaskans.                                                                    
He continued to explain the needs  of a study on the general                                                                    
population of  Alaskan women and  newborns. Until  the state                                                                    
conducted a  study, the state would  continue experiencing a                                                                    
huge cost  in the  medical system.  He indicated  that about                                                                    
half of the babies born  in Alaska were born under Medicaid,                                                                    
about  5000 per  year. The  greatest proportion  of newborns                                                                    
were deficient  in vitamin D.  He concluded  that, according                                                                    
to the  testimony of  the chief  medical officer,  the state                                                                    
had  to have  Alaskan  research on  Alaskans from  different                                                                    
parts  of the  state before  he would  agree to  address the                                                                    
high  cost  medical  measure.  The  proposed  funding  would                                                                    
provide  actual  research on  Alaskans  so  that DHSS  would                                                                    
start saving  the state money  by avoiding the  condition of                                                                    
vitamin D deficiency.                                                                                                           
                                                                                                                                
1:52:23 PM                                                                                                                    
                                                                                                                                
Representative  Wilson provided  a hypothetical  scenario in                                                                    
which she brought her child  to a pediatrician. She wondered                                                                    
if  the  doctor would  not  be  able  to address,  test,  or                                                                    
provide  a prescription  for a  vitamin  D deficiency  until                                                                    
research was conducted.                                                                                                         
                                                                                                                                
Co-Chair Seaton  was not saying that  a particular physician                                                                    
would not  address the issue.  However, in general,  most of                                                                    
the state's doctors went to  school 30 years prior and never                                                                    
took  a course  in immunology.  Some physicians  were up  to                                                                    
speed on  things. He  reported that  about half  of Alaska's                                                                    
babies were  born under  Medicaid and most  of them  did not                                                                    
have a pediatrician. A large  portion of Alaska's population                                                                    
was vitamin D deficient. The  state needed data that applied                                                                    
to   Alaska's  general   population  showing   a  need   for                                                                    
treatment. He noted that the  preventative medicine group in                                                                    
Washington  D.C.  refused to  look  at  Alaska as  the  only                                                                    
arctic state  that might need  more than what was  needed in                                                                    
California. The  research would  help provide  the necessary                                                                    
data  that could  save  the state  a  significant amount  of                                                                    
money.                                                                                                                          
                                                                                                                                
Representative  Wilson asked  if  a Medicaid  representative                                                                    
was present.  She was very  concerned about Denali  Kid Care                                                                    
patients not  seeing pediatricians.  She asked if  there was                                                                    
anything  preventing pediatricians  from  doing testing  and                                                                    
providing necessary vitamin supplements.  She wanted to hear                                                                    
from   Medicaid.   Co-Chair   Seaton  clarified   that   the                                                                    
discussion was about neonatal care.                                                                                             
                                                                                                                                
Representative  Wilson  was  pretty  sure a  person  saw  an                                                                    
obstetrician prior to seeing a pediatrician.                                                                                    
                                                                                                                                
Vice-Chair  Gara   indicated  that   from  working   with  a                                                                    
significant amount of  youth and people who  had very little                                                                    
in  their lives,  they did  not necessarily  have a  regular                                                                    
doctor. People sought treatment  in emergent situations such                                                                    
as giving birth. It was the  reality for folks without a lot                                                                    
of money.                                                                                                                       
                                                                                                                                
1:56:44 PM                                                                                                                    
                                                                                                                                
Representative  Ortiz opined  that  it was  common in  rural                                                                    
Alaska not to have access to an obstetrician.                                                                                   
                                                                                                                                
Representative  Grenn  acknowledged the  co-chair's  passion                                                                    
for the subject.  He had learned a  significant amount about                                                                    
Vitamin D  from the handouts  that had been  distributed. He                                                                    
noted the co-chair  having shined a light  on the importance                                                                    
of  vitamin  D  and  the   negative  impacts  of  vitamin  D                                                                    
deficiency. The  amendment would not change  whether someone                                                                    
had  a pediatrician.  The amendment  asked  for $500,000  to                                                                    
conduct research  on something  that the state  already knew                                                                    
about but  was necessary  to move  forward. He  would rather                                                                    
spend  $500,000 on  Vitamin D  to distribute  throughout the                                                                    
state. He thought a larger issue was at hand.                                                                                   
                                                                                                                                
1:59:04 PM                                                                                                                    
                                                                                                                                
Representative  Pruitt thought  the  appropriation was  more                                                                    
fitting  as a  capital  expenditure.  He expressed  concerns                                                                    
about   using   Alaska    Comprehensive   Health   Insurance                                                                    
Association (ACHIA)  funding for the proposed  amendment. He                                                                    
noted  the co-chair  had discussed  the issue  of vitamin  D                                                                    
deficiency  for the  past several  years, so  much that  the                                                                    
member from  Anchorage currently had  a bottle of  Vitamin D                                                                    
at his  desk, and  departments were  including vitamin  D in                                                                    
their presentations. He wondered  what the end results would                                                                    
be confirming that Alaskans were  deficient in vitamin D. He                                                                    
thought  it was  already  established  that Alaskans  needed                                                                    
more  vitamin D.  He  could not  think of  a  better way  of                                                                    
getting vitamin  D except to stand  in the sun or  to take a                                                                    
pill. He wondered about the benefit of the expenditure.                                                                         
                                                                                                                                
Co-Chair  Seaton responded  that although  half of  Alaska's                                                                    
babies were  born under Medicaid, it  was not a change  of a                                                                    
federal program.  It was  a change  in state  guidelines and                                                                    
standards  of  what should  be  done.  Currently, the  state                                                                    
guidelines were the national standards  suited for the Lower                                                                    
48. He  argued that  Alaska was the  only arctic  state, and                                                                    
DHSS was  following national guidelines, the  only exception                                                                    
was for  mothers and  babies in  the Yukon  Kuskokwim Delta.                                                                    
For mothers and  babies in the Anchorage  area, for example,                                                                    
they fell under national  guidelines which indicated that it                                                                    
was not necessary  to test or supplement  pregnant women. He                                                                    
argued that  there was a  huge medical cost accruing  to the                                                                    
State of Alaska.                                                                                                                
                                                                                                                                
2:03:58 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
2:10:58 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
HB  285  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
HB  286  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
Co-Chair   Seaton  relayed   that  the   meeting  would   be                                                                    
adjourned. He discussed the schedule for the following day.                                                                     
                                                                                                                                

Document Name Date/Time Subjects
HB 286 H UOA 3 Amendment Supporting Document.pdf HFIN 3/8/2018 1:00:00 PM
HB 286
HB 286 H SAP 25 Amendment Fund Analysis Supporting Document.pdf HFIN 3/8/2018 1:00:00 PM
HB 286
HB 286 HB 285 Amendments with Actions as of 3-8-18.pdf HFIN 3/8/2018 1:00:00 PM
HB 285
HB 286