Legislature(2015 - 2016)CAPITOL 106
03/17/2016 03:00 PM House HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| HB234 | |
| HB237 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 234 | TELECONFERENCED | |
| += | HB 237 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 344 | TELECONFERENCED | |
HB 234-INSURANCE COVERAGE FOR TELEMEDICINE
3:07:14 PM
CHAIR SEATON announced that the first order of business would be
HOUSE BILL NO. 234, "An Act relating to insurance coverage for
mental health benefits provided through telemedicine."
3:08:09 PM
ANITA HALTERMAN, Staff, Representative Liz Vazquez, Alaska State
Legislature, paraphrased from the Sponsor Statement [included in
members' packets], which read:
This bill seeks to require health care insurers that
offer, issue, or renew insurance plans in Alaska to
reimburse mental health professionals for medically
necessary services delivered using telemedicine via
secure phone or internet video applications. This
legislation would not require an initial face to face
visit but requires providers be licensed in Alaska.
There is no law in Alaska requiring private insurance
companies that provide mental health benefits to
reimburse for services provided though telemedicine.
There are thousands of Alaskans across the state that
have private health insurance but have little or no
access or choice of professional mental health
providers because some private insurers do not
reimburse for telephonic or video mental health
counseling. Currently, mental health providers and
individuals must demonstrate to some insurance
companies that the individual has a severe mobility
issue and cannot obtain counseling where they live, or
that an emergency exists. In many cases individuals
are still often refused reimbursement for mental
health services furnished through telemedicine.
Alaska's Medicaid program funds most mental health
services for individuals with severe or chronic mental
illness. Medicaid regulations clearly allows payment
for telemedicine delivery, and do not require face-to-
face visits. Thus, there is currently a double
standard in Alaska between public and private health
care reimbursement for services furnished through
telemedicine. The national trend is to allow for
reimbursement for mental health services provided
through telemedicine. According to the Center for
Connected Health Policy, State Telehealth Laws and
Medicaid Programs Policies, 32 states and the District
of Columbia currently have telehealth parity laws,
some of which will go into effect by 2016 and 2017. An
interactive map from the Center for Connected Health
Policy can be retrieved online at
http://cchpca.org/state-laws-and-reimbursement-
policies.
Historically, there was a reluctance to reimburse for
services delivered through telemedicine because there
was no established code of ethics regarding electronic
counseling and no secure video or telephonic
resources. However, today the mental health counseling
profession has to comply with the national
Telemedicine Codes of Ethics addressing internet
services. In addition, there are free encrypted, HIPAA
compliant telephone and video conferencing
applications that work with low broadband internet.
Thus, with the current available technology and code
of ethics regulating the professional use of this
technology, there are numerous advantages to both
patients and Alaskan mental health providers.
Advantages of Telemedicine:
• Provides for better access/privacy in rural and
remote as well as urban areas of Alaska
• Early intervention is key to prevention, which saves
money
• Often individuals will seek counseling earlier in
distress if they aren't seen entering an office
• Alaskans with mild to moderate needs may seek help
that is more convenient/accessible
• It saves time and money for many patients if they do
not have to leave home or office
• Greater access for referrals to providers who
specialize in treating specific issues
• Better access means a potential reduction in
suicides, domestic violence and more serious crises
• Costs are expected to be the same to insurance
companies as face to face counseling
• Zero impact on state budget
In summary, this proposed legislation is very limited
in scope. First, it does not require insurers to
provide or cover mental health benefits. It only
requires insurers that presently offer mental health
benefits to reimburse for these benefits delivered
through telemedicine. In addition, this bill requires
that the mental health service be provided "by a
health care provider licensed in this state".
In conformance with the mental health profession, this
bill uses the term "mental health" versus "behavioral
health". Research has shown that both terms are used
interchangeably by those in the mental health
profession and that the term "behavioral health" is
not defined within Alaska Statute or regulation.
MS. HALTERMAN explained that the bill sponsor had included in
members' packets a definition of telemedicine, which read:
7 AAC 12.449. Definitions. "Telemedicine" means the
practice of health care delivery, evaluation,
diagnosis, consultation, or treatment, using the
transfer of medical data, audio, visual, or data
communications that are performed over two or more
locations between providers who are physically
separated from the recipient or from each other.
