Legislature(2013 - 2014)HOUSE FINANCE 519

03/24/2014 08:30 AM FINANCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= HB 278 EDUCATION: FUNDING/TAX CREDITS/PROGRAMS TELECONFERENCED
<Bill Hearing Postponed>
+ HB 177 COMMERCIAL FISHING LOANS TELECONFERENCED
<Bill Hearing Postponed>
+ HB 134 MEDICAID PAYMENT FOR MEDISET PRESCRIPTION TELECONFERENCED
Heard & Held
+ HB 210 STUDENT RESTRAINT, SECLUSION, PSYC DRUGS TELECONFERENCED
<Bill Hearing Postponed>
+ HB 202 BISON DRAWING PERMIT FEES TELECONFERENCED
<Bill Hearing Postponed>
+ HCR 15 TASK FORCE ON UNMANNED AIRCRAFT SYSTEMS TELECONFERENCED
<Bill Hearing Postponed>
+= HB 21 FOUR-DAY SCHOOL WEEK TELECONFERENCED
<Bill Hearing Postponed>
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 75 CONTRIBUTION FROM PFD: AUDITS; UNIVERSITY TELECONFERENCED
Moved CSHB 75(FIN) Out of Committee
- Committee Schedule Subject to Change.
Legislation may be heard later in the week under
"Bills Previously Heard or Scheduled"
                  HOUSE FINANCE COMMITTEE                                                                                       
                      March 24, 2014                                                                                            
                         8:38 a.m.                                                                                              
                                                                                                                                
8:38:06 AM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair Stoltze called the  House Finance Committee meeting                                                                    
to order at 8:38 a.m.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Alan Austerman, Co-Chair                                                                                         
Representative Bill Stoltze, Co-Chair                                                                                           
Representative Mia Costello                                                                                                     
Representative Bryce Edgmon                                                                                                     
Representative David Guttenberg                                                                                                 
Representative Cathy Munoz                                                                                                      
Representative Steve Thompson                                                                                                   
Representative Tammie Wilson                                                                                                    
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Lindsey Holmes                                                                                                   
Representative Les Gara                                                                                                         
Representative Mark Neuman, Vice-Chair                                                                                          
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Representative Costello, Sponsor;  Charles Guinchard, Staff,                                                                    
Representative     Costello;    Daniel     George,    Staff,                                                                    
Representative  Bill   Stoltze;  Dan   DeBartolo,  Director,                                                                    
Permanent Fund Dividend, Department of Revenue.                                                                                 
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Margaret Brodie,  Director, Healthcare  Services, Department                                                                    
of   Health   And    Social   Services,   Anchorage;   Barry                                                                    
Christensen,  Alaska   Pharmacists  Association,  Ketchikan;                                                                    
Patricia Senner, Alaska  Nurses Association, Anchorage; Mike                                                                    
Coons, Self,  Palmer; Jeff Jessee, Chief  Executive Officer,                                                                    
Alaska  Mental  Health  Trust  Authority;  Jordan  Marshall,                                                                    
Rasmuson Foundation, Anchorage.                                                                                                 
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
HB 21     FOUR-DAY SCHOOL WEEK                                                                                                  
                                                                                                                                
          HB 21 was SCHEDULED but not HEARD.                                                                                    
                                                                                                                                
HB 75     CONTRIBUTION FROM PFD: AUDITS; UNIVERSITY                                                                             
                                                                                                                                
          CSHB 75  (FIN) was REPORTED out  of committee with                                                                    
          a  "do  pass"  recommendation  and  with  one  new                                                                    
          indeterminate fiscal  note from the  Department of                                                                    
          Revenue  and   one  new   fiscal  note   from  the                                                                    
          University.                                                                                                           
                                                                                                                                
HB 134    MEDICAID PAYMENT FOR MEDISET PRESCRIPTION                                                                             
                                                                                                                                
          HB 134 was HEARD and HELD in committee for                                                                            
          further consideration.                                                                                                
                                                                                                                                
HB 177    COMMERCIAL FISHING LOANS                                                                                              
                                                                                                                                
          HB 177 was SCHEDULED but not HEARD.                                                                                   
                                                                                                                                
HB 202    BISON DRAWING PERMIT FEES                                                                                             
                                                                                                                                
          HB 202 was SCHEDULED but not HEARD.                                                                                   
                                                                                                                                
