Legislature(2023 - 2024)ADAMS 519

05/08/2023 01:30 PM House FINANCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ HB 112 PROFESSION OF PHARMACY TELECONFERENCED
Heard & Held
+ HB 21 SCHOOL/UNIVERSITY EMPLOYEE HEALTH INSUR TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HJR 2 CONST. AM: APPROP LIMIT TELECONFERENCED
Heard & Held
+= HB 38 APPROPRIATION LIMIT; GOV BUDGET TELECONFERENCED
Heard & Held
                  HOUSE FINANCE COMMITTEE                                                                                       
                        May 8, 2023                                                                                             
                         1:33 p.m.                                                                                              
                                                                                                                                
                                                                                                                                
1:33:57 PM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair Foster  called the House Finance  Committee meeting                                                                    
to order at 1:33 p.m.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Bryce Edgmon, Co-Chair                                                                                           
Representative Neal Foster, Co-Chair                                                                                            
Representative DeLena Johnson, Co-Chair                                                                                         
Representative Julie Coulombe                                                                                                   
Representative Mike Cronk                                                                                                       
Representative Alyse Galvin                                                                                                     
Representative Sara Hannan                                                                                                      
Representative Andy Josephson                                                                                                   
Representative Dan Ortiz                                                                                                        
Representative Will Stapp                                                                                                       
Representative Frank Tomaszewski                                                                                                
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
None                                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Alexei  Painter,  Director,  Legislative  Finance  Division;                                                                    
Bernard    Aoto,   Staff,    Representative   Will    Stapp;                                                                    
Representative Sarah  Vance, Sponsor;  Representative Justin                                                                    
Ruffridge,  Sponsor;  Sylvan  Robb,  Director,  Division  of                                                                    
Corporations    Business    and   Professional    Licensing,                                                                    
Department of Commerce Community and Economic Development.                                                                      
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Ajay Desai,  Director, Division of Retirement  and Benefits,                                                                    
Department   of   Administration;   Andrea   Mueca,   Health                                                                    
Operations  Manager, Division  of  Retirement and  Benefits,                                                                    
Department  of   Administration;  Ken   Truitt,  Legislative                                                                    
Liaison, Department  of Administration; Dr.  Ashley Schaber,                                                                    
Chair, Alaska Board of Pharmacy.                                                                                                
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
HJR  2    CONST. AM: APPROP LIMIT                                                                                               
                                                                                                                                
          HJR 2 was HEARD and HELD in committee for further                                                                     
          consideration.                                                                                                        
                                                                                                                                
HB  21    SCHOOL/UNIVERSITY EMPLOYEE HEALTH INSUR                                                                               
                                                                                                                                
          HB 21 was HEARD and HELD in committee for further                                                                     
          consideration.                                                                                                        
                                                                                                                                
HB  38    APPROPRIATION LIMIT; GOV BUDGET                                                                                       
                                                                                                                                
          HB 38 was HEARD and HELD in committee for further                                                                     
          consideration.                                                                                                        
                                                                                                                                
HB 112    PROFESSION OF PHARMACY                                                                                                
                                                                                                                                
          HB 112 was HEARD and HELD in committee for                                                                            
          further consideration.                                                                                                
                                                                                                                                
Co-Chair Foster reviewed the meeting agenda.                                                                                    
                                                                                                                                
HOUSE JOINT RESOLUTION NO. 2                                                                                                  
                                                                                                                                
     Proposing amendments to the Constitution of the State                                                                      
     of Alaska relating to an appropriation limit.                                                                              
                                                                                                                                
HOUSE BILL NO. 38                                                                                                             
                                                                                                                                
     "An Act relating to an appropriation limit; relating                                                                       
     to the budget responsibilities of the governor; and                                                                        
     providing for an effective date."                                                                                          
                                                                                                                                
1:35:48 PM                                                                                                                    
                                                                                                                                
Co-Chair Foster invited questions on HJR 2 and HB 38.                                                                           
                                                                                                                                
Representative Coulombe asked if revenue put into accounts                                                                      
such as the Permanent Fund Earnings Reserve Account (ERA)                                                                       
would be included in the spending cap.                                                                                          
                                                                                                                                
ALEXEI  PAINTER,  DIRECTOR,  LEGISLATIVE  FINANCE  DIVISION,                                                                    
responded  that one  of the  exclusions to  the cap  was any                                                                    
appropriation to  the Permanent  Fund. Any  appropriation to                                                                    
the fund was  permitted to exceed the cap.  In addition, the                                                                    
Legislative  Finance Division  (LFD) would  not include  any                                                                    
appropriations in  its calculations of the  limit that would                                                                    
require  further  appropriations   to  spend.  For  example,                                                                    
putting money into the Statutory  Budget Reserve (SBR) would                                                                    
not qualify as an appropriation towards the limit.                                                                              
                                                                                                                                
Representative Coulombe asked if  monies put into the higher                                                                    
education fund  by the legislature  would be subject  to the                                                                    
cap.                                                                                                                            
                                                                                                                                
Mr. Painter  responded that the  situation would  invoke the                                                                    
cap because the monies would  have to be appropriated out of                                                                    
the fund in order to  be spent. Appropriations into the fund                                                                    
would not  be subject to  the cap but appropriations  out of                                                                    
the fund would be subject to the cap.                                                                                           
                                                                                                                                
Representative   Ortiz  asked   whether  the   spending  cap                                                                    
included the  Permanent Fund Dividend (PFD)  and the capital                                                                    
budget.                                                                                                                         
                                                                                                                                
Mr. Painter  responded that  the cap  would not  include the                                                                    
PFD,  but  it would  include  the  capital budget;  however,                                                                    
there   was   the   ability    to   exceed   the   statutory                                                                    
appropriations limit  for capital  expenditures with  a two-                                                                    
thirds vote.                                                                                                                    
                                                                                                                                
Representative Ortiz  asked if it  was safe to say  that the                                                                    
impact  of   the  constitutional  and  statutory   limit  on                                                                    
spending was a limit on the operating budget on its own.                                                                        
                                                                                                                                
Mr. Painter responded,  "to some extent, yes,"  but it would                                                                    
require a two-thirds vote to exceed the limit.                                                                                  
                                                                                                                                
Representative Ortiz  asked if the  bill could still  act as                                                                    
an  effective  spending  limit without  including  the  PFD,                                                                    
which was the most significant spending item.                                                                                   
                                                                                                                                
Mr.  Painter responded  that  it  would act  as  a limit  on                                                                    
expenditures for  all other  items, but  it would  not limit                                                                    
how much money could be spent on the PFD.                                                                                       
                                                                                                                                
1:40:12 PM                                                                                                                    
                                                                                                                                
Representative   Galvin  commented   that   the  state   has                                                                    
essentially  used the  Base Student  Allocation  (BSA) as  a                                                                    
regular formula and oftentimes funds  outside of the formula                                                                    
had  been   incorporated  in  order  to   cover  costs.  She                                                                    
understood that the  limit was calculated by  looking at the                                                                    
past five  years of inflation  and averaging  the increases.                                                                    
She asked what would happen  if there was a significant bump                                                                    
in education costs and wondered if  there would need to be a                                                                    
two-thirds vote to increase spending.                                                                                           
                                                                                                                                
Mr. Painter  responded that the  limit was  calculated based                                                                    
on  a  five-year average  of  gross  domestic product  (GDP)                                                                    
adjusted for  inflation. If there  was a spike  in inflation                                                                    
in the current  year, it would be captured  in the inflation                                                                    
adjustment and  would impact the  prior year's  figures. For                                                                    
example,  the  current  year  would  use  the  prior  year's                                                                    
inflation rate,  which was  8 percent.  By using  prior year                                                                    
inflation,  the  calculation could  be  made  using a  known                                                                    
amount, which was the approach  proposed in the legislation.                                                                    
If  it was  based  on projected  inflation, the  calculation                                                                    
could adjust every minute depending  upon what was happening                                                                    
in real  time; however, the  number would be an  estimate as                                                                    
opposed to a  known number. There was  an inherent tradeoff:                                                                    
the calculation could  be based on inflation  in the current                                                                    
year  but could  only  be an  estimate,  or the  calculation                                                                    
could be based on the inflation  rates in the prior year and                                                                    
be a known number.                                                                                                              
                                                                                                                                
Representative  Galvin understood  that  the  state was  not                                                                    
keeping up  with inflation rates, particularly  in education                                                                    
spending.  She wondered  what would  happen  if the  numbers                                                                    
were based on  figures that were not  accurate. For example,                                                                    
she wondered if the state would  be at a disadvantage if the                                                                    
increase was  only 2.5 percent  as it would still  not match                                                                    
inflation rates.                                                                                                                
                                                                                                                                
Mr. Painter responded that it was a policy call.                                                                                
                                                                                                                                
Representative Galvin asked if  Mr. Painter would agree that                                                                    
there had not  been incremental increases in  the last seven                                                                    
years that would have kept up with inflation.                                                                                   
                                                                                                                                
Mr. Painter responded  that the BSA had increased  by $30 in                                                                    
the present year which was the first increase since 2017.                                                                       
                                                                                                                                
Representative  Galvin   asked  what  percentage   would  be                                                                    
represented by the $30 increase.                                                                                                
                                                                                                                                
Mr. Painter responded that it was about half a percent.                                                                         
                                                                                                                                
Representative Galvin  asked for clarity  that it was  a 0.5                                                                    
percent increase.                                                                                                               
                                                                                                                                
Mr. Painter responded in the affirmative.                                                                                       
                                                                                                                                
Representative Galvin  noted that  the percentage  floor was                                                                    
important when it came to education.                                                                                            
                                                                                                                                
1:45:33 PM                                                                                                                    
                                                                                                                                
BERNARD  AOTO, STAFF,  REPRESENTATIVE STAPP,  responded that                                                                    
the five year  trending average when applied  to the current                                                                    
year  would total  $21  billion. He  explained  that the  11                                                                    
percent  figure represented  the  floor,  which would  equal                                                                    
about  $4.9 billion  as proposed  by  HB 38  and about  $5.1                                                                    
billion as  proposed by HJR  2. The floor could  be adjusted                                                                    
according to the percentages.                                                                                                   
                                                                                                                                
Representative  Galvin  asked  Mr.  Aoto  to  translate  the                                                                    
figures to BSA dollars.                                                                                                         
                                                                                                                                
Mr. Aoto  responded that a  1 percent increase to  the limit                                                                    
would be about  $475 million. The proposed  $680 increase to                                                                    
the BSA  would equal  to about a  $175 million  increase. He                                                                    
suggested that  a 1  percent increase  would allow  for more                                                                    
money to be spent on the BSA.                                                                                                   
                                                                                                                                