3:14:07 PM
MS. HALTERMAN stated that it was necessary for a review of the
definition for behavioral health to be included in statute. She
relayed that it was necessary to address the concerns for the
potential shortage of providers for substance abuse needs and
she spoke about the possibilities of treatment for substance
abuse through telemedicine. She acknowledged the obligation for
licensing of the provider, and that some people felt that a face
to face encounter was necessary prior to engagement in
telemedicine. She expressed a preference to leave the decisions
for best practices to the medical professionals rather than
dictate through public policy. She stated that she was not
supporting this change, but would prefer to keep the proposed
bill simple, as it ensured parity and was consistent with the
work in most other states. She relayed that telemedicine was
reimbursed in more than 32 states, and she gave Alaska an A+ for
its Medicaid reimbursement for telemedicine, but an F for its
private sector reimbursement. She declared that it was time for
that [private sector reimbursement for telemedicine] to change.
3:17:15 PM
CHAIR SEATON directed attention to the sponsor statement which
stated that mental health and behavioral health definitions were
used interchangeably, yet the definition for behavioral health
in the proposed bill, which included substance abuse and
counseling, would not be covered in the proposed bill. He
suggested the need to look at that more carefully. He expressed
his understanding that there may not be enough providers for
substance abuse, alcohol treatment, and other similar issues.
He surmised that should telehealth be eliminated as a mechanism
for providing that counseling, there would not be any expansion
of the provider pool because it was not legal for reimbursement.
He reported that this was concern voiced by the Alaska Mental
Health Board Advisory Board on Alcoholism and Drug Abuse and may
be addressed further.
REPRESENTATIVE VAZQUEZ relayed that the sponsor did not want to
mandate what constituted mental health services to the insurance
companies. The bill simply stated that mental health services
which were offered, also needed to be available via
telemedicine. She declared that this was not expanding or
mandating anything further to the insurance companies. She
pointed to the shortage of providers, with individuals in need
of services, and many outlying villages not very accessible.
CHAIR SEATON offered his belief that this was not a discussion
for expansion of the definition to include other things, but
that coverage of substance abuse, alcoholism, and counseling
should also be offered through telemedicine. He declared that
he was not advocating expansion of the bill or the requirements.
He opined that the bill stated that if those services were
already offered, then they should also be provided by
telemedicine. He pointed out that the current definition
specifically excluded alcoholism or drug abuse counseling, and
he was unclear if that was the intent.
3:22:23 PM
MS. HALTERMAN pointed out that neither Alaska's statute nor
regulation currently defined behavioral health, although she
discovered that behavioral health was defined in 7 AAC 70.996 as
"the outpatient evaluation or treatment of an individual's
mental health or substance use." In 7 AAC 160.990.87, it was
defined as a behavioral health clinic service; and in 7 AAC
135.010(c), behavioral health rehabilitation services was
identified. She stated that mental health benefits were defined
as the following in state statute, AS 21.54.500, under
definitions (22), she read:
benefits provided for mental health services as
defined under the terms of a health care insurance
plan but does not include benefits for treatment of
substance abuse or chemical dependency.
MS. HALTERMAN reiterated that behavioral health had not been
defined in the insurance statute, hence the lack for a
consistent definition. She reported that a general term
definition for behavioral health had been found in the federal
agency, Substance Abuse and Mental Health Services
Administration (SAMHSA) which encompassed the promotion of
emotional health, the prevention of mental illness and substance
abuse use disorders, and treatment and services for mental
and/or substance use disorders. She relayed that the lack of
definition in state statute had road blocked them.
CHAIR SEATON asked whether this bill would require coverage
through telemedicine for a private insurance company currently
covering substance abuse or behavioral health. He asked if this
was the intention of the bill.
REPRESENTATIVE TARR shared that she had not yet fully resolved
her comfort level regarding the requirement for the in-person
contact, as there could be an emergency circumstance, and she
would not want that to preclude the delivery of telehealth
services. She added that a lot of the experience with mental
health services and its indicators related to demeanor,
behavior, and overall appearance. She suggested a search for
the sweet spot where things were not limited unnecessarily, but
to also encourage the initial in-person assessment.
MS. HALTERMAN offered to share an analysis which addressed the
states' positioning on telemedicine. She stated that there were
also national standards provided for telemedicine. [Included in
members' packets.] She declared that the proposed bill did not
change the provider responsibility to determine its own best
practice, it left the decision in the hands of the provider and
not the insurance company.
REPRESENTATIVE TARR directed attention to page 1, line 9, of the
proposed bill, and read: "and may not require that prior in-
person contact occur... " She questioned whether this language
could be made less restrictive, as her interpretation was the
opposite of that from Ms. Halterman. She asked that the
Legislative Legal Services "help sort that out." She directed
attention to the 288 page Best Practices document.
