Legislature(2017 - 2018)SENATE FINANCE 532

03/26/2018 09:00 AM FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 116 EDUCATION TAX CREDITS;SUNSET;REPEALS TELECONFERENCED
Heard & Held
*+ SB 198 UAA LONG-ACTING CONTRACEPTION STUDY TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
SENATE BILL NO. 198                                                                                                           
                                                                                                                                
      "An Act relating to a study of the effectiveness and                                                                      
      cost of providing long-acting reversible contraception                                                                    
      to women with substance abuse disorders."                                                                                 
                                                                                                                                
10:13:32 AM                                                                                                                   
                                                                                                                                
SENATOR  PETE  KELLY,  SPONSOR,  introduced  the  legislation.  He                                                              
remarked   that  good  people   had  spent  time   and  effort  to                                                              
correct    social   ills   like   sexual    assault,   addiction,                                                               
suicide,   and  alcoholism   that  were  issues   of  despair.  He                                                              
remarked  that  he had  created  Empowering  Hope,  and felt  that                                                              
the  meetings  were  very effective.   He  shared  that the  group                                                              
probably  could  not fix  all  of Alaska's  ills.  He stated  that                                                              
the  group   narrowed   its  focus  to  fetal   alcohol   spectrum                                                              
disorder  (FASD).   He stated  that  there  was  decision   not to                                                              
have  efforts   to  manage   the  problem,   rather   focusing  on                                                              
eradicating  the  problem.  He  clarified  that FASD  was  part of                                                              
the  Empowering    Hope  legislation.   He   noted  that   he  had                                                              
funding  the  Empowering  Hope  mission  through  his legislative                                                               
office  by  hiring  Ryan Ray  as  executive  director.  He  stated                                                              
that   Empowering    Hope  was   moved   to   the   Institute   of                                                              
Circumpolar Health. He remarked that there were various                                                                         
collaborations, and shared that there were approaches that                                                                      
had been implementation.                                                                                                        
                                                                                                                                
10:22:22 AM                                                                                                                   
                                                                                                                                
HEATHER CARPENTER, STAFF, SENATOR PETE KELLY, discussed the                                                                     
Sectional Analysis (copy on file):                                                                                              
                                                                                                                                
      Section 1:                                                                                                                
      (A) Directs  the  University   of Alaska  Anchorage   Center                                                              
      for Alcohol   and  Addiction  Studies  to  conduct  a  study                                                              
      to evaluate  the  effectiveness   of providing  long-acting                                                               
      reversible    contraception     (LARC)    to   women    with                                                              
      substance  abuse   disorders  who   are  at  high  risk  for                                                              
      unintended   pregnancies   that  may   result  in   prenatal                                                              
      drug or alcohol exposure.                                                                                                 
                                                                                                                                
      The   study   shall   be   done   in   collaboration    with                                                              
      hospitals   and  health   care  providers   in  Alaska   who                                                              
      treat women with substance abuse disorders and:                                                                           
                                                                                                                                
      (1)  Establish   an   advisory   council   to  assist   with                                                              
      designing and implementing the study,                                                                                     
                                                                                                                                
      (2)  Evaluate   best  practices   for  treating   women  and                                                              
      children   when   there  is   a   high  risk   of   neonatal                                                              
      abstinence  syndrome   (NAS)   or  fetal  alcohol   spectrum                                                              
      disorders (FASD),                                                                                                         
                                                                                                                                
      (3)   Facilitate    a   network   for   sharing    of   best                                                              
      practices,                                                                                                                
                                                                                                                                
      (4) Identify   women and  children  to  participate   in the                                                              
      study on a voluntary basis,                                                                                               
                                                                                                                                
      (5)  Provide  LARC  to  participants   who  are  at  a  high                                                              
      risk  for  unintended   pregnancies   that   may  result  in                                                              
      prenatal drug or alcohol exposure,                                                                                        
                                                                                                                                
      (6) Evaluate   the  cost  and  effectiveness   of  providing                                                              
      LARC to reduce the occurrence of NAS and FASD,                                                                            
                                                                                                                                
      (7) Develop  a  cohort  of women  and  children  who  can be                                                              
     evaluated in later studies regarding NAS and FASD,                                                                         
                                                                                                                                