Representative  Galvin  understood  that  instead  of  there                                                                    
being a $175 million incremental  increase, there would be a                                                                    
$475 increase if the legislation  were to pass. She asked if                                                                    
her understanding was correct.                                                                                                  
                                                                                                                                
Mr.  Aoto  responded that  the  increase  in the  percentage                                                                    
would increase  the allotted spending  amount to  about $475                                                                    
million. The  legislature would need  to make a  policy call                                                                    
on how to spend the money.                                                                                                      
                                                                                                                                
Representative  Galvin   understood  there  would   be  $475                                                                    
million available, but the legislature  would choose the way                                                                    
in  which the  money would  be spent  and whether  the money                                                                    
would   be  incorporated   into  the   spending  floor   for                                                                    
education.                                                                                                                      
                                                                                                                                
Mr.  Aoto replied  that  the legislature  had  the power  of                                                                    
appropriation.                                                                                                                  
                                                                                                                                
Co-Chair Foster  suggested that  the bill's  sponsor respond                                                                    
to the questions.                                                                                                               
                                                                                                                                
Representative   Stapp   commented    that   any   type   of                                                                    
appropriation  limit  had  to  be  tied  to  something.  The                                                                    
existing  appropriation limit  was tied  to a  "hard number"                                                                    
while the bills before the  committee were tied to a percent                                                                    
of the state's  gross economic output. He  suggested that if                                                                    
the  percentages were  changed upwards  that there  would be                                                                    
more space  created in the  budget to appropriate  money for                                                                    
operating and  capital expenditures. If the  statutory limit                                                                    
in  HB   38  was   increased,  capital   expenditures  could                                                                    
theoretically fall underneath the appropriation.                                                                                
                                                                                                                                
1:49:54 PM                                                                                                                    
                                                                                                                                
Representative Josephson  recalled the figure  $5.4 billion.                                                                    
He understood  neither HB 38  nor HJR 2 required  a division                                                                    
between capital and operating.                                                                                                  
                                                                                                                                
Mr. Aoto  responded that the  11 percent figure under  HJR 2                                                                    
would  be  $4.8  billion,  and  13  percent  would  be  $5.1                                                                    
billion.  He  clarified  that the  figures  represented  the                                                                    
dollar amounts if the legislation was implemented by FY 24.                                                                     
                                                                                                                                
Representative  Josephson   commented  that   regardless  of                                                                    
whether  HJR 2  or  HB  38 were  to  pass,  the capital  and                                                                    
operating  expenses would  not  be divided.  Both pieces  of                                                                    
legislation proposed a single and unified limit.                                                                                
                                                                                                                                
Mr.  Aoto responded  that  there was  a  singular limit  but                                                                    
there was  a provision on  page 2, line  4 of HJR  2 stating                                                                    
that   a  two-thirds   vote  would   be  required   for  the                                                                    
legislature to appropriate an  additional amount for capital                                                                    
improvements in excess of the limit.                                                                                            
                                                                                                                                
Representative  Josephson  asked  what was  anticipated  for                                                                    
capital  expenditures when  the  11 percent  and 13  percent                                                                    
figures were decided upon.                                                                                                      
                                                                                                                                
Representative Stapp  responded that  the 11 and  13 percent                                                                    
numbers were  amended downward in the  previous committee of                                                                    
referral [House  Ways and Means Committee].  He thought that                                                                    
while it  was important to  have an appropriation  limit, he                                                                    
did not  want to  implement legislation that  would incumber                                                                    
the legislature's ability to make  investments in the state.                                                                    
He  thought  a  happy  medium   could  be  achieved  if  the                                                                    
percentages were amended upwards.                                                                                               
                                                                                                                                
Representative Josephson  thought Representative  Stapp must                                                                    
have  had  a target  dollar  amount.  He clarified  that  he                                                                    
wanted to  know the size of  the capital budget under  HJR 2                                                                    
in the event that a two-thirds vote was not achieved.                                                                           
                                                                                                                                
Representative Stapp responded that it  would be any type of                                                                    
appropriation that  fell within  the statutory limit  of the                                                                    
bill. He noted that it could  be amended. He deferred to his                                                                    
staff to elaborate.                                                                                                             
                                                                                                                                
1:53:34 PM                                                                                                                    
                                                                                                                                
Mr.  Aoto  responded that  the  total  would be  about  $4.8                                                                    
billion. The operating budget plus  the capital budget would                                                                    
need  to  equal $4.8  billion  if  the legislature  did  not                                                                    
achieve a two-thirds vote.                                                                                                      
                                                                                                                                
Representative  Josephson  asked   if  a  legislature  could                                                                    
"suffocate"  the  capital  budget   and  supplant  and  grow                                                                    
operating budgets.                                                                                                              
                                                                                                                                
Representative   Stapp    understood   that   Representative                                                                    
Josephson was  asking if  the legislature  could effectively                                                                    
spend  the  entirety  of  the operating  budget  up  to  the                                                                    
spending cap and not have a  capital budget. He asked if his                                                                    
understanding of the question was correct.                                                                                      
                                                                                                                                
Representative  Josephson  replied  in the  affirmative.  He                                                                    
wanted  information  on  the de  minimis  match,  which  was                                                                    
around $100 million.                                                                                                            
                                                                                                                                
Representative Stapp  responded that it  could theoretically                                                                    
be done  if there was enough  revenue. He did not  think the                                                                    
legislature would  ever intentionally suffocate  the capital                                                                    
budget  and  argued that  the  legislature  already had  the                                                                    
ability to do so if it wanted.                                                                                                  
                                                                                                                                
Representative Josephson understood  that the administration                                                                    
of past  Governor Sean Parnell  saw revenue that  could have                                                                    
"floated  all boats."  There was  $95 million  designated to                                                                    
the Susitna-Watana Dam two years  in a row under the Parnell                                                                    
Administration. If  a similar  circumstance occurred  in the                                                                    
present  day and  an  individual was  advocating  for a  BSA                                                                    
increase, the  individual would be  at odds with  people who                                                                    
wanted  a larger  capital budget.  He understood  that there                                                                    
would be plenty  of money to satisfy the  capital budget and                                                                    
the public  school advocate,  but the  two parties  would be                                                                    
battling  for  space.  He asked  if  his  understanding  was                                                                    
correct.                                                                                                                        
                                                                                                                                
Representative    Stapp   responded    that   Representative                                                                    
Josephson's  description  was  one  way  to  articulate  the                                                                    
situation.  He  would argue that there was  already a battle                                                                    
going on. He  thought that a threshold to  achieve a capital                                                                    
budget was  a more  equitable solution for  the bulk  of the                                                                    
legislature and he  would hope that it would  be more likely                                                                    
that  the legislature  would be  in favor  of a  more robust                                                                    
capital  budget  that met  the  needs  of the  entire  state                                                                    
rather than a limited amount.                                                                                                   
                                                                                                                                
Mr. Aoto added that  the financial situation the legislature                                                                    
was presently in was not because  of a cap, but because of a                                                                    
lack of revenue.                                                                                                                
                                                                                                                                
Representative Josephson understood  that if the legislation                                                                    
were to pass, the legislature  could have all the revenue it                                                                    
wanted  but  could  not  spend   beyond  the  cap  to  solve                                                                    
identified problems.                                                                                                            
                                                                                                                                
Mr. Aoto  responded that there  was a list of  exceptions in                                                                    
which  the legislature  could  appropriate  beyond the  cap,                                                                    
such  as a  disaster declaration.  The instances  that would                                                                    
qualify  as exceptions  to  the limit  were  subject to  the                                                                    
opinion of the legislature.                                                                                                     
                                                                                                                                
1:58:03 PM                                                                                                                    
                                                                                                                                
Co-Chair Johnson asked if the  green section of slide 12 [in                                                                    
the  previously  presented  PowerPoint  presentation  titled                                                                    
"HJR2 GDP   Based Spending  Cap" (copy on file)] represented                                                                    
the  full  amount of  the  percent  of market  value  (POMV)                                                                    
revenue that would be drawn.  She wondered if the amount was                                                                    
split out in any way.                                                                                                           
                                                                                                                                
Mr. Painter  responded in the  affirmative. The  entire POMV                                                                    
draw was  shown as  unrestricted general fund  (UGF) revenue                                                                    
and the PFD was shown as the unfunded expenditure.                                                                              
                                                                                                                                
Co-Chair Johnson  understood that some were  concerned about                                                                    
there being taxes without a  spending limit and that the PFD                                                                    
was not subject to the limit.  She did not think the PFD was                                                                    
being considered  in the equation  if 50 percent  of revenue                                                                    
was  not taken  out for  the PFD.  She asked  Representative                                                                    
Stapp to  expand on the contradiction  that some individuals                                                                    
did  not want  any new  taxes  unless there  was a  spending                                                                    
limit, but  the PFD was  not subject to the  spending limit.                                                                    
She asked  him to elaborate  on the  way in which  the PFD's                                                                    
exclusion would impact taxes and the spending limit.                                                                            
                                                                                                                                
Representative  Stapp   responded  that  slide  13   of  the                                                                    
presentation addressed  the question.  The slide  showed the                                                                    
governor's proposed 15 percent  constitutional limit on GDP.                                                                    
The   constitutional  limit   would   effectively  put   all                                                                    
available revenue  within the spending cap.  The proposed 15                                                                    
percent  of  GDP  constitutional limit  could  theoretically                                                                    
allow for  all money  to be appropriated  through government                                                                    
expenditures if there  was a $0 PFD. He  recognized that the                                                                    
PFD was  the largest appropriation the  legislature made. If                                                                    
half of  the POMV  was appropriated  towards the  PFD, there                                                                    
would  not be  enough revenue  to reach  the current  limits                                                                    
unless new revenues were added.                                                                                                 
                                                                                                                                
Co-Chair  Johnson  understood  that excluding  the  dividend                                                                    
from the  cap would have  a different effect because  it was                                                                    
tied  to GDP.  She thought  information was  being conflated                                                                    
and wanted to  ensure that it was noted that  it was tied to                                                                    
GDP  and  was  not  based on  traditional  elements  of  the                                                                    
spending cap.                                                                                                                   
                                                                                                                                