MS. HALTERMAN replied that the bill addressed an obligation of
the insurance industry, not the medical professional, as it
imposed the requirement that the insurance company not enact the
face to face requirement. She relayed that, if the provider
determined that the face to face encounter was the best
practice, they had the right to make that medical decision when
dealing with the patient.
3:30:06 PM
CHAIR SEATON directed attention to page 1, line 5, of the
proposed bill, and clarified that nothing precluded a health
care insurer from offering mental health and substance abuse
counseling through telemedicine, although nothing required the
insurer to offer this through telemedicine.
MS. HALTERMAN expressed her agreement.
3:31:36 PM
CHAIR SEATON opened public testimony.
3:32:00 PM
LYN FREEMAN, MD, Mind Matters Research, reported that she was a
clinical researcher, as well as a private provider for chronic
diseases, mental illness, and mental stress. She mentioned the
issue of provider determination for appropriate treatment by
telemedicine, and assured the committee that even the first
contact through telemedicine was good. She encouraged the
committee not to limit this contact. She reported that she had
created a mental health intervention, through a grant from the
National Institutes of Health, to overcome the long term and
late term side effects of cancer and its treatments. She noted
that this intervention had been clinically designed, tested, and
delivered in Alaska. She stated that it was delivered "first
and foremost" to improve the quality of life and the medical
outcomes of Alaskans. She added that this had also been
delivered in the State of Washington as "a multi trial effect."
She delivered this mental health support to patients in Alaska,
as it had been found to be highly effective in reducing and
reversing symptoms. She relayed that she had been treating
patients in her office, but had recognized that access for face
to face treatment was too expensive for many areas of the state.
She declared that, although she would prefer to have a face to
face delivery, the telemedicine delivery was "every bit as
efficacious and beneficial to the patients it served as the ones
that I treated in person." She directed attention to nationwide
research on telemedicine for similar results. She acknowledged
that there were situations when it was necessary to have the
patient in person, and that professionals were aware of the need
to identify these situations. She stated her support of the
proposed bill.
REPRESENTATIVE VAZQUEZ asked for an example to the lack of
telemedicine becoming a barrier to access for treatment.
DR. FREEMAN declared that there were five people just this week
who she had not been able to schedule for weekly visits for a
variety of reasons.
REPRESENTATIVE VAZQUEZ asked how many patients had been affected
so far this year due to the lack of telemedicine.
DR. FREEMAN opined that there were about 40 patients, although
she had severely limited her treatment schedule to those whom
she could personally treat. She stated that passage of the
proposed bill would allow her to make this treatment more
available.
REPRESENTATIVE TARR asked for a description regarding the face
to face meetings and whether they were a necessity.
DR. FREEMAN explained that she used HIPAA compliant programs for
phone calls which allowed for the ability to visualize the
patient and interact live in real time. She pointed out that
telemedicine was defined in some states as face to face, per the
ability to see someone's face, although that definition did vary
from state to state. She declared that often a phone call could
offer plenty of evidence for whether there should be a treatment
in-person. She said that she was able, almost every time, to
have a first meeting with a patient with a visual form of
telemedicine. She reported that the patient only needed a
computer with a screen, and a quiet, private place. She
declared that the purpose and intent was to serve people in the
least stressful and most convenient way as these populations
were already overwhelmed and did not need additional stressors
and barriers in their way.
3:42:00 PM
MICHAEL SOBOCINSKI, Alaska Psychological Association, declared
support of the proposed bill by the association. They believed
that the use of technology, such as telemedicine, was critical
in Alaska in order to provide access to needed health care
services, especially in the provision of mental health services.
He affirmed that there had been many obstacles to access, and he
opined that the proposed bill would help advance health care.
CHAIR SEATON asked if there was any problem with the various
definitions for mental health when billing the insurance
companies for care provision to mental health or substance abuse
issues.
MR. SOBCINSKI replied that he worked in the community mental
health center, and he was not as familiar with insurance in the
private sector. He stated that very often people with mental
health issues had co-occurring substance use problems, and that
most providers would see people with both issues. He offered
his belief that the definitions would be determined by the
private insurance providers.