HB 210    STUDENT RESTRAINT, SECLUSION, PSYC DRUGS                                                                              
                                                                                                                                
          HB 210 was SCHEDULED but not HEARD.                                                                                   
                                                                                                                                
HB 278    EDUCATION: FUNDING/TAX CREDITS/PROGRAMS                                                                               
                                                                                                                                
          HB 278 was SCHEDULED but not HEARD.                                                                                   
                                                                                                                                
HCR 15    TASK FORCE ON UNMANNED AIRCRAFT SYSTEMS                                                                               
                                                                                                                                
          HCR 15 was SCHEDULED but not HEARD.                                                                                   
                                                                                                                                
HOUSE BILL NO. 134                                                                                                            
                                                                                                                                
     "An Act requiring Medicaid payment for scheduled unit                                                                      
     dose prescription drug packaging and dispensing                                                                            
     services for specified recipients."                                                                                        
                                                                                                                                
8:38:47 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE    COSTELLO,    SPONSOR,    introduced    the                                                                    
legislation. She offered that  the senior citizen population                                                                    
in  Alaska  was the  fastest  growing  in the  country.  She                                                                    
explained that  Mediset [medication management  service] was                                                                    
an  enhanced  pharmacy service  for  a  patient on  multiple                                                                    
medications  available   by  prescription.   The  pharmacist                                                                    
packaged the  medications in order  to aid the  patient with                                                                    
proper  dosing  requirements.  She elaborated  that  seniors                                                                    
were   often   "overwhelmed"   when  faced   with   multiple                                                                    
medication dosing requirements  and that "medication issues"                                                                    
was  a major  cause  of senior  emergency  room visits.  The                                                                    
Department  of   Health  and  Social  Services   (DHSS)  was                                                                    
currently administering  the program via regulation  and the                                                                    
goal  of HB  134 was  to establish  Mediset in  statute. She                                                                    
introduced the  legislation in  order to  facilitate seniors                                                                    
to remain  living at  home rather than  moving to  high cost                                                                    
institutions   due   to    medication   mismanagement.   She                                                                    
reiterated that  the bill provided the  department statutory                                                                    
oversight for  the program.  The state  was on  the "cutting                                                                    
edge" of  offering the  program to  "vulnerable" populations                                                                    
and stressed the  importance of the program to  be driven by                                                                    
statute and not by regulation.                                                                                                  
                                                                                                                                
CHARLES GUINCHARD, STAFF,  REPRESENTATIVE COSTELLO, showed a                                                                    
video about the Mediset program.                                                                                                
                                                                                                                                
8:41:48 AM                                                                                                                    
                                                                                                                                
Video                                                                                                                           
                                                                                                                                
8:45:56 AM                                                                                                                    
                                                                                                                                
End of video                                                                                                                    
                                                                                                                                
Co-Chair  Stoltze wondered  why the  fiscal note,  FN1 (DHS)                                                                    
was  zero  when the  bill  originally  had "serious"  fiscal                                                                    
implications.                                                                                                                   
                                                                                                                                
Mr.  Guinchard  referred  to  a  document:  "Explanation  of                                                                    
Changes"  (copy on  file). He  explained  that the  original                                                                    
version of the  bill had the same intent  but was structured                                                                    
differently. After  discussions with DHSS parts  of the bill                                                                    
were  "reorganized" to  eliminate any  unintended costs  for                                                                    
the department.                                                                                                                 
                                                                                                                                
Mr.  Guinchard  provided  a  sectional  analysis.  He  cited                                                                    
Section 1, paragraph  (a) which established the  fee for the                                                                    
program:                                                                                                                        
                                                                                                                                
     Sec.  47.07.031. Scheduled  units  of use  prescription                                                                    
     drug  dispensing  services.  (a)  In  addition  to  the                                                                  
     services   provided  for   under   AS  47.07.030,   the                                                                    
     department  shall establish  a  fee to  be  added to  a                                                                    
     dispensing  fee   to  pay  a  qualified   pharmacy  for                                                                    
     dispensing  services for  a prescription  that requires                                                                    
     scheduled  units   of  use  in   medication  compliance                                                                    
     packaging  for the  purpose  of  assisting a  qualified                                                                    
     medical assistance recipient under  (c) of this section                                                                    
     to adhere to a specific dosing regimen.                                                                                    
                                                                                                                                