2:03:04 PM                                                                                                                    
                                                                                                                                
Mr.  Painter   commented  that  appropriations   were  often                                                                    
constrained by revenue  and any spending limit  would not be                                                                    
as important  when revenue was  the constraint.  A situation                                                                    
in which a  spending limit would have made  a difference was                                                                    
in the prior year's session  because revenue was not as much                                                                    
of  a  constraint.  Instead of  a  revenue  constraint,  the                                                                    
constraint was the  desire to not spend all of  the money. A                                                                    
spending  limit  would serve  to  cap  the years  with  high                                                                    
revenue. There  could also be a  cap set on oil  which would                                                                    
provide a different constraint.                                                                                                 
                                                                                                                                
Mr.  Aoto responded  that  the value  of  using a  GDP-based                                                                    
spending  cap  was  that  it   would  capture  a  number  of                                                                    
different aspects  of the economy  that should  be monitored                                                                    
by  the   legislature,  such   as  general   population  and                                                                    
inflation. It also would allow  the legislature to factor in                                                                    
elements such  as consumer spending, business  spending, net                                                                    
imports, and  net exports when  deciding how  to appropriate                                                                    
funds. There were previous iterations  of spending caps that                                                                    
tried  to  use  one  aspect  of  population  inflation  that                                                                    
resulted in  a more  draconian and restrictive  spending cap                                                                    
than the one proposed by HJR 2.                                                                                                 
                                                                                                                                
Co-Chair Johnson asked if a  floor was not needed because of                                                                    
the  existence of  the POMV.  She did  not want  to craft  a                                                                    
situation in  which the spending  cap would  force austerity                                                                    
on the  state. She understood  that the Permanent  Fund draw                                                                    
would always provide the needed funds  if it were based on a                                                                    
balanced  budget. She  asked if  there  was ever  a time  in                                                                    
which  the GDP  spending  limit  would be  so  low that  the                                                                    
legislature  would  not  be  able   to  meet  the  needs  of                                                                    
Alaskans.                                                                                                                       
                                                                                                                                
Representative  Stapp  responded  that  in the  event  of  a                                                                    
fiscal  disaster  in  which there  were  multiple  years  of                                                                    
declining GDP  growth, it  would be  more likely  that there                                                                    
would be a revenue limit and  not a spending limit. If there                                                                    
was a  serious drop  in GDP over  a five-year  period, there                                                                    
would also be  a significant drop in the  spending limit and                                                                    
there would be an increase  in out-migration from the state.                                                                    
The  government adjusted  its spending  downward when  there                                                                    
was  a major  out-migration in  state  in the  1980s and  he                                                                    
thought  the  same  strategy could  be  implemented  if  the                                                                    
situation were to happen again.  He thought it would be wise                                                                    
to reevaluate spending levels if  there was another surge in                                                                    
out-migration.  He did  not foresee  the scenario  occurring                                                                    
but suggested that Mr. Painter elaborate on the question.                                                                       
                                                                                                                                
Mr. Painter commented that when the  limit was set in FY 83,                                                                    
expenditures were close to the  limit in the first few years                                                                    
and  then   spending  was  flat  for   nearly  two  decades;                                                                    
therefore, the limit was not  a meaningful factor. A similar                                                                    
situation  could  occur with  a  GDP  limit, but  the  limit                                                                    
likely  would  not  have  grown as  quickly  as  the  figure                                                                    
representing  population plus  inflation  because GDP  would                                                                    
have  also been  impacted.  In the  1980s,  revenue was  the                                                                    
reason for the state's limited expenditures.                                                                                    
                                                                                                                                
2:09:11 PM                                                                                                                    
                                                                                                                                
Representative  Hannan  wanted  more information  about  the                                                                    
idea  of  excluding the  PFD  from  the spending  caps.  She                                                                    
understood the thought process in  comparison to the current                                                                    
spending cap;  however, the proposed spending  cap seemed to                                                                    
be  higher   than  some  of  the   state's  constitutionally                                                                    
mandated  spends.  She asked  for  more  information on  the                                                                    
reason for holding the PFD outside of the spending cap.                                                                         
                                                                                                                                
Representative  Stapp opined  that  the PFD  was a  separate                                                                    
political  issue  that  warranted  its  own  resolution.  He                                                                    
thought  that if  the  percentages  of the  cap  were to  be                                                                    
amended to  14 percent or  15 percent, it would  include all                                                                    
available  revenue. He  thought it  was interesting  to note                                                                    
that  the PFD  had been  subject to  a significant  swing in                                                                    
variation of  appropriation. If  a hard  limit was  fixed in                                                                    
the bill, it would effectively  require a policy call on the                                                                    
dividend within  the spending cap. If  all available revenue                                                                    
fell  under the  cap, a  dividend amount  could be  inferred                                                                    
within the cap.                                                                                                                 
                                                                                                                                
Representative  Hannan asked  if Representative  Stapp found                                                                    
any jurisdictions in which a  spending cap was separate from                                                                    
a  taxation  policy. She  acknowledged  that  there were  no                                                                    
individual taxes implemented in  Alaska and that most states                                                                    
that had taken  on a spending cap did so  in order to govern                                                                    
a sales  tax, income tax,  or property tax. She  wondered if                                                                    
Representative  Stapp's  research  found  any  jurisdictions                                                                    
where revenues and spending caps were separate.                                                                                 
                                                                                                                                
Representative  Stapp  asked  for clarification  on  whether                                                                    
Representative  Hannan was  asking if  had found  a spending                                                                    
cap in his research that was divorced from taxation.                                                                            
                                                                                                                                
Representative Hannan responded in the affirmative.                                                                             
                                                                                                                                
Representative Stapp  replied that the current  spending cap                                                                    
in the  state had no  bearing on taxation and  any variation                                                                    
in  spending  caps  that  were  indexed  at  population  and                                                                    
inflation had no impact on tax  policy. He thought GDP was a                                                                    
better metric to use when  coordinating a tax policy because                                                                    
if there was a more robust  private sector, there would be a                                                                    
better base upon which to implement taxes.                                                                                      
                                                                                                                                
Representative  Hannan  suggested  ignoring  Alaska  as  the                                                                    
state  was  the exception  and  not  the rule.  She  offered                                                                    
Colorado  as an  example and  explained that  an implemented                                                                    
spending cap was immediately followed  by tax increases. She                                                                    
asked if there was any state  apart from Alaska that had set                                                                    
a spending  cap without  also addressing taxation  policy in                                                                    
the state.                                                                                                                      
                                                                                                                                
Representative  Stapp  responded  that  unlike  every  other                                                                    
state, Alaska  did not have  a broad based tax.  The concept                                                                    
behind  the limit  was to  encourage responsible  government                                                                    
appropriations. He could not think  of an example of another                                                                    
state apart from Alaska that  had implemented a spending cap                                                                    
withing addressing  taxation policy  because Alaska  did not                                                                    
have a broad based tax.                                                                                                         
                                                                                                                                
2:14:13 PM                                                                                                                    
                                                                                                                                
Representative Galvin wondered whether  a spending cap would                                                                    
bring   about   more   transparency,   accountability,   and                                                                    
responsiveness,  which is  what she  thought Alaskan  voters                                                                    
wanted.  She was  aware of  a paper  by the  Economic Policy                                                                    
Institute   that  argued   that  spending   caps  were   not                                                                    
necessarily   beneficial   in    achieving   the   goal   of                                                                    
transparency. When there was a  shock to the economic system                                                                    
such  as the  2008  recession, Alaska  was  not impacted  as                                                                    
strongly as other states because  Alaska was able to quickly                                                                    
invest. She  recalled that in  2008, Alaska  invested around                                                                    
25 percent into the nation's  economy and saved over 700,000                                                                    
jobs.  She asked  Mr. Painter  to  speak about  the ways  in                                                                    
which the  state would  be impacted if  there was  a similar                                                                    
event  in  the  future,  but the  state  had  implemented  a                                                                    
spending  cap.  She  also  asked how  a  disaster  would  be                                                                    
defined and how it was  determined that a situation was dire                                                                    
enough to warrant spending beyond the cap.                                                                                      
                                                                                                                                
Mr. Painter  responded that the  definition of  disaster was                                                                    
in  statute  and  the  governor had  the  power  to  declare                                                                    
disasters in  response to natural disasters,  diseases, war,                                                                    
or  other   similar  events.  He  did   not  think  economic                                                                    
disasters were  included in the definition.  He thought that                                                                    
if the GDP crashed and a  disaster was severe enough, a GDP-                                                                    
based  spending limit  could  potentially  mean that  Alaska                                                                    
could  not respond;  however, it  was based  on a  five-year                                                                    
average with  a lag.  If a GDP-based  spending limit  was in                                                                    
place  during   the  current  session,  the   data  used  to                                                                    
determine the limit would be  the previous year's GDP and it                                                                    
would  not  necessarily  be restrictive.  If  the  statutory                                                                    
limit  was set  close to  the current  expenditures and  the                                                                    
constitutional limit  was set  higher, the  expenditures for                                                                    
economic disasters  would likely be capital  spending, which                                                                    
was the case in 2008. The  capital funds could be spent with                                                                    
a  two-thirds  majority under  the  spending  cap. It  could                                                                    
become  problematic if  there  was  a significant  long-term                                                                    
disaster, but the  state would have had  to have significant                                                                    
savings in order to spend the  funds in the first place. The                                                                    
spending limit  would not  be the  limiting factor  if there                                                                    
was a multi-year depression. The  statutory limit could also                                                                    
be  amended by  future legislatures  with a  simple majority                                                                    
vote of both bodies.                                                                                                            
                                                                                                                                
Representative Galvin  asked how long the  recession in 2015                                                                    
lasted in Alaska.                                                                                                               
                                                                                                                                
Mr.  Painter responded  that he  did not  know as  far as  a                                                                    
formal  definition   of  recession  from   a  macro-economic                                                                    
perspective. There were  deficits from FY 15  through FY 21,                                                                    
but that alone  did not necessarily qualify  the time period                                                                    
as a recession.                                                                                                                 
                                                                                                                                
Representative  Galvin  asked  if Alaska  was  sensitive  to                                                                    
extreme fluctuations.                                                                                                           
                                                                                                                                
Mr.  Painter responded  that the  economy in  the state  was                                                                    
more volatile than most states.  It was also not necessarily                                                                    
correlated to the nation's economy.  Alaska had a relatively                                                                    
volatile  economy because  of its  dependence on  a volatile                                                                    
resource.                                                                                                                       
                                                                                                                                
2:20:33 PM                                                                                                                    
                                                                                                                                
Representative    Josephson   asked    what   the    current                                                                    
constitutional  limit from  1982 would  be as  a percent  of                                                                    
GDP.                                                                                                                            
                                                                                                                                