      (8)  Provide  a  data  driven   framework   to  establish  a                                                              
      comprehensive   strategy  for  using   LARC  to  reduce  NAS                                                              
      and FASD in Alaska.                                                                                                       
                                                                                                                                
      (B)  Directs  the   University   to  complete   two  interim                                                              
      reports  by June  30 of 2019  and  2020 and  a final  report                                                              
      by June 30, 2021.                                                                                                         
                                                                                                                                
      (C)  Provides  definitions   for  "fetal  alcohol   spectrum                                                              
      disorder,"  "long-acting   reversible  contraception,"   and                                                              
      "neonatal abstinence syndrome."                                                                                           
                                                                                                                                
      Section 2:                                                                                                                
                                                                                                                                
      Repeals  Section  1  on  June  30,  2021,  which   coincides                                                              
      with the date of the final report on the project                                                                          
                                                                                                                                
10:25:17 AM                                                                                                                   
                                                                                                                                
Senator  Olson  wondered  where  in the  state the  studies  would                                                              
be  conducted.   He  shared  that   the  issues  discussed   often                                                              
occurred   in  rural  Alaska.   Senator  Kelly   deferred  to  Mr.                                                              
Ray.                                                                                                                            
                                                                                                                                
JEFF  JESSE,  DEAN,  COLLEGE  OF  HEALTH,  UNIVERSITY  OF  ALASKA,                                                              
ANCHORAGE   (via   teleconference),    discussed   the   bill.  He                                                              
stressed   that  the  abuse  of  alcohol   and  drugs  had  severe                                                              
consequences   to Alaskans,   especially  to  the unborn   and the                                                              
consequences    of   that   effect   over   their   lifetime.   He                                                              
remarked  that  fetal  alcohol  spectrum  disorder  was a  problem                                                              
for  many   years   in  the  state.   He  noted   that   over  120                                                              
children   were  diagnosed  every  year.   He  remarked  that  the                                                              
number  did  not include  the  many  children  who  were  affected                                                              
by alcohol  exposure,   but their  symptoms  did  not rise  to the                                                              
level  of  diagnosis.   He  remarked   that  there  was  also  the                                                              
advent   of  the  opioid   crisis,   which   resulted   in  a  500                                                              
percent   in  neonatal   abstinence   syndrome  over   the  recent                                                              
decade.   He  remarked   that  those   were  critical   human  and                                                              
financial  issues  for  the  state.  He stressed   that there  was                                                              
an importance   for financial   investment  in the  university  to                                                              
ensure   that   there  was   the  capacity   for   assistance   in                                                              
addressing   major  policy,   by  providing   objective   data  to                                                              
have   the  best   information   available   to   make   the  best                                                              
decision.                                                                                                                       
                                                                                                                                
10:31:50 AM                                                                                                                   
                                                                                                                                
TREVOR  STORRS,  EXECUTIVE   DIRECTOR,  ALASKA  CHILDRENS   TRUST,                                                              
ANCHORAGE  (via  teleconference),   testified  in  support  of the                                                              
bill.  He  stated  that   there  was  a project   to  help  reduce                                                              
child  abuse,   so  Alaska  was   able  to  identify   key  social                                                              
determinants,     which   included    unplanned    and    unwanted                                                              
pregnancies.   He shared  that  the  Center  for  Disease  Control                                                              
(CDC)  reported  in  2006 that  49  percent  of  pregnancies  were                                                              
unintended.   He  stated  that  4  of  5  pregnancies   for  women                                                              
ages  19 and  younger  were unintended.   He stressed  that  under                                                              
the   age  of   15,  98   percent  of   those   pregnancies   were                                                              
unplanned.  He  shared  that births  from  unplanned  pregnancies                                                               
were  associated    with  adverse   maternal   and  child   health                                                              
outcomes.                                                                                                                       
                                                                                                                                
10:37:11 AM                                                                                                                   
                                                                                                                                
PATRICK  REINHART,   EXECUTIVE  DIRECTOR,   GOVERNORS  COUNCIL  ON                                                              
DISABILITIES,    ANCHORAGE   (via   teleconference),    spoke   in                                                              
support  of  the  bill.   He remarked   that  the  council  had  a                                                              
large  FASD work  group  that  included  individuals  from  around                                                              
the  state,   which  included   a  prevention   subcommittee.   He                                                              
stated  that  there  was a  submitted  letter  of  support  in the                                                              
packet.                                                                                                                         
                                                                                                                                