Mr.  Guinchard   noted  a  number   of  qualifiers   in  the                                                                    
paragraph.   He  cited   line  8,   "…to  pay   a  qualified                                                                    
pharmacy…."  He reported  that a  definition of  Mediset and                                                                    
qualified pharmacy was included later  in the bill. He moved                                                                    
to lines 9  through 10, and explained that  the words, "that                                                                    
requires scheduled  units of  use" mandated  the need  for a                                                                    
doctor's prescription for a Mediset.                                                                                            
                                                                                                                                
Co-Chair Stoltze asked for clarification about the need.                                                                        
                                                                                                                                
Mr.  Guinchard explained  that  in order  to  qualify for  a                                                                    
Mediset, the physician must prescribe its use.                                                                                  
                                                                                                                                
Mr. Guinchard continued with paragraph (b):                                                                                     
                                                                                                                                
     (b) A pharmacy is  qualified to dispense a prescription                                                                    
     in  medication compliance  packaging for  payment under                                                                    
     this section if the pharmacy  is a provider of services                                                                    
     under the medical  assistance program established under                                                                    
     this  chapter and  provides  dispensing  services to  a                                                                    
     qualified medical assistance  recipient as follows: (1)                                                                    
     consolidating prescriptions  for purposes  of reporting                                                                    
     to  the  prescriber  on  prescription  compliance;  (2)                                                                    
     creating  medication   compliance  packaging   for  the                                                                    
     interval specified  on the prescription,  using trained                                                                    
     personnel;  (3)   offering  quarterly  review   with  a                                                                    
     recipient  or  the   recipient's  representative  of  a                                                                    
     recipient's complete medication  profile and medication                                                                    
     administration record, including  review of compliance;                                                                    
     (4)  reporting to  the  prescriber patient  compliance,                                                                    
     polypharmacy,   or   other   issues  related   to   the                                                                    
     recipient's  medication  at  least quarterly;  and  (5)                                                                    
     delivering prescriptions using  the most cost-effective                                                                    
     method.                                                                                                                    
                                                                                                                                
Mr.  Guinchard  pointed  out that  the  paragraph  specified                                                                    
pharmacy  qualification or  the criteria  for qualification.                                                                    
The paragraph  included the five criteria  for qualification                                                                    
beginning on  page 3, line  2. The qualifiers were  the cost                                                                    
drivers  for  a Mediset.  He  noted  that qualification  (1)                                                                    
consolidated  the   patient's  prescriptions,   (2)  created                                                                    
medication  compliance  packaging,  (3)  required  quarterly                                                                    
review  with  the  patient   or  representative  to  "ensure                                                                    
compliance,"  (4)   mandated  that  the   pharmacist  report                                                                    
compliance  adherence   to  prescriber,  and   (5)  required                                                                    
delivery to recipient.                                                                                                          
                                                                                                                                
Mr. Guinchard continued with paragraph (c):                                                                                     
                                                                                                                                
     (c)  A medical  assistance  recipient  is qualified  to                                                                    
     receive   a  prescription   in  medication   compliance                                                                    
     packaging under  (a) of this  section if  the recipient                                                                    
     is  a person  who  is eligible  for medical  assistance                                                                    
     under  AS 47.07  and is  (1) residing  in a  congregate                                                                    
     living  home,   as  defined  by  the   department;  (2)                                                                    
     receiving community-based  waiver services;(3) disabled                                                                    
     or blind; (4)  an adult with a  serious mental illness,                                                                    
     as  defined   by  the  department;   or  (5)   a  child                                                                    
     experiencing   a  severe   emotional  disturbance,   as                                                                    
     defined by the department.                                                                                                 
                                                                                                                                
Mr.  Guinchard observed  that the  language was  added under                                                                    
guidance by  the department  which ensured  that individuals                                                                    
currently covered  by Mediset would maintain  coverage under                                                                    
the legislation.                                                                                                                
                                                                                                                                
8:50:29 AM                                                                                                                    
                                                                                                                                
Mr.  Guinchard   turned  to  paragraph  (d)   that  included                                                                    
definitions beginning on page 2, line 24:                                                                                       
                                                                                                                                