Representative Stapp responded that  he would guess it would                                                                    
be  around 25  percent or  26  percent. He  deferred to  Mr.                                                                    
Painter.                                                                                                                        
                                                                                                                                
Mr. Painter replied that he  thought it would be approaching                                                                    
50 percent  because the 13  percent level  represented about                                                                    
$5.8 billion and the current  constitutional limit was about                                                                    
$11.3 billion.  If the figures  were doubled it  would total                                                                    
about  50 percent.  He was  not  certain of  the figure  and                                                                    
would  return   to  the  committee   with  a   more  precise                                                                    
calculation.                                                                                                                    
                                                                                                                                
Representative  Josephson  noted that  Representative  Stapp                                                                    
had  mentioned  a  five-year  economic  downturn.  He  asked                                                                    
Representative Stapp to repeat his comments.                                                                                    
                                                                                                                                
Representative Stapp responded  that the GDP was  based on a                                                                    
five-year rolling  average. If  there was a  severe economic                                                                    
downturn  for  five  consecutive  years,  downward  pressure                                                                    
would be  placed on a  GDP-based spending limit based  on an                                                                    
average.                                                                                                                        
                                                                                                                                
Representative Josephson  noted that  there was  an economic                                                                    
downturn from 1933 through 1938  and the Roosevelt Recession                                                                    
immediately followed  in 1937. He relayed  that the response                                                                    
at the  time was  a Keynesian approach  to prime  the public                                                                    
and  get  the  economy  going  and  to  avoid  the  European                                                                    
experience of  complete political disruption. He  noted that                                                                    
the  situation would  not occur  in the  same way  in Alaska                                                                    
because it  was a  state and not  a country;  however, given                                                                    
the countercyclical  nature of the  state and the  fact that                                                                    
the  2008 recession  was a  "blip"  to Alaska,  he asked  if                                                                    
there would be  circumstances in which the  state was unable                                                                    
to respond and  it would be watching events  unfold that the                                                                    
state  could  theoretically  resolve   but  could  not  take                                                                    
action.                                                                                                                         
                                                                                                                                
Representative Stapp  responded that the big  difference was                                                                    
that the state could control  fiscal policy but not monetary                                                                    
policy.  In the  event of  a recession,  the state  would be                                                                    
limited by  a collapse  in all  available revenue  and there                                                                    
would  be massive  out-migration. He  thought that  the best                                                                    
way to  prepare for  a disaster scenario  would be  to amend                                                                    
the  percentages  upward.  He  reiterated that  he  was  not                                                                    
worried about  a spending  cap having  a negative  impact on                                                                    
the state  in a disaster  because there would be  a collapse                                                                    
in all  revenue and the spending  cap would be the  least of                                                                    
the state's worries.                                                                                                            
                                                                                                                                
Representative  Josephson replied  that there  was a  strong                                                                    
governor model in  the state and the  legislature would need                                                                    
a two-thirds vote to override a  veto. In a crisis, it was a                                                                    
limitation on legislative prerogative.                                                                                          
                                                                                                                                
2:25:14 PM                                                                                                                    
                                                                                                                                
Representative  Ortiz  wondered if  it  would  be better  to                                                                    
suspend the  idea of  a spending cap  until the  question of                                                                    
revenue  was  resolved.  He  thought  that  revenue  was  in                                                                    
essence  the current  spending cap  and that  it had  been a                                                                    
successful  model.  The  legislature  was  able  to  address                                                                    
capital  projects and  deferred maintenance  when the  state                                                                    
had more  revenue in the  prior year. He did  not understand                                                                    
why a  spending cap would  be tied  to GDP when  revenue was                                                                    
not tied to GDP.                                                                                                                
                                                                                                                                
Representative Stapp  responded that the main  issue was how                                                                    
the  state allocated  the existing  revenue it  already had.                                                                    
He thought  the most  valuable information from  Mr. Painter                                                                    
on the history  of the cap was that  both the constitutional                                                                    
limit  and  statutory  limit  for  appropriations  had  been                                                                    
violated  by  the  legislature  on  multiple  occasions.  He                                                                    
suggested that  when a  limit existed in  statute or  in the                                                                    
constitution   that  had   been  repeatedly   violated,  the                                                                    
legislature had  the responsibility to do  its due diligence                                                                    
to  reform   the  issue   and  increase   accountability  to                                                                    
citizens. It was possible to have  a tie in terms of overall                                                                    
GDP  that would  allow for  future conversations  on revenue                                                                    
and on  the PFD  amount. The  main goal of  the bill  was to                                                                    
smooth  out  the  boom  and bust  cycle  that  was  Alaska's                                                                    
revenue picture.  He argued that the  state likely allocated                                                                    
money in  high revenue  years such  as FY 12  and FY  15 for                                                                    
good purposes,  but he thought  the state also wasted  a lot                                                                    
of money.                                                                                                                       
                                                                                                                                
2:29:28 PM                                                                                                                    
                                                                                                                                
Representative Coulombe  asked how the current  spending cap                                                                    
related to the private sector.                                                                                                  
                                                                                                                                
Mr. Painter  responded that the  spending cap was tied  to a                                                                    
fixed number that grew by  population and inflation. The cap                                                                    
did not  directly reference the  size of the economy  in any                                                                    
way.                                                                                                                            
                                                                                                                                
Representative  Coulombe  asked  if   the  state  needed  to                                                                    
respond  to  the  spending   occurring  within  the  private                                                                    
sector.                                                                                                                         
                                                                                                                                
Mr. Painter responded  that the spending cap was  based on a                                                                    
fixed number which grew by  population and it did not matter                                                                    
if  the  population  was   employed.  However,  revenue  did                                                                    
originate from the private sector.                                                                                              
                                                                                                                                
Representative Coulombe asked how  the proposed spending cap                                                                    
would incorporate the private sector into the equation.                                                                         
                                                                                                                                
Mr.  Aoto responded  that the  cap would  use state  GDP and                                                                    
that  some  of  the  elements of  state  GDP  were  business                                                                    
expenses, business  spending, net imports, and  net exports,                                                                    
which were all directly related to the private sector.                                                                          
                                                                                                                                
Representative  Coulombe commented  that  many examples  had                                                                    
been brought up  during the meeting on what  could happen in                                                                    
extreme  situations. She  thought that  the state's  revenue                                                                    
had  been   historically  volatile,   and  Alaska   was  not                                                                    
financially disciplined  in high revenue years.  She thought                                                                    
that there would be fewer  emergencies if the state invested                                                                    
in a more  regimented manner. There would  be more stability                                                                    
in the  savings accounts to increase  education spending and                                                                    
it  would encourage  savings and  "rainy day"  finances. She                                                                    
liked the idea of a spending  cap because it would force the                                                                    
legislature to  think about the  future and it  would smooth                                                                    
out emergency spending and big deposits.                                                                                        
                                                                                                                                
Representative Tomaszewski thanked  Representative Stapp for                                                                    
bringing forth the  bill and he thought that  it was exactly                                                                    
what  the state  needed.  He thought  the  state needed  the                                                                    
ability  to control  spending and  the cap  would allow  for                                                                    
steady funding  and decreased  dependence upon  digging into                                                                    
its savings accounts. He  commended Representative Stapp for                                                                    
his responses  to the questions  of other  committee members                                                                    
and   he  looked   forward  to   hearing   more  about   the                                                                    
legislation.                                                                                                                    
                                                                                                                                
HJR  2  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
HB  38  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
HOUSE BILL NO. 21                                                                                                             
                                                                                                                                
     "An Act relating to group  insurance coverage and self-                                                                    
     insurance  coverage  for   school  district  employees,                                                                    
     employees of  the University  of Alaska,  and employees                                                                    
     of  other   governmental  units   in  the   state;  and                                                                    
     providing for an effective date."                                                                                          
                                                                                                                                
2:34:58 PM                                                                                                                    
                                                                                                                                
Co-Chair  Foster  invited  the  sponsor  and  her  staff  to                                                                    
introduce the bill.                                                                                                             
                                                                                                                                
REPRESENTATIVE SARAH  VANCE, SPONSOR, introduced HB  21. She                                                                    
offered a PowerPoint presentation  "HB 21; School Healthcare                                                                    
Consolidation,"  dated May  8, 2023  (copy on  file). School                                                                    
districts  were experiencing  challenges  in recruiting  and                                                                    
retaining teachers and staff,  which was an issue compounded                                                                    
by  the rising  costs of  health  care. She  had attended  a                                                                    
local  school board  meeting in  her district  at which  she                                                                    
heard the teacher representative  for health insurance plead                                                                    
with school  board members to  hold an emergency  meeting to                                                                    
discuss  what could  be done  to better  recruit and  retain                                                                    
teachers. The rising  costs of health care  and premiums for                                                                    
families were  forcing teachers  to leave  the state  or the                                                                    
profession. She recommended the  introduction of HB 21 after                                                                    
attending the meeting.                                                                                                          
                                                                                                                                
Representative Vance advanced to  slide 2 and explained that                                                                    
the bill had  been offered and heard  in prior legislatures,                                                                    
but  only  as  a   requirement  that  all  school  districts                                                                    
consolidate. She indicated that HB  21 was different in that                                                                    
it supported  local control and was  completely optional for                                                                    
schools. She moved to slide  2 and relayed that according to                                                                    
an Institute  of Social and  Economic Research  (ISER) study                                                                    
from  2019, there  were three  aspects  of public  education                                                                    
costs in Alaska  that set it apart from  other states: small                                                                    
schools, health care, and energy.                                                                                               
                                                                                                                                
Representative Vance  continued to  slide 3. Alaska  had the                                                                    
highest  per-capita health  care costs  in the  nation which                                                                    
negatively  impacted  private  and  public  sectors  of  the                                                                    
economy.  The  high costs  put  downward  pressure on  wages                                                                    
which  made it  difficult  for schools  to offer  nationally                                                                    
competitive salaries to teachers in  Alaska. Her goal was to                                                                    
ease the financial  burden on school districts  and give the                                                                    
state   more  leverage   to  negotiate   with  health   care                                                                    
providers. She  moved to slide  5 and relayed that  the bill                                                                    
would amend current  statute to allow the  option for school                                                                    
districts, the universities, and  governmental units such as                                                                    
cities  and  boroughs  to  participate  in  AlaskaCare.  The                                                                    
aforementioned entities  would have  the choice to  opt into                                                                    
the pool  and enable the Department  of Administration (DOA)                                                                    
to negotiate a better cost of health care.                                                                                      
                                                                                                                                