3:44:50 PM
ROBERT LANE, MD, Alaska Pacific University, Alaska Psychological
Association, expressed his support for the proposed bill, as it
put private providers on equal footing with those in the
Medicaid system. He reported that, as part of the training
facility, they were teaching students to be well-practiced with
the ability to do telemedicine. He added that, as a
psychologist in private practice he had focused almost entirely
on substance abuse, and that there had never been a problem with
his billing for treatment under his psychologist license. He
pointed out that a letter for support had been sent. [Included
in members' packets.]
3:46:59 PM
DIANE INGLE reported that she had sent a letter in support of
the proposed bill from a patient perspective [included in
members' packets]. She shared that she had long term challenges
with mental health, and that she had been fortunate enough to
always receive treatment for services, which allowed her to have
a successful educational experience, earning a graduate degree
in public health. She reported that she had served the
Municipality of Anchorage as the Director of the Department of
Health and Human Services. She shared that she had found that
mental health counseling in conjunction with any medical
management was the best way to deal with the issue. She pointed
out that many people in Alaska were socially isolated for a
variety of reasons including sexual and physical abuse, and were
not given the opportunity to easily leave their home to seek
counseling. She noted that there were times when it was not
possible to go to the provider, which were often the times when
she was most in need to talk with her provider. She shared that
she felt compelled to share her story because she believed that
mental health had all too often been pushed out of sight, and it
was necessary to "bring good quality services and help people
who can be successful, be successful."
3:53:15 PM
ROBIN MINARD, Director, Public Affairs, Mat-Su Health
Foundation, reported that the Mat-Su Health Foundation shared
ownership in the Mat-Su Regional Medical Center and invested its
profits from this partnership back into the community in order
to improve the health and wellness of Alaskans living in the
area. She declared support for HB 234, as it increased the
access to needed mental health services provided by
telemedicine. She asked that there be inclusion for substance
abuse disorders along with mental health in the proposed bill,
as it would encourage more providers to do the necessary work to
"get into telemedicine." She reported that a 2013 community
health needs assessment from more than 500 Mat-Su residents had
identified that the top five health and wellness goals for the
community were all related directly to access to behavioral
health care. She stated that this assessment data made clear
that the residents did not have access to vital care for mental
health and substance abuse disorder needs. She shared that,
without this access, many people could not seek needed care
until the situation became a crisis, with a visit to the
emergency room of a hospital. She reported that, in 2013,
alcohol related disorders for behavioral health care were the
number one reason for emergency room visits to the Mat-Su
Regional Medical Center, at a cost of $23 million not including
the doctor, emergency medical service (EMS), or police costs.
She declared that telemedicine was a proven way to increase
access to health care, pointing out that recruiting and
retaining an effective behavioral health workforce was difficult
in states with large rural populations, similar to Alaska. She
stated that, statewide, Alaska had significantly lower rates of
psychiatrists, psychologists, substance abuse counselors, and
marriage and family counselors compared to the national average,
with both Alaska and the Mat-Su designated as federal mental
health shortage areas. She reported that data had shown that
there were several behavioral health providers who had not been
able to find psychiatrists to work on-site, hence the need for
telemedicine to get access to medication management services for
the clients. She reported that there was a tremendous need in
the Matanuska-Susitna Borough for infant and early childhood
mental health specialists. She emphasized that the cost for
travel to receive and provide mental health and substance abuse
care was tremendous, and ultimately lead to the treatment of
problems at a crisis level, instead of earlier when care was
less expensive. She shared the experiences of a local provider
now offering telemedicine, stating that the provider had "seen
no significant difference in the effectiveness of the service
provided via telemedicine versus traditional in-office visits."
She reported that 86 percent of those telehealth clients had
evidenced a reduction in substance use, while 100 percent
reported being treated with respect, and 85 percent evidenced an
increase in their quality of life as a result of participation
in the program.
MS. MINARD shared a University of Maryland study from 2003 which
examined the distance travelled for out-patient substance abuse
treatment and its impact of client retention. This report
stated that clients who travelled less than one mile were 50
percent more likely to complete treatment than those who
travelled more than one mile, with everything else consistent.
She noted that clients in the local telehealth program, with no
distance to travel, had a 33 percent lower no-show rate than
clients in traditional treatment groups.
3:59:09 PM
MARGARET BRODIE, Director, Division of Health Care Services,
Department of Health and Social Services, said that the
department fully supported telemedicine and that it was a really
good way for the state to save money.
3:59:32 PM
RANDALL BURNS, Director, Central Office, Division of Behavioral
Health, Department of Health and Social Services, reiterated
that the department was fully in support of telehealth and
believed that parity was a very important issue.