     (d) In this section,                                                                                                       
     (1) "medication  compliance packaging" means  a package                                                                    
     containing  a   specified  quantity  of  one   or  more                                                                    
     prescription medications that have been divided by a                                                                       
     provider  into  units  of  use   to  be  taken  over  a                                                                    
     specified period  according to  a   prescription issued                                                                    
     by  an   authorized  health  care  provider   and  that                                                                    
     requires specialized dispensing  services;(2) "units of                                                                    
     use" means a prescription medication packaged in a way                                                                     
     that is designed to simplify a medication regimen to                                                                       
    improve adherence to a daily therapeutic schedule.                                                                          
                                                                                                                                
Mr. Guinchard  noted that "medication  compliance packaging"                                                                    
defined the  type of packaging  the pharmacist must  use. He                                                                    
commented that  "units of use"  referred to  each individual                                                                    
pill separated in parts of the packaging.                                                                                       
                                                                                                                                
Mr. Guinchard continued  with page 3, Section  2 and Section                                                                    
3 regarding the effective date.   He detailed that Section 2                                                                    
specified that any change to  the state Medicaid program was                                                                    
contingent upon  federal approval.  Section 3  provided that                                                                    
the effective date was contingent upon federal approval.                                                                        
                                                                                                                                
Representative   Costello  requested   that  Mr.   Guinchard                                                                    
explain  the reason  why the  fiscal note  was significantly                                                                    
reduced from the previous committee.                                                                                            
                                                                                                                                
Mr.  Guinchard complied  and cited  one  specific change  on                                                                    
page  2,  beginning  on  line  3  regarding  the  five  cost                                                                    
drivers.  He offered  that in  the previous  version of  the                                                                    
bill,  [HB 134]  DHSS  discerned that  the  language in  the                                                                    
legislation  required that  a fee  must  be established  for                                                                    
each of  the cost drivers.  The language was changed  in the                                                                    
current  version  [CSHB 134  HSS]  on  page 2.  The  current                                                                    
version of  the bill established  one fee in  paragraph (a).                                                                    
He continued that another  "significant" change that reduced                                                                    
the  fiscal note  was  the deletion  of  the paragraph  that                                                                    
required DHSS to provide transportation  for delivery of the                                                                    
Mediset prescriptions if the pharmacy did not deliver.                                                                          
                                                                                                                                
Co-Chair  Austerman asked  for  more  basic information.  He                                                                    
asked if Mediset was a current state program.                                                                                   
                                                                                                                                
Representative  Costello  replied  in the  affirmative.  She                                                                    
shared  that  upon  regulatory review;  the  department  was                                                                    
considering eliminating  the program.  She was asked  by the                                                                    
department to address the issue,  "as a policy decision," in                                                                    
statute.  She felt  that the  Mediset program  was important                                                                    
enough  to adopt  as statute  to enable  independent seniors                                                                    
and lower cost senior care.                                                                                                     
                                                                                                                                
Co-Chair Austerman asked  if Medicaid had paid  the costs in                                                                    
the past.                                                                                                                       
                                                                                                                                
Representative  Costello  deferred   to  the  department  to                                                                    
answer the question.                                                                                                            
                                                                                                                                
Co-Chair   Austerman  asked   what   criteria  qualified   a                                                                    
prescription for Mediset.                                                                                                       
                                                                                                                                
Representative   Costello   responded   that   the   Mediset                                                                    
packaging required  a doctor's prescription. A  doctor would                                                                    
prescribe Mediset due to the  "complexity of medication" and                                                                    
vulnerability of the patient.                                                                                                   
                                                                                                                                
Co-Chair Austerman  thought that  the benefits  were obvious                                                                    
but  that   the  program  might   be  abused   without  more                                                                    
definitive prescribing regulations.                                                                                             
                                                                                                                                
Co-Chair  Stoltze  relayed that  he  was  told at  a  senior                                                                    
center that  the [Mediset] "process helped  triage the level                                                                    
of care  for efficiency" and  reduced the number  of seniors                                                                    
in required care.                                                                                                               
                                                                                                                                
Representative  Costello  commented  that  the  concern  for                                                                    
abuse  was warranted.  The opportunity  for  abuse was  also                                                                    
lessened  because  multiple  medications with  month's  long                                                                    
prescriptions would  otherwise sit  in a person's  home. The                                                                    
Mediset   pharmacist   can   stop   prescriptions   due   to                                                                    
contraindications or adverse  reactions. Without Mediset the                                                                    
medications required disposal. In  some instances, it wasn't                                                                    
safe to  have the  medications sitting at  home on  a shelf,                                                                    
creating  opportunities for  theft  and  abuse. She  thought                                                                    
that Mediset prevented more situations  for abuse as opposed                                                                    
to creating situations for abuse.                                                                                               
                                                                                                                                