Representative  Vance continued  to slide  5. She  explained                                                                    
that the  main benefit  of consolidation  was that  it would                                                                    
save money.  By expanding  the number  of participants  in a                                                                    
health care pool, the potential  for savings increased. Most                                                                    
of the state's  school districts were small  and carried the                                                                    
cost burden  alone. Several  school districts  had responded                                                                    
to the proposed consolidation  and reported possible savings                                                                    
of  about $7  million per  year. This  would allow  for some                                                                    
districts to  not only  close their  budget gap  but provide                                                                    
better  health  care  to  participants.  The  Mat-Su  school                                                                    
district  had  reported  that  if  all  district  employees'                                                                    
bargaining  units  were  to be  consolidated,  the  district                                                                    
could  save up  to $7  million. The  savings would  be about                                                                    
$3,000 per employee  and would equate to a  $125 increase in                                                                    
the Base  Student Allocation (BSA).  If all  districts chose                                                                    
to consolidate, the savings would  be about $200 million per                                                                    
year. The bill would also  provide more health care options.                                                                    
Some districts were facing  challenges in finding affordable                                                                    
health care  options due  to high-use  numbers and  the bill                                                                    
would  expand  options  to offset  high-use.  An  additional                                                                    
benefit would  be that the  bill would reduce the  burden on                                                                    
staff  and  allow  schools to  focus  on  providing  quality                                                                    
education.                                                                                                                      
                                                                                                                                
Representative Vance advanced to  slide 6 and concluded that                                                                    
the bill was  intended to reduce education  costs and better                                                                    
serve the needs of Alaskans.                                                                                                    
                                                                                                                                
2:40:59 PM                                                                                                                    
                                                                                                                                
Representative  Vance   offered  to  review   the  sectional                                                                    
analysis (copy on file).                                                                                                        
                                                                                                                                
Co-Chair  Foster replied  that  he would  like  to hear  the                                                                    
sectional analysis.                                                                                                             
                                                                                                                                
Representative  Vance relayed  that she  would provide  some                                                                    
highlights  of the  sectional. She  indicated  that the  one                                                                    
change made  by the House  Labor and Commerce  Committee was                                                                    
Section 9:                                                                                                                      
                                                                                                                                
     Section 9. Authorizes  the Department of Administration                                                                    
     to investigate  the potential  costs of  any interested                                                                    
     school  district, local  government, or  the University                                                                    
     of Alaska,  and share that report  with the Legislature                                                                    
     before the  Commissioner approves their  admission into                                                                    
     AlaskaCare                                                                                                                 
                                                                                                                                
Representative Vance continued by  highlighting Section 3 of                                                                    
the sectional:                                                                                                                  
                                                                                                                                
     Section  3. Allows  the Commissioner  of Administration                                                                    
     to   expend  from   the  public   education  fund   (AS                                                                    
     14.17.300) to  the group health and  life benefits fund                                                                    
     (AS  39.30.095)  a total  of  $100,000,000  or less  as                                                                    
     needed  to  pay  claims submitted  by  school  district                                                                    
     employees  who  are  covered  by   a  policy  of  self-                                                                    
     insurance  provided by  the  state;  and, requires  the                                                                    
     Commissioner  of  Administration  to repay  the  public                                                                    
     education fund,  over a  period of  10 years,  the full                                                                    
     amount  of  the  commissioner's expenditures  from  the                                                                    
     public education fund                                                                                                      
                                                                                                                                
Representative  Vance explained  that Section  3 had  been a                                                                    
particular topic  of interest and  she deferred to  the will                                                                    
of the committee  on whether to include it in  the bill. She                                                                    
relayed that Sections 4 through  6 contained the majority of                                                                    
the content of  the bill. She stated that  Section 4 allowed                                                                    
schools  districts and  the  university to  be  part of  the                                                                    
state health  care plan. The  other sections [Section  5 and                                                                    
Section 6] gave the board  of regents, universities, and the                                                                    
Regional Educational Attendance  Area (REAA) the legislative                                                                    
authority to  optionally participate  in the  plans. Section                                                                    
10  authorized DOA  to provide  group  medical insurance  to                                                                    
school  employees,  school  district  employees,  and  other                                                                    
governmental  employees by  means of  self-insurance. If  it                                                                    
was not beneficial for an entire  unit to opt into the pool,                                                                    
DOA  could  determine  that  the  unit  would  benefit  more                                                                    
through  a policy  of  self-insurance.  She emphasized  that                                                                    
there  were options  depending on  the cost  and the  health                                                                    
care provider.                                                                                                                  
                                                                                                                                
Representative Vance  continued on Section 12  and explained                                                                    
that it ensured  that the bill was  applicable to collective                                                                    
bargaining agreements and other  contracts that would become                                                                    
legally binding on  or after the effective  date of Sections                                                                    
1 through  8. Section  13 would require  self-insured school                                                                    
districts  to transfer  the closing  balance of  their self-                                                                    
funded  insurance  reserve  account after  enrollment  in  a                                                                    
health  care  plan  administered  by  the  state.  It  would                                                                    
require   that   the   amounts    be   applied   to   offset                                                                    
reimbursements owed  by the  school district.  She continued                                                                    
that Section 14 noted that  the bill would not automatically                                                                    
go into  effect and  would allow  for a  one-year transition                                                                    
period   to  adopt   regulations  and   gauge  interest   in                                                                    
consolidation.  It  would allow  DOA  to  see the  cost  and                                                                    
benefits and any required further analysis.                                                                                     
                                                                                                                                
Co-Chair Foster invited questions from the committee.                                                                           
                                                                                                                                
2:45:21 PM                                                                                                                    
                                                                                                                                
Representative   Stapp   expressed   his   appreciation   to                                                                    
Representative  Vance  for  bringing forward  the  bill.  He                                                                    
asked  about  the  actuarial  analysis   of  the  impact  on                                                                    
AlaskaCare.  He  thought  that small  and  high-risk  groups                                                                    
would flow into  the AlaskaCare plan, and he  thought it was                                                                    
unlikely  that larger  entities  like  the Anchorage  School                                                                    
District would  consolidate due  to the  nature of  cost. He                                                                    
understood that the  last time the state looked  at the plan                                                                    
was in 2014  and he thought it  would be good to  look at it                                                                    
again. He asked if the  sponsor or a representative from the                                                                    
Division of Retirement and Benefits  (DRB) wanted to comment                                                                    
on the potential  influx of a high-risk  population into the                                                                    
plan.                                                                                                                           
                                                                                                                                
Representative Vance responded that  she had spoken with DOA                                                                    
and it was  not planning on doing actuarial  analysis of the                                                                    
bill  until  it reached  the  House  Finance Committee.  She                                                                    
noted  that  representatives  from DRB  were  available  for                                                                    
questions.                                                                                                                      
                                                                                                                                
Representative   Stapp  asked   if  someone   could  provide                                                                    
comments  on the  overall  impact  of the  bill  and of  the                                                                    
influx of high-risk individuals on the overall plan.                                                                            
                                                                                                                                
AJAY DESAI,  DIRECTOR, DIVISION OF RETIREMENT  AND BENEFITS,                                                                    
DEPARTMENT    OF   ADMINISTRATION    (via   teleconference),                                                                    
responded that DRB had not  done any actuarial analysis yet.                                                                    
The division  had only determined initial  operational costs                                                                    
based on  the initial analysis  of the bill, which  had been                                                                    
submitted to the legislature.                                                                                                   
                                                                                                                                
Representative  Stapp  asked  for more  information  on  the                                                                    
method of  actuarial analysis. He  opined that  an actuarial                                                                    
analysis  was   a  key   ingredient  when   determining  the                                                                    
viability of the long-term impact of the bill.                                                                                  
                                                                                                                                
Co-Chair Foster asked Mr. Desai  at what point the actuarial                                                                    
analysis would occur.                                                                                                           
                                                                                                                                
Mr. Desai deferred the question to his colleague.                                                                               
                                                                                                                                
2:49:04 PM                                                                                                                    
                                                                                                                                
ANDREA  MUECA,   HEALTH  OPERATIONS  MANAGER,   DIVISION  OF                                                                    
RETIREMENT  AND  BENEFITS,   DEPARTMENT  OF  ADMINISTRATION,                                                                    
JUNEAU  (via teleconference),  responded  that the  division                                                                    
was planning  on testing three  scenarios when  it conducted                                                                    
the  actuarial analysis:  a neutral  cost impact,  a reduced                                                                    
cost impact, and an increased  cost impact. Depending on who                                                                    
joins the plan, it was  unclear whether the state would save                                                                    
money,  lose  money,  or   be  financially  unaffected.  She                                                                    
relayed that the division would  get updated analysis within                                                                    
three weeks.                                                                                                                    
                                                                                                                                
Co-Chair Foster noted that part  of the reason for the delay                                                                    
was   that  the   cost  for   the  actuarial   analysis  was                                                                    
substantial. He asked what Ms. Mueca for the expected cost.                                                                     
                                                                                                                                
Ms.  Mueca  responded that  the  request  would cost  around                                                                    
$30,000.                                                                                                                        
                                                                                                                                
Representative  Stapp understood  that there  was a  similar                                                                    
analysis conducted  in 2014 for  the Senate that had  a cost                                                                    
of about $200,000. He asked if  Ms. Mueca was sure she could                                                                    
do a thorough analysis for $30,000.                                                                                             
                                                                                                                                
Ms. Mueca responded that she  was not familiar with the 2014                                                                    
analysis and  she would have  to look through the  study for                                                                    
updated  information. She  thought the  turnaround would  be                                                                    
quicker  if the  division could  follow a  template for  the                                                                    
analysis.                                                                                                                       
                                                                                                                                
Co-Chair  Foster  thought  he  saw an  email  recently  that                                                                    
suggested a range of $150,000 to $200,000.                                                                                      
                                                                                                                                
Representative  Vance commented  that  the  progress of  the                                                                    
bill was at the will of the finance committee.                                                                                  
                                                                                                                                
Representative  Hannan   understood  that  there   were  two                                                                    
districts  represented in  the packet  of letter  of support                                                                    
for the bill  (copy on file). She noted  that some districts                                                                    
had  more  than  one  insurance   plan  because  there  were                                                                    
different   bargaining   units  represented   by   different                                                                    
individuals.  She  wondered   if  Representative  Vance  had                                                                    
received  direct communication  from other  school districts                                                                    
indicating interest  in consolidation.  She was  generally a                                                                    
"huge fan" of universal healthcare,  but she also had served                                                                    
on  her health  plan's  trust and  understood that  teachers                                                                    
were  typically  expensive  to insure.  The  most  expensive                                                                    
periods of time  in a person's life  were childbearing years                                                                    
and the years proceeding  retirement, and many teachers were                                                                    
young women. She asked if the  sponsor had heard from the 51                                                                    
other  districts   in  the  state  and   wondered  if  other                                                                    
districts were interested in joining the plan.                                                                                  
                                                                                                                                