CHAIR SEATON asked if the department had any further comments on
parity, and if they dealt with any private insurance.
MR. BURNS said that the department did not deal with private
insurance.
MS. BRODIE said that this would affect the Medicaid program as
many services it currently paid for would be billed back to the
insurance companies, thereby recovering the money for the state.
CHAIR SEATON mused that a private insurance company which paid
for counseling for chemical dependency was not required to offer
this through telemedicine. He asked, if the proposed bill
required that private insurance which offered substance abuse
services must also offer counseling through telemedicine, what
effect this would have on Medicaid.
MS. BRODIE replied that this would increase the collectable
amount from insurance companies, as the services would increase.
REPRESENTATIVE VAZQUEZ asked for a specific example for how the
proposed bill would benefit the Medicaid program.
MS. BRODIE explained that for the use of telehealth with
chemical dependency counseling, if an individual had insurance
and Medicaid for these services, the Medicaid program would bill
the insurance companies for those costs, and would save money in
other areas by reducing the utilization of emergency rooms and
primary care. Patients would receive the proper care and
treatment in the appropriate setting.
MR. BURNS added that there were occasions when the provision of
tele-behavior health services for consultation to an individual
awaiting transfer to Alaska Psychiatric Institute (API), thereby
avoiding the necessity for transfer, would allow for the private
insurance to be billed.
REPRESENTATIVE VAZQUEZ asked how much this would have saved in
FY15.
MR. BURNS replied that it did not happen that often as it was
currently difficult to connect a patient with a psychiatrist in
an emergent situation, although it had been possible upon
occasion.
REPRESENTATIVE WOOL asked for clarification about a patient with
private insurance and Medicaid.
MS. BRODIE explained that Medicaid was the payer of last resort,
so any other health care insurer was billed for any covered
services.
REPRESENTATIVE WOOL mused that, as Medicaid was the safety net
for covering costs that private insurance did not cover, it was
important for the State of Alaska to have private insurance pay
for telemedicine. He asked if insurance covered substance abuse
with telemedicine if it was not the primary issue.
MS. BRODIE, in response to Chair Seaton, explained that, if
insurance does not cover a service through telemedicine, and an
individual has Medicaid, then the state would pay for this
through Medicaid because Medicaid does cover that service.
However, if the insurance company did cover this service and it
was also offered through telemedicine, it would be possible to
bill them.
REPRESENTATIVE WOOL asked about the travel expenses for
treatment paid by Medicaid, and offered his belief that there
would be savings with telemedicine.
MS. BRODIE said that was correct, that there would be savings
for travel and lodging, as well.
REPRESENTATIVE VAZQUEZ asked for the amount of savings from
travel and lodging.
MS. BRODIE said that she did not have a figure available, and
that she was unsure for finding them.
4:12:19 PM
CHAIR SEATON closed public testimony after ascertaining that no
one further wished to testify.
4:12:26 PM
REPRESENTATIVE VAZQUEZ said that the Medicaid program had model
regulations for telemedicine legislation, touted as best
practices nationally.
CHAIR SEATON questioned whether behavioral health and substance
abuse should also be required for coverage by telemedicine, if
it was already covered in an insurance plan. He relayed that
testimony had indicated telemedicine was much more effective for
consistency and follow up, and that improvement to the success
rate for substance abuse would go up. He acknowledged that the
House Health and Social Services Standing Committee did not "do
too much with private insurance," although the bill would next
be heard in the House Labor and Commerce Standing Committee
which specifically worked with these definitions. He offered
his belief that the committee should arrive at a correct
definition to ensure that the behavioral health services covered
by private insurance should also be covered by telemedicine. He
stated that this would not be an expansion of private insurance
coverage. He expressed concern for forwarding his own
conceptual amendment, and asked that the sponsor of the proposed
bill write an amendment to be included with the bill during its
hearing in the House Labor and Commerce Standing Committee. He
offered his belief that:
it's a good bill and has a lot of issues that it's
covering, but I think that substance abuse is so
profound and prolific here in our state that if we
could address that and make treatment of substance
abuse more effective, I think that that's something
that we should seriously consider in the offering of
telemedicine.
4:15:46 PM
REPRESENTATIVE TARR expressed her concern for a circumstance
with co-occurring disorders when the provider states that it can
only help with part of the problem. She acknowledged that the
proposed bill only dealt with one specific component, mental
health services.