Representative Wilson  referred to paragraph (c)  on page 2.                                                                    
She interpreted  the legislation  to mean that  only seniors                                                                    
who  were disabled  or blind  or  receiving waiver  services                                                                    
qualified  for the  program.  She  wondered whether  persons                                                                    
covered under  the state's  retirement system  qualified for                                                                    
Mediset.                                                                                                                        
                                                                                                                                
Co-Chair  Stoltze  wanted  to defer  the  questions  to  the                                                                    
department for answers.                                                                                                         
                                                                                                                                
Representative  Thompson  asked  about  the  elimination  of                                                                    
transportation costs. He wondered  how the medications would                                                                    
be delivered in rural areas without a cost.                                                                                     
                                                                                                                                
Mr. Guinchard  noted that the  ability to be  reimbursed for                                                                    
transportation  remained in  regulation. The  transportation                                                                    
mandate was eliminated from the legislation.                                                                                    
                                                                                                                                
Representative  Thompson wondered  whether  a problem  might                                                                    
arise in the future over  transportation cost. He wanted the                                                                    
service to be available in remote areas.                                                                                        
                                                                                                                                
Mr.  Guinchard  deferred to  the  department  to answer  the                                                                    
question.                                                                                                                       
                                                                                                                                
9:01:53 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stoltze  requested  that   Ms.  Brodie  state  the                                                                    
departments  position  on  the   bill  and  incorporate  the                                                                    
member's previous questions in her statement.                                                                                   
                                                                                                                                
MARGARET BRODIE,  DIRECTOR, HEALTHCARE  SERVICES, DEPARTMENT                                                                    
OF    HEALTH   AND    SOCIAL   SERVICES,    ANCHORAGE   (via                                                                    
teleconference),  stated that  the department  supported the                                                                    
Mediset  program  as  a  beneficial  service.  The  pharmacy                                                                    
monitored  the  potential  for adverse  reactions  from  the                                                                    
medications interactions  and consulted with  the prescriber                                                                    
on  behalf of  the  patient. The  transportation costs  were                                                                    
included   in   the   cost   of   dispensing   the   Mediset                                                                    
prescription. Every two years  the department considered all                                                                    
of  the costs  of the  program, including  mailing to  rural                                                                    
areas.  She  informed  the committee  that  anyone  who  was                                                                    
prescribed  Mediset was  eligible, not  only individuals  on                                                                    
waivers. The  majority of senior's medications  were covered                                                                    
under Medicare part D rather than Medicaid.                                                                                     
                                                                                                                                
Representative Thompson asked  about page 2, line  10 of the                                                                    
legislation and cited the  word, "polypharmacy." He wondered                                                                    
how medications were coordinated between prescribers.                                                                           
                                                                                                                                
Ms. Brodie replied that the  coordination occurred through a                                                                    
database. The data base was updated  once a month and not in                                                                    
real time.  The individual was  also expected to  notify the                                                                    
pharmacist of their use of other medications.                                                                                   
                                                                                                                                
Representative  Wilson  asked  where the  bill  stated  that                                                                    
anyone  who  was prescribed  Mediset  was  eligible for  the                                                                    
program.                                                                                                                        
                                                                                                                                
Ms. Brodie  replied that medical necessity  was the standard                                                                    
for  Mediset eligibility.  The criteria  listed in  the bill                                                                    
defined the  medically necessity  conditions to  qualify for                                                                    
Mediset.                                                                                                                        
                                                                                                                                
Representative  Wilson  wondered  whether a  person  in  the                                                                    
state's retirement  health insurance  plan was  eligible for                                                                    
Mediset.                                                                                                                        
                                                                                                                                
Ms.  Brodie noted  that she  did not  know what  the state's                                                                    
plan covered.                                                                                                                   
                                                                                                                                
Co-Chair  Stoltze stated  that  the  legislation dealt  with                                                                    
Medicaid  and  Medicare  recipients and  asked  for  further                                                                    
clarification.                                                                                                                  
                                                                                                                                
Ms.  Brodie  stated that  she  was  speaking in  regards  to                                                                    
Medicaid.                                                                                                                       
                                                                                                                                