10:38:22 AM                                                                                                                   
                                                                                                                                
ART  DELAUNE,   GOVERNORS  COUNCIL   ON DISABILITIES,    FAIRBANKS                                                              
(via  teleconference),    spoke   in  support  of   the  bill.  He                                                              
echoed  Mr.  Rienhart's   comments.  He  shared  that  he was  the                                                              
parent  of two  men  who were  exposed  to  alcohol  in the  womb.                                                              
He  stressed  that  he  was very  aware  of  the  consequences  of                                                              
unintended   pregnancies   of   women  who   had  addictions.   He                                                              
shared   that  one  of  his  sons   had  siblings   who  were  all                                                              
alcohol-exposed   and in  state  custody.  He shared  that  he was                                                              
involved  in  consequences   for  women  who  were  finding  homes                                                              
for  children   who  were  exposed   to  alcohol.  He  understood                                                               
that  there  was  a  stigma   attached  to  mothers   of  children                                                              
with  FASD.  He shared  that  the  mothers  felt guilty  and  were                                                              
judged   by   others.    He   stressed    the   no   women   would                                                              
intentionally    expose    their   children    to   the   lifelong                                                              
disability.    He   stressed   that   the   addictions    impaired                                                              
judgment and resulted in poor decisions.                                                                                        
                                                                                                                                
10:42:11 AM                                                                                                                   
                                                                                                                                
ALYSON   CURREY,   LEGISLATIVE    LIAISON,   PLANNED   PARENTHOOD                                                               
VOTES,  JUNEAU,  addressed   some  concerns  with  the  bill.  She                                                              
shared   that  Planned   Parenthood,   in  2016,  provided   long-                                                              
acting  reversible   contraception   (LARC)   to  more  than  1000                                                              
patients  in  Alaska.  She strongly  support  efforts  to  address                                                              
barriers   to  access   to  the  full   range  of  birth   control                                                              
methods.  She  supported   efforts  to  evaluate   best  practices                                                              
for  treatment,  and  facilitate  the  efforts.  She  shared  that                                                              
there  was  a history  of  coercion  around  provider-controlled                                                                
contraceptive   methods  such  as LARC.  She  share  that  because                                                              
of  the  history  and  potential  for  ongoing  coercion,   nobody                                                              
should   be  directed   toward   any  particular   method   solely                                                              
because   it   was   cost   effective   or   more   effective   at                                                              
preventing   pregnancy,   which  may  not  be  a woman's   primary                                                              
goal  when  using   contraception.   She  felt   that  women  with                                                              
substance  use  disorders  were  just as  deserving  of the  right                                                              
to  make  their  own  reproductive  health   decisions.  She  felt                                                              
that  the  state   should  ensure   that  every  person   receives                                                              
complete,  unbiased   information   on the  full  range  of  birth                                                              
control   methods.   She  stated   that  she   submitted   written                                                              
comments.                                                                                                                       
                                                                                                                                
Co-Chair   MacKinnon   wondered   whether   Ms.   Currey   was  in                                                              
opposition  to  the  bill,  or whether  there  was  a request  for                                                              
amendments.   Ms.  Currey   replied   that  she  was   asking  for                                                              
amendments.                                                                                                                     
                                                                                                                                
10:45:51 AM                                                                                                                   
                                                                                                                                
Senator  Micciche   wondered  whether  the  eight  pieces  of  the                                                              
study  in  Section  1  were understood.   Ms.  Currey  replied  in                                                              
the  affirmative.   She  stressed  that   her  concerns  were  not                                                              
related  to  that  section.  She  remarked  that  the legislation                                                               
did  not  clarify  the  need   for collaboration    with  experts,                                                              
contraception, and family planning.                                                                                             
                                                                                                                                
Senator   Micciche   looked   at   item   3,  which   related   to                                                              
facilitating   a  network  for  sharing   of best   practices.  He                                                              
appreciated   the discussion   outside  of  the bill.  Ms.  Currey                                                              
responded   that  there   was  a  desire   to  be  aware   of  the                                                              
concerns   and   use  a   reproductive   justice   approach   when                                                              
working  with  women  with  substance  use  disorders.  She  hoped                                                              
that  the   women  would   not  be  pushed   toward  one   method,                                                              
without   information   on  the  full   range  of  birth   control                                                              
methods.                                                                                                                        
                                                                                                                                
