03/28/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES

             SB   5-MEDICAL ASSISTANCE ELIGIBILITY                                                                          
                                                                                                                              
CHAIR DAVIS announced the first order  of business would be SB 5,                                                               
the Denali KidCare bill.                                                                                                        
                                                                                                                                
JON  SHERWOOD, Medical  Assistance  Administrator, Department  of                                                               
Health and  Social Services (DHSS),  said he would  speak briefly                                                               
to  two issues.  At the  last hearing  there were  some questions                                                               
about   regulations   defining  "therapeutic   abortion."   Those                                                               
regulations  apply  to the  old  general  relief medical  program                                                               
which  has not  been funded  in 13  years; they  do not  apply to                                                               
Denali KidCare.                                                                                                                 
                                                                                                                                
Second, DHSS  has a  process for  determining what  an "abortion-                                                               
related" service  is. They look  at the  procedure code/diagnosis                                                               
code   combination.   There  is   a   wide   range  of   possible                                                               
combinations.  If  necessary  they request  medical  records  for                                                               
review. The significant point is  to confirm that stillbirths and                                                               
miscarriages  are  not  included  when  counting  the  number  of                                                               
abortion-related services.                                                                                                      
                                                                                                                                
1:38:36 PM                                                                                                                    
SENATOR MEYER  asked, "When was  the last  time we looked  at the                                                               
definition of medically necessary?"                                                                                             
                                                                                                                                
MR. SHERWOOD answered it was around  2003; he was not involved so                                                               
he doesn't know  any details, but there was a  bill introduced to                                                               
try and define it.                                                                                                              
                                                                                                                                
SENATOR MEYER  said the  definition the  committee saw  last week                                                               
seemed pretty  broad. He  asked if  any counseling  services with                                                               
regard  to adoption  are required  to  be offered  by the  doctor                                                               
prior to performing an abortion.                                                                                                
                                                                                                                                
MR. SHERWOOD said  doctors are not required to  certify that they                                                               
have  done  any counseling.  Basically,  case  law says  "medical                                                               
necessity" means to  be neutral. The state  cannot be restrictive                                                               
in terms of what it deems medically necessary.                                                                                  
                                                                                                                                
1:41:05 PM                                                                                                                    
SENATOR MEYER  said he  had already  voiced his  frustration with                                                               
the bill,  unless the  governor's concerns  can be  addressed. We                                                               
would be potentially increasing the number of abortions.                                                                        
                                                                                                                                
1:41:40 PM                                                                                                                    
MR.  SHERWOOD said  we  would  expand access,  but  he could  not                                                               
comment on the absolute number.                                                                                                 
                                                                                                                                
1:42:28 PM                                                                                                                    
CHAIR DAVIS opened  the floor for discussion  from the committee.                                                               
She said  she knows members  are concerned about  the legislation                                                               
being vetoed when it reaches  the governor's desk. She has talked                                                               
with him  and members of  DHSS staff,  and has been  assured that                                                               
they are  trying to reach a  solution. She said she  was ready to                                                               
move the bill.                                                                                                                  
                                                                                                                                
1:45:38 PM                                                                                                                    
SENATOR DYSON said  he appreciated her attitude and  he wanted to                                                               
clear  up something.  The governor  did  not veto  this bill  for                                                               
political reasons. He had been  assured that no state funds would                                                               
go to finance elective abortions; then  he found out that was not                                                               
true.  Expansion of  Denali KidCare  would  finance state  funded                                                               
elective  abortions.   It  was  a  principled   decision  by  the                                                               
governor, not  politically motivated.  The governor's  office has                                                               
been trying to  find a way out  of this dilemma and  they are not                                                               
optimistic.                                                                                                                     
                                                                                                                                
1:47:00 PM                                                                                                                    
CHAIR DAVIS said she appreciated his comments.                                                                                  
                                                                                                                                
SENATOR EGAN moved to report  SB 5 from committee with individual                                                               
recommendations and attached fiscal note(s).                                                                                    
                                                                                                                                
SENATOR DYSON objected.                                                                                                         
                                                                                                                                
1:48:25 PM                                                                                                                    
SENATOR  MEYER  said he  would  like  to  speak. He  said  Denali                                                               
KidCare provides a very valuable  service, and because of that he                                                               
would  vote to  move the  bill forward.  He said  the legislature                                                               
should continue the discussion. He  does want to see a resolution                                                               
to the concerns he has voiced;  however, if the bill just sits in                                                               
committee  the  conversation will  stop.  He  is hopeful  that  a                                                               
resolution will  be reached  before the  bill reaches  the Senate                                                               
floor.                                                                                                                          
                                                                                                                                
A  roll-call vote  was taken.  Senators Meyer,  Ellis, Egan,  and                                                               
Chair Davis voted yes. Senator Dyson  voted no. In a 4:1 vote, SB
 was passed from committee.