Representative Vance responded that  she had emailed all the                                                                    
districts asking  for their interest  and input and  she had                                                                    
heard back from Ketchikan,  Kenai Peninsula, and Mat-Su. The                                                                    
districts as  a whole had been  quiet and she was  unsure if                                                                    
districts  were still  deliberating.  The  Mat-Su and  Kenai                                                                    
Peninsula districts  were some  of the larger  districts and                                                                    
had indicated that they wanted  the health care option to be                                                                    
available.                                                                                                                      
                                                                                                                                
Representative Hannan  commented that the letter  of support                                                                    
from Mat-Su was not in her  packet and she would like to see                                                                    
the letter. She  was unsure if the Mat-Su  district had more                                                                    
than one  unit represented in  the plan or whether  the plan                                                                    
was unified.                                                                                                                    
                                                                                                                                
Representative Vance  responded that  she would  provide the                                                                    
information to  the committee. She recalled  that Mat-Su had                                                                    
four  bargaining units  and  it was  a  conversation to  see                                                                    
whether  some   or  all  wanted   to  join  the   plan.  She                                                                    
anticipated that each school district  or unit would come to                                                                    
DOA and have a conversation  about their needs and determine                                                                    
whether the plan  would save money while  providing the same                                                                    
level of health care, or whether it would be more costly.                                                                       
                                                                                                                                
Co-Chair Foster  noted that there was  a representative from                                                                    
DOA available for  questions. He asked if  DOA could comment                                                                    
on the actuarial analysis.                                                                                                      
                                                                                                                                
2:56:04 PM                                                                                                                    
                                                                                                                                
KEN    TRUITT,    LEGISLATIVE   LIAISON,    DEPARTMENT    OF                                                                    
ADMINISTRATION,  (via  teleconference), responded  that  DOA                                                                    
would begin an actuarial study  when it was requested by the                                                                    
finance committee. It could not  begin the analysis until it                                                                    
was formally requested.                                                                                                         
                                                                                                                                
Co-Chair  Foster  asked if  Mr.  Truitt  could provide  more                                                                    
information about the cost.                                                                                                     
                                                                                                                                
Mr.  Truitt responded  that  the cost  was  estimated to  be                                                                    
around $30,000.                                                                                                                 
                                                                                                                                
Representative Ortiz  asked what  went into  determining the                                                                    
costs in  the fiscal note  [by DOA with Control  Code vwuQl]                                                                    
of  about $350  million  per year  [he  later corrected  the                                                                    
number  to  $350,000]. He  asked  how  the fiscal  note  was                                                                    
determined.                                                                                                                     
                                                                                                                                
Mr.  Truitt  responded that  the  question  would be  better                                                                    
answered by Ms. Mueca.                                                                                                          
                                                                                                                                
Ms. Mueca  responded that the  fiscal note totals had  to do                                                                    
with the  requirements for staffing. She  explained that DRB                                                                    
would need  three full-time employees, actuaries,  and legal                                                                    
counsel in order to conduct the study.                                                                                          
                                                                                                                                
Representative Ortiz  noted that  he meant  to say  that the                                                                    
fiscal note totaled $350,000 not $350 million.                                                                                  
                                                                                                                                
Representative  Galvin commented  that  the  concept of  the                                                                    
bill  could be  a "game  changer" for  education. She  noted                                                                    
that her  questions were similar to  Representative Hannan's                                                                    
and  wanted  to  know  how   many  districts  had  indicated                                                                    
interest in the  plan. She wondered if  districts could help                                                                    
each other if many were  interested in the plan. She thought                                                                    
the bill could help the state support its children.                                                                             
                                                                                                                                
3:00:47 PM                                                                                                                    
                                                                                                                                
Representative  Stapp asked  what the  current per  employee                                                                    
per year cost was for AlaskaCare.                                                                                               
                                                                                                                                
Ms. Mueca responded that the  average per employee per month                                                                    
cost  was around  $1,734. She  would have  to calculate  the                                                                    
numbers to provide the annual cost.                                                                                             
                                                                                                                                
Representative  Stapp commented  that it  was about  $20,000                                                                    
per year based  on Ms. Mueca's response. There  was a Haight                                                                    
Law Group  study [from 2014]  that showed a cost  of $18,446                                                                    
per employee per year for  insurance. He understood that the                                                                    
goal of  the bill was to  bring about savings and  that some                                                                    
school districts would choose  to consolidate to save money.                                                                    
He thought some groups or  districts could drive the cost of                                                                    
AlaskaCare up. He reiterated that  he did not understand how                                                                    
the actuarial analysis could be conducted for $30,000.                                                                          
                                                                                                                                
Ms. Mueca responded that there  was already a starting point                                                                    
for the actuarial analysis which  was the reason why DRB was                                                                    
quoted  $30,000  for the  analysis.  She  could provide  any                                                                    
additional information about  the analysis if Representative                                                                    
Stapp would like.                                                                                                               
                                                                                                                                
Representative  Stapp asked  for a  list of  the information                                                                    
that the division was going  to examine. He thought that the                                                                    
actuaries  would want  to look  at the  employee costs,  the                                                                    
deductibles, and other factors.                                                                                                 
                                                                                                                                
Ms. Mueca would follow up with the information.                                                                                 
                                                                                                                                
3:03:57 PM                                                                                                                    
                                                                                                                                
Representative  Coulombe   relayed  that  she   assumed  the                                                                    
university supported  the bill. She asked  if her assumption                                                                    
was correct.                                                                                                                    
                                                                                                                                
Representative  Vance  responded  that  the  university  was                                                                    
neutral on  the bill and  adding the university to  the plan                                                                    
was not  a necessity. When  she introduced a version  of the                                                                    
bill four years prior, her  school district did not need the                                                                    
plan;  however, the  district  desperately  needed the  bill                                                                    
four  years  later. She  thought  the  change spoke  to  the                                                                    
importance  of having  health care  options  for the  future                                                                    
because many  municipalities that do not  currently need the                                                                    
option might need it in future years.                                                                                           
                                                                                                                                
Representative  Coulombe  asked  if  DOA  would  help  small                                                                    
school  districts  decide whether  it  was  prudent for  the                                                                    
districts to join the plan.                                                                                                     
                                                                                                                                
Representative Vance responded that  Section 9 addressed the                                                                    
issue. She  explained it was  a requirement that there  be a                                                                    
report   detailing   the    potential   costs   before   the                                                                    
commissioner authorized acceptance of the units.                                                                                
                                                                                                                                
Representative Coulombe  asked if the prior  versions of the                                                                    
bill   that   mandated    participation   were   driven   by                                                                    
Representative Stapp's earlier point  that the plan could be                                                                    
overwhelmed   by   high-needs    groups.   She   asked   for                                                                    
Representative  Vance's  opinion  on  whether  participation                                                                    
should be mandatory.                                                                                                            
                                                                                                                                
Representative  Vance  responded  that   there  had  been  a                                                                    
conversation  about  mandatory  participation in  2014.  She                                                                    
stated  her  understanding  that some  districts  wanted  to                                                                    
maintain  local control  and opposed  the  idea of  forceful                                                                    
consolidation.  She  added  that  AEA  also  opposed  making                                                                    
participation in the plan mandatory.                                                                                            
                                                                                                                                
Representative   Coulombe  liked   that  participation   was                                                                    
voluntary.                                                                                                                      
                                                                                                                                
3:07:27 PM                                                                                                                    
                                                                                                                                
Co-Chair  Johnson  asked  if the  information  requested  by                                                                    
Representative Stapp  could be provided to  all members. She                                                                    
wondered how many  districts had a blind  health care trust.                                                                    
She understood that Mat-Su did not.                                                                                             
                                                                                                                                
Representative Vance  was uncertain of the  number. The Mat-                                                                    
Su district had  given great support to the  bill because it                                                                    
could save $7  million per year. The district  was the first                                                                    
to reach  out to  her office in  support of  the legislation                                                                    
because  it  estimated a  $3,000  savings  per employee  per                                                                    
paycheck.                                                                                                                       
                                                                                                                                
Co-Chair Johnson commented that  the bill had potential. She                                                                    
understood  that   some  contracts  had  higher   levels  of                                                                    
transparency than  others. She  hoped transparency  would be                                                                    
increased if the bill were to pass.                                                                                             
                                                                                                                                
Representative Vance  noted that the AlaskaCare  2020 active                                                                    
employees premiums chart  (copy on file) as  provided by DOA                                                                    
was included  in member's packets. She  highlighted that she                                                                    
was offering the bill as a  tool for the legislature to draw                                                                    
on to examine cost-reducing methods  and to make the most of                                                                    
the state's  dollars while  providing excellent  health care                                                                    
to Alaskans. She  argued that the state  indirectly paid for                                                                    
health  care in  one form  or another  through the  BSA. She                                                                    
would let  the committee determine which  entities should be                                                                    
included in  the plan  but her  goal was  to put  all school                                                                    
districts on equal footing. There  were some small districts                                                                    
that needed help and larger ones  that did not. The bill was                                                                    
meant to look to the  future and recruit and retain teachers                                                                    
by providing great health care.                                                                                                 
                                                                                                                                
HB  21  was   HEARD  and  HELD  in   committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
3:11:04 PM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
3:16:42 PM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
HOUSE BILL NO. 112                                                                                                            
                                                                                                                                
     "An Act relating to the  Board of Pharmacy; relating to                                                                    
     the  practice  of  pharmacy;  relating  to  pharmacies;                                                                    
     relating to  prescription drug  manufacturers; relating                                                                    
     to  prescriptions  for  epinephrine;  relating  to  the                                                                    
     administration  of epinephrine;  and  providing for  an                                                                    
     effective date."                                                                                                           
                                                                                                                                
