Legislature(2017 - 2018)BELTZ 105 (TSBldg)
03/08/2018 01:30 PM LABOR & COMMERCE
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SB 62-REPEAL CERTIFICATE OF NEED PROGRAM 2:04:33 PM CHAIR COSTELLO reconvened the meeting, announced the consideration of SB 62, and noted the proposed committee substitute (CS). 2:05:02 PM SENATOR MEYER moved to adopt the work draft CS for SB 62, labeled 30-LS0502\D, as the working document. CHAIR COSTELLO objected for discussion purposes. 2:05:19 PM NATASHA MCCLANAHAN, Staff, Senator Mia Costello, Alaska State Legislature, Juneau, Alaska, explained the following changes from version A to version D of SB 62: SB 62 version A would have repealed the certificate of need program for healthcare facilities. After three committee hearings in Senate Labor and Commerce changes were made to the legislation based on conversations with stakeholders and public testimony. SB 62 version D allows for an exemption from the certificate of need program if the new construction of a healthcare facility, alteration of bed capacity, or addition of a category of health services is in a location that is over 100 miles from another healthcare facility. This removes a barrier for remote communities that are currently struggling to attract and retain healthcare services in an effort to provide equal access to care for all Alaskans. 2:06:22 PM CHAIR COSTELLO removed her objection and version D was adopted. She noted an attorney from legislative legal was available to answer questions. She asked Mr. Zepp to comment on how the committee substitute changes the scope of the bill. It is a tailored response to the testimony the committee heard from Interior Alaskans about their inability to access health care in the community. She noted that the next committee of referral is Finance. GARY ZEPP, Staff, Senator David Wilson, Alaska State Legislature, Juneau, Alaska, said the evolution of the bill is in the right direction for the people of Delta. The original intent was for communities to decide and remove the government barriers that are currently in place for the certificate of need program. While the bill isn't as broad in scope, he believes the sponsor would be pleased that it is still helping Alaskans provide health care services and facilities in their communities. CHAIR COSTELLO said the committee also heard that going through the process of certificate of need was valuable. Communities can still go through that process. She noted that they reached out to the Department of Health and Social Services (DHSS) for information about applications received and what communities are paying. There was a recognition that the regulations regarding certificate of need have not been updated in some time. Her hope is that as this version of the bill moves forward, it sends a message to the department that updating the regulations would be helpful. She looks forward to discussion in the Senate Finance because it surrounds the cost of health care. Whether this is the answer remains to be seen. 2:10:17 PM SENATOR GARDNER asked if the committee could expect to hear from the Department of Health and Social Services on the committee substitute and see updated fiscal notes. CHAIR COSTELLO said it was her understanding that DHSS won't state a position on the bill until it looks like it will pass. MS. MCCLANAHAN agreed; a letter to that effect from [the DHSS deputy commissioner] is in the backup documents. 2:11:08 PM SENATOR STEVENS commented that it's backward to think that the department won't get involved until it looks like the bill will pass. CHAIR COSTELLO said unless it's a governor's bill, that's been the common approach. She said her office could reach out to the department and see if they have a position on the committee substitute. 2:11:52 PM SENATOR MICCICHE said the change to AS 18.07.031(a) adds the words "in a location within 100 miles of another healthcare facility." The applicability seems to require two parts - located more than 100 miles from another health care facility and that it has an existing certificate of need issued by DHSS. He asked when a certificate of need exists, does it remain in effect after the construction and during the operation of the health care facility or at some point, could it be closed down after the project is complete and would the applicability affect the outcome of Section 1. 2:12:59 PM JEAN MISCHEL, Legislative Counsel, Legislative Legal Services, Legislative Affairs Agency, Alaska State Legislature, Juneau, Alaska, said the applicability provision is essentially a hold harmless provision. The courts have found that certificates of need have some value and are construed as a property interest. They exist during the operation of the health care facility; they don't go away after construction. They're attached, they get renewed, and modified over time. SENATOR MICCICHE commented that exactly 100 miles is not covered. Section 1 has more than 100 miles in applicability and within 100 miles, which is somewhat less than 100 miles. He asked if that is a potential problem. Although the chance that it is exactly between 100 and 101 miles is rare, he asked if that is a gap the committee should clarify. MS. MISCHEL said she didn't see the gap. Legislative legal interprets "within 100 miles" to include 100 miles and "more than 100 miles" would be anything over 100 miles. 2:15:04 PM CHAIR COSTELLO stated she would hold SB 62 until the Department of Health and Social Services provided an updated opinion on the topic. MS. MCCLANAHAN clarified that the letter was from the deputy commissioner of DHSS, not the commissioner.