Representative  Wilson asked  whether a  person on  Medicaid                                                                    
living at  home that did  not fall into the  criteria listed                                                                    
in the bill qualified.                                                                                                          
                                                                                                                                
Ms. Brodie stated that if  the physician or pharmacist found                                                                    
it  medically necessary  outside  of the  listed criteria  a                                                                    
person would qualify.                                                                                                           
                                                                                                                                
Representative  Guttenberg,  in response  to  Representative                                                                    
Wilson's questions, surmised that  "if the doctor prescribed                                                                    
something and it's  covered under your plan"  the person was                                                                    
eligible.                                                                                                                       
                                                                                                                                
Representative Edgmon asked whether  the bill was "tailored"                                                                    
for the developmentally disabled.                                                                                               
                                                                                                                                
Representative  Costello   replied  that  HB  134   was  not                                                                    
specifically  tailored to  anyone.  The legislation  covered                                                                    
anyone  who would  benefit  from  medication management  for                                                                    
multiple medications.                                                                                                           
                                                                                                                                
Representative  Edgmon   deduced  that  the  bill   was  all                                                                    
inclusive  but  that  a subset  of  beneficiaries  would  be                                                                    
disabled individuals.                                                                                                           
                                                                                                                                
Co-Chair  Austerman  asked  whether  a  single  prescription                                                                    
prescribed for Mediset would be eligible.                                                                                       
                                                                                                                                
Ms.  Brodie replied  that  Mediset  addressed only  multiple                                                                    
prescriptions.                                                                                                                  
Co-Chair  Austerman wondered  whether two  medications would                                                                    
qualify.                                                                                                                        
                                                                                                                                
Ms. Brodie answered in the affirmative.                                                                                         
                                                                                                                                
Representative  Munoz asked  whether  Mediset was  currently                                                                    
offered through the department.                                                                                                 
                                                                                                                                
Ms.  Brodie  replied  that  the   Mediset  program  was  not                                                                    
eliminated. A  regulation change altered the  dispensing fee                                                                    
distribution  to  once  monthly.  The  Mediset  program  was                                                                    
currently in place.                                                                                                             
                                                                                                                                
Representative  Munoz  asked  how  the  fee  worked  and  if                                                                    
monthly payment would continue.                                                                                                 
                                                                                                                                
Ms.  Brodie replied  that the  legislation would  change how                                                                    
the payment was distributed.  The legislation would disburse                                                                    
the dispensing fee more often,  but decreased the fee by the                                                                    
amount  of the  Mediset fee.  The department  paid the  same                                                                    
amount as  under regulation through  a dispensing fee  and a                                                                    
Mediset fee and  reimbursement would be paid  more than once                                                                    
a month.                                                                                                                        
                                                                                                                                
Representative Munoz  questioned what the estimated  cost of                                                                    
adding the Mediset fee was.                                                                                                     
                                                                                                                                
Ms.  Brodie  replied that  there  were  no additional  costs                                                                    
because the dispensing fee was  reduced by the amount of the                                                                    
Mediset fee.                                                                                                                    
                                                                                                                                
Co-Chair Austerman noted that the  fiscal note was zero, FN1                                                                    
(DHS). He requested a copy of the original fiscal note.                                                                         
                                                                                                                                
Representative   Guttenberg   asked  whether   the   program                                                                    
included  reductions  in  pharmaceutical fees.  He  wondered                                                                    
whether the program was fiscally neutral.                                                                                       
                                                                                                                                
Ms.  Brodie   replied  that  no  other   fees  existed.  She                                                                    
explained that with  passage of the bill, the  state paid $8                                                                    
for dispensing fees and $2 for a Mediset totaling $10.                                                                          
                                                                                                                                
Representative  Guttenberg  asked  whether the  program  was                                                                    
revenue neutral.                                                                                                                
                                                                                                                                
Ms. Brodie answered in the affirmative.                                                                                         
                                                                                                                                
9:14:38 AM                                                                                                                    
                                                                                                                                
Co-Chair Stoltze OPENED public testimony.                                                                                       
                                                                                                                                