3:17:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JUSTIN  RUFFRIDGE,  SPONSOR,  introduced  HB
112.  He explained  that  the bill  came  about after  being                                                                    
discussed  for  multiple  years   by  the  Alaska  Board  of                                                                    
Pharmacy. The  board was tasked  with regulation  changes by                                                                    
the   administration,  and   it   thoroughly  examined   the                                                                    
regulations of  the profession  of pharmacy.  The regulation                                                                    
changes were  referred to as  "right touch"  regulations and                                                                    
modernized the  profession as it had  changed immensely over                                                                    
the past 25  years. The board started keeping a  list of the                                                                    
items that would  need to be changed in statute  in order to                                                                    
implement  the  right  touch regulations.  The  bill  was  a                                                                    
collection  of the  statute changes  to  help modernize  the                                                                    
profession and  it would also  give the board  the authority                                                                    
to  continue the  regulatory process.  He  relayed that  the                                                                    
chair of  the board  would offer  a presentation  to explain                                                                    
the bill in more detail.                                                                                                        
                                                                                                                                
DR.  ASHLEY SCHABER,  CHAIR, ALASKA  BOARD OF  PHARMACY (via                                                                    
teleconference),  introduced   the  PowerPoint  presentation                                                                    
"House Bill 112:  Profession of Pharmacy" dated  May 8, 2023                                                                    
(copy  on file).  She began  on slide  2 which  detailed the                                                                    
board's  2023 strategic  plan. There  had been  a cumulative                                                                    
effort over the last several  years to ensure that the board                                                                    
had  statute  changes  that  would  allow  it  to  meet  its                                                                    
mission. She highlighted that one  of the board's four goals                                                                    
[listed  on  the  slide]  was  to  grow  the  economy  while                                                                    
promoting community  health and safety. Many  of the changes                                                                    
related   to  the   aforementioned  goal,   particularly  to                                                                    
routinely  review  the  effectiveness  of  regulations  that                                                                    
reduced  the  barrier   to  licensure  without  compromising                                                                    
patient  health  and  safety. She  relayed  that  the  board                                                                    
currently had  seven members, five of  whom were pharmacists                                                                    
and two of whom were public members.                                                                                            
                                                                                                                                
Dr.  Schaber   continued  to  slide   3  and   offered  some                                                                    
background  information on  HB 112.  She explained  that the                                                                    
bill   would  address   necessary  changes   by  doing   the                                                                    
following:                                                                                                                      
                                                                                                                                
      Streamlining licensure process while improving                                                                         
        public safety                                                                                                           
      Compliance with the Drug Supply Chain and Security                                                                     
        Act                                                                                                                     
      Alignment with other professional boards in Alaska                                                                     
        and pharmacy boards in other states                                                                                     
      Clarification of pharmacists' roles in epinephrine                                                                     
        access                                                                                                                  
                                                                                                                                
Dr.  Schaber indicated  that the  bill  was a  collaborative                                                                    
effort  between   the  board  and  the   Alaska  Pharmacists                                                                    
Association.                                                                                                                    
                                                                                                                                
Dr.  Schaber continued  on slide  4. The  first goal  was to                                                                    
streamline  the  licensure  process while  improving  public                                                                    
safety.  The  bill  eliminated unnecessary  forms  currently                                                                    
required in  statute. The forms were  redundant and included                                                                    
information that was already part  of the licensure process.                                                                    
The elimination of the forms  would reduce the burden on the                                                                    
applicant  and on  the board.  It also  clarified that  only                                                                    
pharmacists  who dispensed  controlled  substances would  be                                                                    
required to  register with the Prescription  Drug Monitoring                                                                    
Program  (PDMP).  It  would also  add  a  national  criminal                                                                    
background  check  for  all   applicants,  which  would  add                                                                    
another  layer  of  protection.  The  background  check  was                                                                    
required in 30 other states  and was a statutory requirement                                                                    
for nursing and other professions.                                                                                              
                                                                                                                                
3:23:48 PM                                                                                                                    
                                                                                                                                
Representative Hannan  asked what  details were  included in                                                                    
the national  background check when  it was returned  to the                                                                    
board. She asked if included  specific information or simply                                                                    
showed  whether  an  applicant   had  committed  a  criminal                                                                    
violation.                                                                                                                      
                                                                                                                                
Dr. Schaber  responded that she  did not know  which details                                                                    
were included in the background  check. She thought that the                                                                    
background  check  acted  as a  flag  to  prompt  additional                                                                    
review.                                                                                                                         
                                                                                                                                
Representative Ruffridge responded  that the application for                                                                    
licensure currently  had a "self-selection"  response, which                                                                    
meant that  the application asked whether  an individual had                                                                    
been   convicted  of   a  crime   or  was   currently  under                                                                    
investigation for  a crime. Applicants  were able  to select                                                                    
"no" on the  application even if the true  answer was "yes,"                                                                    
and  there would  be no  follow-up. During  his time  on the                                                                    
board, there were  at least a few cases in  which the answer                                                                    
checked on  the application  was no,  but the  actual answer                                                                    
was  yes. The  reason for  the  request was  to ensure  that                                                                    
applicants were answering  truthfully on their applications.                                                                    
If a person  were to lie, there would be  reason to deny the                                                                    
individual a license.                                                                                                           
                                                                                                                                
Representative Hannan  noted that  the committee  spent time                                                                    
in  the  prior  week  talking about  background  checks  for                                                                    
cannabis convictions  that were no longer  convictions under                                                                    
the law  and how  the process should  be changed.  She could                                                                    
see a problematic situation occurring  in which a pharmacist                                                                    
applicant had  a cannabis conviction  in another  state, but                                                                    
it was not considered a  criminal offense in Alaska. She was                                                                    
hoping that there  would be more detail than a  yes or no as                                                                    
the answer  was often  more complicated.  She did  not think                                                                    
answering yes  should be  an automatic  denial, but  she was                                                                    
unsure if federal law would allow nuances to be considered.                                                                     
                                                                                                                                
Representative Ruffridge responded  that marijuana was still                                                                    
considered  an illicit  substance because  it was  federally                                                                    
illegal.  A violation  with a  controlled drug  of any  type                                                                    
would  be  a   flag  to  prompt  additional   review  of  an                                                                    
application. The board considered it  an issue in its hiring                                                                    
process even though  marijuana was legal at  the state level                                                                    
because   pharmacists  would   have  access   to  controlled                                                                    
substances.                                                                                                                     
                                                                                                                                
Representative  Coulombe asked  Representative Ruffridge  to                                                                    
put his credentials on the record.                                                                                              
                                                                                                                                
Representative Ruffridge responded that  he was the previous                                                                    
chair  of the  Board  of  Pharmacy. He  had  a doctorate  in                                                                    
pharmacy and  had been  a licensed  pharmacist in  the state                                                                    
since 2008.                                                                                                                     
                                                                                                                                
3:29:31 PM                                                                                                                    
                                                                                                                                
Dr. Schaber  continued on slide 5.  The next goal was  to be                                                                    
compliant  with  the  Drug Supply  Chain  and  Security  Act                                                                    
(DSCSA). She read from the slide as follows:                                                                                    
                                                                                                                                
      The federal Drug Supply Chain and Security Act                                                                         
        (DSCSA) further secures the U.S. drug supply through                                                                    
        a system to prevent harmful drugs  from entering the                                                                    
        supply chain, detect harmful drugs if they do enter,                                                                    
        and enable rapid response when such drugs are found.                                                                    
          o Boards of Pharmacy play a key role in this                                                                          
             process through appropriate licensing of drug                                                                      
             distributors and pharmacies                                                                                        
                                                                                                                                
      HB 112 ensures the AK Board of Pharmacy powers and                                                                     
        duties support the DSCSA related to manufacturers,                                                                      
        out-of-state pharmacies, and internet pharmacies to                                                                     
        ensure Alaskans receive safe medications                                                                                
                                                                                                                                
Dr.   Schaber  explained   that  the   change  would   be  a                                                                    
modernization  to   the  process.   Currently,  out-of-state                                                                    
pharmacies were required to register  based on a statute put                                                                    
in  place in  1992. The  drug supply  chain and  pharmacy in                                                                    
general  had  changed  significantly  since  1992  when  the                                                                    
original  statute  was  put  in   place.  She  relayed  that                                                                    
compliance  with DSCSA  would  give  the board  jurisdiction                                                                    
over out-of-state pharmacies. There  was a concern that out-                                                                    
of-state  pharmacies that  were  mailing prescriptions  into                                                                    
the  state  might   not  be  providing  the   same  kind  of                                                                    
counseling  that the  in-state pharmacies  were required  to                                                                    
provide. The  concern had  been raised  many times  over the                                                                    
years in the form of public comment.                                                                                            
                                                                                                                                
Dr. Schaber  continued on slide  6 and the next  goal, which                                                                    
was alignment. To  achieve the goal, the  bill would replace                                                                    
one  of  the  two  public   member  seats  with  a  pharmacy                                                                    
technician seat. As  the field of pharmacy  had changed over                                                                    
the  years, the  role  of pharmacy  technicians had  changed                                                                    
with it. Both public member  seats had been vacant for about                                                                    
a year and  adding the pharmacy technician  seat would allow                                                                    
for an additional perspective. The  board also hoped that it                                                                    
would help  fill the  vacancy. The next  change would  be to                                                                    
allow  the  board to  adopt  language  to create  a  retired                                                                    
pharmacist status.  It would align  the board  with pharmacy                                                                    
boards in  other states and  with other  professional boards                                                                    
in the  state. The last  change associated with the  goal of                                                                    
compliance    was   to    clarify   the    board   executive                                                                    
administrator's  salary  which   would  allow  the  required                                                                    
flexibility for  a pharmacist  to serve in  the role  in the                                                                    
future.  The salary  was currently  not  flexible enough  to                                                                    
allow a pharmacist to apply  for the position. The board did                                                                    
not want to require that  a pharmacist serve in the position                                                                    
because  applicants  with  other credentials  were  able  to                                                                    
serve also, but it wanted to allow for the possibility.                                                                         
                                                                                                                                
3:34:02 PM                                                                                                                    
                                                                                                                                
Dr. Schaber continued on slide  7 which detailed the goal of                                                                    
epinephrine access. The  changes in the bill  would move the                                                                    
epinephrine  training  program  from the  authority  of  the                                                                    
Department of Health  (DOH) to be overseen by  the board. It                                                                    
also   clarified   that   a  pharmacist   could   administer                                                                    
epinephrine  or prescribe  epinephrine auto-injectors  to an                                                                    
individual who had completed the  training program. It would                                                                    
ultimately  increase epinephrine  access  for Alaskans  with                                                                    
anaphylactic emergencies  or those  who might not  know they                                                                    
were at  risk for  anaphylactic emergencies. She  added that                                                                    
access was  especially important in  the rural areas  of the                                                                    
state.  Some  of the  changes  in  the bill  also  increased                                                                    
access by decreasing barriers to  dialysis fluids, which was                                                                    
also important  for Alaskans living  in rural areas  on home                                                                    
dialysis by  allowing patients to  receive the  treatment at                                                                    
home.                                                                                                                           
                                                                                                                                