10:48:59 AM                                                                                                                   
                                                                                                                                
MARY  NANUWAK,  SELF,  BETHEL  (via  teleconference),   felt  that                                                              
the  contraceptive  studies  have  been  controversial.   She felt                                                              
that  the studies   were often  biased.  She  remarked  that  FASD                                                              
was   preventable.   She   considered   Bethel   a  "third   world                                                              
country."   She  stressed   that  individuals   should   be  given                                                              
informed  consent  to  make their  own  decisions.  She felt  that                                                              
Senator   Giessel   should   not   be   considered   the   medical                                                              
authority.   She  shared  that  there  were  many   native  people                                                              
who  did not  speak  English,  which  could  be  complicated.  She                                                              
stressed   that  she   did  not   like  the   attitudes   of  some                                                              
professionals, because it caused confusion.                                                                                     
                                                                                                                                
Co-Chair MacKinnon CLOSED public testimony.                                                                                     
                                                                                                                                
10:52:47 AM                                                                                                                   
                                                                                                                                
RYAN   RAY,  HEALTH   POLICY   FELLOW,   UNIVERSITY   OF   ALASKA,                                                              
shared  that   he had   been  involved  in  the  Empowering   Hope                                                              
mission  since  the beginning.   He shared  that  he was  integral                                                              
in conducting the pregnancy test dispenser study.                                                                               
                                                                                                                                
Senator  Olson  wondered  where  the concentration   of the  study                                                              
would  be  conducted.  He  noted  that  some  of the  issues  were                                                              
concentrated   in  rural   Alaska,   where  women   did  not  have                                                              
access  to  information   and  contraception.    Mr.  Ray  replied                                                              
that  the  goal  was  to  develop  a  network   of  hospitals  and                                                              
birthing  centers  to  ensure  that  those  in rural  Alaska  were                                                              
not  left   out  of  the  study.   He  stated  that   the  primary                                                              
partnership   was   with  the   Alaska  Regional   NEST   Program,                                                              
which  had  taken the  lead  in addressing   NAS.  He stated  that                                                              
other hospitals would be partnering with the study.                                                                             
                                                                                                                                
Co-Chair   MacKinnon  stated   that  the  fiscal   note  would  be                                                              
updated.                                                                                                                        
                                                                                                                                
Co-Chair   MacKinnon  announced   that  the  public   hearing  for                                                              
the operating budget is cancelled.                                                                                              
                                                                                                                                
Senator  Micciche  looked  forward   to hearing  from  the  public                                                              
once the committee had received the budget.                                                                                     
                                                                                                                                
SB   198  was   HEARD   and  HELD   in   committee   for   further                                                              
consideration.                                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 116 Education Tax Credit.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Education Tax Credit_resident support.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Education Tax Credit support Dickson.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Graduate Student Letter B Ritchie.docx SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Letter of Support - Education Tax Credit Support Letter Sitnasuak 2018.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Letters of Support - Consolidated.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Miscellaneous Document - CY2017 Education Tax Credit Report.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Sectional Analysis.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Sponsor Statement .pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Summary of Changes .pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Support Education Tax Credit SB 116 and HB 233 - 2018.pdf SFIN 3/26/2018 9:00:00 AM
HB 233
SB 116
SB 116 Support Education Tax Credit.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Support Letter Alaska Chamber.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 116 Support Letter Harris.pdf SFIN 3/26/2018 9:00:00 AM
SB 116
SB 198 Individuals invited to testify.pdf SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Sectional Analysis.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Sponsor Statement.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Supporting Documents - ACT Letter of Support.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Supporting Documents - Alaska Dispatch Article May 2016.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Supporting Documents - JSAT Article.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 Supporting Documents - NEJM Study May 2012.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198_LARC study_testimony_PPVNH.pdf HHSS 4/19/2018 3:00:00 PM
SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 attachment 2_Guttmacher Guarding against Coercion.pdf SFIN 3/26/2018 9:00:00 AM
SB 198
SB 198 attachment 1_SisterSong LARC Statement of Principles.pdf SFIN 3/26/2018 9:00:00 AM
SB 198
SB 116 HB233 SB116 PWSSC support.pdf SFIN 3/26/2018 9:00:00 AM
HB 233
SB 116