CHAIR SEATON asked if substance abuse was defined in state
statute, suggesting that this definition could be cited.
MS. HALTERMAN offered her belief that the definition was not
included in state statute. She shared that there had been a
change within the Department of Health and Social Services that
integrated behavioral health, mental health issues, and
substance abuse, and these all used the same standard set of
billing codes for these services. She pointed out that there
was the potential side effect that individuals had to lose their
employment in order to gain Medicaid coverage for the necessary
treatment.
4:18:28 PM
MR. BURNS opined that there were still some issues around the
coding for the services that these were not as integrated as
preferred.
MS. BRODIE reported that the Department of Health and Social
Services was working to make headway on the coding to make it
work for the providers in Alaska. She noted that there had been
substantial changes to the medical billing and the diagnosis
codes.
REPRESENTATIVE TARR asked whether the accessibility to a
computer and internet service for an individual who could not
afford these would be considered a part of the service so the
insurance provider would assist with availability.
MS. BRODIE explained that telemedicine was not limited to video,
that it could be telephonic, as well.
REPRESENTATIVE TARR asked if a telephone was the only
technological necessity.
MS. BRODIE expressed her agreement.
4:22:16 PM
CHAIR SEATON re-opened public testimony.
4:22:28 PM
KATE BURKHART, Executive Director, Advisory Board on Alcoholism
& Drug Abuse, Division of Behavioral Health, Department of
Health and Social Services, offered a definition of substance
abuse treatment, as defined in statute, AS 47.37.270(15), which
she read:
a broad range of emergency, outpatient, intermediate,
and in-patient services and care that may be extended
to alcoholics, intoxicated persons, or drug abusers,
including diagnostic evaluation, medical, psychiatric,
psychological and social service care, vocational
rehabilitation, and career counseling.
MS. BURKHART stated that this was a different definition than
that definition for treatment for mental illness or mental
health in the community mental health act.
4:24:01 PM
CHAIR SEATON closed public testimony on HB 234.
4:24:18 PM
REPRESENTATIVE TARR said that she was supportive of the
intentions of the proposed bill, although she had some concerns
with the substance abuse issues.
REPRESENTATIVE VAZQUEZ opined that, as the bill was being
referred to the House Labor and Commerce Standing Committee,
they were well versed in insurance issues. She suggested that
some of these issues may be moot per mandates of the Patient
Protection and Affordable Care Act, although, she admitted to
being not versed on these requirements.
CHAIR SEATON stated that the focus was only for the telemedicine
portion, and that it was either [PP]ACA compliant or offered by
private insurance. He pointed out that if coverage was offered,
it had to be extended to include telemedicine.
REPRESENTATIVE WOOL asked about a limitation to the availability
of providers, as well as considerations for the coding issues
and co-occurrence with other mental illness.
MS. HALTERMAN expressed her agreement that there were some
outstanding questions that still needed to be addressed,
including a clear definition in state statute for behavioral
health, and the shortage of providers to serve these
populations. She stated that she would like to move forward
with the requirement for mental health coverage, with a promise
to explore these other issues.
REPRESENTATIVE VAZQUEZ reported that there was a definition of
mental illness in AS 47.30.915(c)(14), and she stated:
mental illness means an organic mental or emotional
impairment that has substantial adverse effects on an
individual's ability to exercise conscious control of
the individual's actions or ability to perceive
reality or to reason or understand; intellectual
disability, developmental disability, or both;
epilepsy, drug addiction, and alcoholism do not per se
constitute mental illness, although person's suffering
from these conditions may also be suffering from
mental illness.
REPRESENTATIVE VAZQUEZ pointed out that the current definition
excluded drug addiction and alcoholism.
CHAIR SEATON clarified that this was not an attempt to expand
the definition of mental health. If coverage for substance
abuse treatment was offered, then this should also be offered
through telemedicine. He said that he was comfortable moving
forward with the proposed bill.
REPRESENTATIVE VAZQUEZ expressed her agreement that she would
prefer to move the bill forward to the next committee of
referral.
CHAIR SEATON suggested having an amendment written.
REPRESENTATIVE TARR said that she would not object to moving the
proposed bill, and expressed her desire that the House Labor and
Commerce Standing Committee could resolve the issue.
4:31:43 PM
REPRESENTATIVE VAZQUEZ moved to report HB 234, Version 29-
LS1251\A, out of committee with individual recommendations and
the accompanying fiscal notes. There being no objection, HB 234
was moved from the House Health and Social Services Standing
Committee.