Dr.  Schaber  concluded  her presentation  on  slide  8  and                                                                    
thanked  the   committee  for  its   time.  She   urged  the                                                                    
committee's support of the bill.                                                                                                
                                                                                                                                
Co-Chair Foster asked for clarity  on the uses of situations                                                                    
in which epinephrine would be used.                                                                                             
                                                                                                                                
Dr.  Schaber responded  that  epinephrine  was an  emergency                                                                    
medication used  for allergic reactions,  such as  eggs, bee                                                                    
stings, or  peanuts. Some individuals  were aware  that they                                                                    
had anaphylaxis,  and some  were not  aware until  they were                                                                    
exposed to the substance that causes a reaction.                                                                                
                                                                                                                                
Representative  Hannan  asked   about  the  board  executive                                                                    
administrator's salary  detailed in Section 10  of the bill.                                                                    
She  asked how  many other  professional boards  allowed for                                                                    
similar flexibility in  salary. She wondered if  there was a                                                                    
salary  classification  for  pharmacists in  the  state  pay                                                                    
schedules.                                                                                                                      
                                                                                                                                
3:37:10 PM                                                                                                                    
                                                                                                                                
SYLVAN  ROBB, DIRECTOR,  DIVISION  OF CORPORATIONS  BUSINESS                                                                    
AND   PROFESSIONAL   LICENSING,   DEPARTMENT   OF   COMMERCE                                                                    
COMMUNITY  AND ECONOMIC  DEVELOPMENT,  responded that  there                                                                    
were other pharmacists  that worked for the  state and there                                                                    
were pay  schedules in  place. The  pay ranged  depending on                                                                    
duties: for example, there was  a pharmacist employed in the                                                                    
Alaska   Psychiatric  Institute   (API)  as   well  as   DOH                                                                    
pharmacists  in for  Medicaid  purposes  with salary  ranges                                                                    
from   24   through   range  27.   Relating   to   executive                                                                    
administrator  of other  boards, six  of the  boards had  an                                                                    
executive administrator positions and  one other board had a                                                                    
similar position with  a different title. Only  the Board of                                                                    
Nursing  had  required   qualifications  for  the  executive                                                                    
administrator role as it required  that the individual was a                                                                    
registered nurse (RN).                                                                                                          
                                                                                                                                
Representative  Hannan asked  if the  nursing board  members                                                                    
were paid on the RN pay schedule.                                                                                               
                                                                                                                                
Ms.  Robb  responded  that  the members  were  not  paid  as                                                                    
nurses.   The   executive   administrator   positions   were                                                                    
considered partially exempt and  the salary for the position                                                                    
was not  specified in statute;  however, it was  the highest                                                                    
paid position because  it required that the  individual be a                                                                    
licensed  professional and  have a  master's degree,  it was                                                                    
the highest  paid of  the executive  administrator positions                                                                    
and was a range 25.                                                                                                             
                                                                                                                                
Representative  Hannan   asked  if  the  phrasing   for  the                                                                    
pharmacy board's  executive administrator  was unique  or if                                                                    
other   boards  had   similar  required   competencies.  She                                                                    
wondered if  the administrators were  adequately compensated                                                                    
based on the advanced requirements.                                                                                             
                                                                                                                                
Ms.  Robb  responded that  not  all  heath care  boards  had                                                                    
executive  administrators. The  nursing board  was the  only                                                                    
board  requiring the  administrator to  be a  member of  the                                                                    
nursing profession. The pay  for the executive administrator                                                                    
positions ranged  depending on  the workload and  on whether                                                                    
the   pay   was   dictated   in   statute.   The   executive                                                                    
administrator position for the  pharmacy board was currently                                                                    
not filled by a pharmacist.  If the board hired a pharmacist                                                                    
for  the  position,  it  wanted   the  ability  to  pay  the                                                                    
individual fairly based on the advanced requirements.                                                                           
                                                                                                                                
Representative Hannan  asked what  the range  increase would                                                                    
be  in  order  to  pay  the  executive  administrator  as  a                                                                    
pharmacist.                                                                                                                     
                                                                                                                                
Ms. Robb replied that the  other pharmacists that worked for                                                                    
the state were range 24  through range 27 depending on their                                                                    
duties. The board would have  to work with classification to                                                                    
determine   which  other   state  pharmacist   position  the                                                                    
executive  administrator was  most  similar to  in order  to                                                                    
determine the range.                                                                                                            
                                                                                                                                
3:41:53 PM                                                                                                                    
                                                                                                                                
Representative  Josephson asked  if the  licensees of  board                                                                    
paid for the executive administrator positions.                                                                                 
                                                                                                                                
Ms. Robb  responded in  the affirmative  and noted  that the                                                                    
divisions  were funded  through receipt-supported  services.                                                                    
The cost  of all staff for  a particular board were  paid by                                                                    
the licensees  for that particular profession.  The Division                                                                    
of Corporations Business  and Professional Licensing (DCBPL)                                                                    
conducted time keeping  in order to allow  staff to indicate                                                                    
which  program  they were  working  on  to ensure  that  the                                                                    
charges were allocated appropriately.                                                                                           
                                                                                                                                
Representative  Josephson understood  that  the boards  were                                                                    
providing services  "out of the  kindness of  their hearts."                                                                    
He  was  not  aware  that   some  boards  had  an  executive                                                                    
administrator apart from the Medical  Board. He asked if the                                                                    
state would pick up the extra  costs if a board chose not to                                                                    
hire an administrator.                                                                                                          
                                                                                                                                
Ms. Robb responded that all were  paid by the licensees of a                                                                    
board,  and it  would not  matter whether  the board  had an                                                                    
executive administrator.                                                                                                        
                                                                                                                                
Representative  Josephson asked  why  each  board would  not                                                                    
want their own executive administrator.                                                                                         
                                                                                                                                
Ms.  Robb  responded  that  it depended  on  the  scope  and                                                                    
complexity of the  program. The Board of Nursing  was a team                                                                    
of 10 individuals that oversaw  28,000 licensees and it made                                                                    
sense for  the board  to employ an  executive administrator.                                                                    
There  were some  boards with  more  complex licensing  than                                                                    
others  and   needed  more  employees.  Boards   with  fewer                                                                    
licensees and  less complex licensing processes  had less of                                                                    
a need for an executive administrator.                                                                                          
                                                                                                                                
3:44:36 PM                                                                                                                    
                                                                                                                                
Representative   Coulombe   understood   that   out-of-state                                                                    
pharmacies  had to  be registered  but  did not  have to  be                                                                    
licensed. She asked if her understanding was correct.                                                                           
                                                                                                                                
Representative Ruffridge responded in the affirmative.                                                                          
                                                                                                                                
Representative  Coulombe wanted  to ensure  that adding  the                                                                    
licensing   requirement  would   not  be   too  much   of  a                                                                    
hinderance.  She relayed  that there  were many  individuals                                                                    
who relied  on online  pharmacies. She asked  what licensing                                                                    
would be like for an out-of-state pharmacy.                                                                                     
                                                                                                                                
Representative  Ruffridge responded  that under  the current                                                                    
process,  registering  with  the Board  of  Pharmacy  simply                                                                    
indicated that a pharmacist existed  and may or may not send                                                                    
for medications  with the state.  There was  no jurisdiction                                                                    
by the  board of the  medications that entered the  state to                                                                    
ensure that counseling had been  provided to the individuals                                                                    
receiving medications.  There was  no ability for  the board                                                                    
to  maintain safety  measures. Over  the  years, mail  order                                                                    
pharmacies had  become more popular and  regulations had not                                                                    
kept up  with the  changes. The change  would not  be overly                                                                    
burdensome to  companies that  already mailed  a significant                                                                    
amount of medications into multiple  states and would simply                                                                    
put  Alaska  in alignment  with  many  other states  in  the                                                                    
nation.                                                                                                                         
                                                                                                                                
Representative  Coulombe  asked  if   there  were  new  fees                                                                    
associated with registration or licensing.                                                                                      
                                                                                                                                
Representative  Ruffridge  responded  that there  were  fees                                                                    
associated with  licensing and  registration, but  the board                                                                    
had gone through multiple iterations  of fee reductions over                                                                    
the  last few  years. He  argued that  the fee  for pharmacy                                                                    
technicians  was essentially  nonexistent. Technicians  were                                                                    
simply  required  to  pay  an  initial  $25  fee  to  become                                                                    
registered and  licensed, which  was reduced  from a  fee of                                                                    
$150.                                                                                                                           
                                                                                                                                
Co-Chair  Foster  suggested  that  Representative  Ruffridge                                                                    
make closing comments.                                                                                                          
                                                                                                                                
Representative  Ruffridge  thanked  the  committee  for  its                                                                    
time. The  bill had been  well vetted and had  been overseen                                                                    
by three different chairs of  the pharmacy board. He thought                                                                    
that the support  for the bill was encouraging  and that the                                                                    
bill represented  the desires of the  profession of pharmacy                                                                    
as a  whole. He  welcomed the support  of the  committee and                                                                    
was happy to answer any other questions.                                                                                        
                                                                                                                                
HB 112 was HEARD and HELD in committee for further                                                                              
consideration.                                                                                                                  
                                                                                                                                
Co-Chair Foster reviewed the agenda for the following day's                                                                     
meeting.                                                                                                                        
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
3:50:04 PM                                                                                                                    
                                                                                                                                
The meeting was adjourned at 3:50 p.m.                                                                                          

Document Name Date/Time Subjects
HB 112 NEW FN DCCED 5-5-23.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB 112 Support as of 4.20.23 Redacted.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB0112 Sectional Analysis CS 4.24.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB0112 Sponsor Statement Version CS 4.24.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB0112 Summary of Changes CS 4.24.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB21 Additional Documents - ISER 2018 Research Summary 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB21 Additional Documents - Slideshow Presentation 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB21 Additional Documents - Letters of Support 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB21 Addtional Supporting Documents - Explanation of Changes from v.A to v.B 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB21 Sectional Analysis ver B 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB21 Sponsor Statement 05.03.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB 112 Alaska Board of Pharmacy PP 050823.pdf HFIN 5/8/2023 1:30:00 PM
HB 112
HB 21 - PHC 5.7.23 Public Testimony Rec'd by 5.9.23.pdf HFIN 5/8/2023 1:30:00 PM
HB 21
HB 112 Public Testimony Rec'd by 050923.pdf HFIN 5/8/2023 1:30:00 PM
HB 112