BARRY    CHRISTENSEN,   ALASKA    PHARMACISTS   ASSOCIATION,                                                                    
KETCHIKAN (via teleconference), testified  in support of the                                                                    
legislation. He appreciated the  sponsor's efforts. He noted                                                                    
past concerns  about the department not  recognizing certain                                                                    
pharmacies, mainly  in the rural areas  and recognized their                                                                    
inclusion in  the legislation. He  referenced page 2  of the                                                                    
bill that  provided that if  one or more  prescriptions were                                                                    
divided   [prescribed   multiple    times   per   day]   the                                                                    
prescription qualified  for Mediset. He emphasized  that the                                                                    
number  of the  prescriptions  was less  important than  the                                                                    
number of  times per day  the medication was  prescribed. He                                                                    
felt that having a Mediset  to help the patient organize the                                                                    
prescription  was   important.  He  remarked  that   he  was                                                                    
confused  about  the  department's explanation  of  the  fee                                                                    
disbursement.                                                                                                                   
                                                                                                                                
Co-Chair Austerman asked whether  the pharmacy only provided                                                                    
Mediset in Ketchikan or included rural areas.                                                                                   
                                                                                                                                
Mr.  Christensen replied  that  his  pharmacy only  serviced                                                                    
Ketchikan.                                                                                                                      
                                                                                                                                
Representative  Guttenberg   asked  whether   the  quarterly                                                                    
review of patients' prescriptions was adequate.                                                                                 
                                                                                                                                
Mr. Christensen  replied that in  his pharmacy every  time a                                                                    
Mediset  prescription was  filled  a review  took place.  He                                                                    
thought  that the  quarterly review  provision ensured  that                                                                    
every pharmacy was performing a minimal level of review.                                                                        
                                                                                                                                
Representative  Guttenberg asked  how  many pharmacies  were                                                                    
located in Ketchikan.                                                                                                           
                                                                                                                                
Mr. Christensen  replied that there were  four pharmacies in                                                                    
Ketchikan. One  pharmacy was operated by  tribal health, and                                                                    
his pharmacy was the only  independent pharmacy and also the                                                                    
only one that filled Mediset prescriptions.                                                                                     
                                                                                                                                
Representative Guttenberg wondered  how his pharmacy handled                                                                    
polypharmacy.                                                                                                                   
                                                                                                                                
Mr. Christensen detailed that all  of the prescriptions were                                                                    
processed  as "point  of sale"  which is  in real  time. The                                                                    
prescription was entered into a  data base and the data base                                                                    
revealed any other prescriptions from any other provider.                                                                       
                                                                                                                                
Representative Guttenberg  had heard that the  data base was                                                                    
not updated as timely as necessary.                                                                                             
                                                                                                                                
Representative  Munoz  asked  Mr.  Christensen's  about  his                                                                    
concern over the department's fee payment.                                                                                      
                                                                                                                                
Mr.  Christensen replied  that  Mediset  services were  more                                                                    
costly than regular prescriptions.  He was concerned whether                                                                    
the  fees would  adequately cover  the additional  costs. He                                                                    
addressed Representative Guttenberg's  concern over the data                                                                    
base.  He  elaborated  that pharmacist  had  access  to  the                                                                    
Alaska  Medicaid   Prescription  Drug  data  base   and  the                                                                    
Prescription Drug  Monitoring Program, which  only addressed                                                                    
narcotics. The  Alaska Medicaid Prescription Drug  data base                                                                    
was done in real time but the monitoring program was not.                                                                       
                                                                                                                                
Representative  Wilson  queried  whether he  filled  Mediset                                                                    
prescriptions for other insurance patients.                                                                                     
                                                                                                                                
Mr. Christensen  replied that most other  insurances did not                                                                    
cover the cost of Mediset and  that the cost was paid by the                                                                    
patient.                                                                                                                        
                                                                                                                                
PATRICIA SENNER,  ALASKA NURSES ASSOCIATION,  ANCHORAGE (via                                                                    
teleconference), testified in favor  of the legislation. She                                                                    
announced that she  was a home health nurse  for many years,                                                                    
which  made   her  aware  of   the  importance   of  patient                                                                    
compliance packaging  to help keep  seniors living  at home.                                                                    
She  believed  that  Mediset  was  equally  as  valuable  in                                                                    
assisted living facilities. She  elaborated that the program                                                                    
benefitted  the  patient  by   allowing  families  or  other                                                                    
caregivers  to   monitor  the  patient's   compliance  which                                                                    
identified problems  earlier. Medisets  were dispensed  on a                                                                    
weekly  basis as  opposed to  one month  or longer.  Mediset                                                                    
saved money for the Medicaid  program; if a prescription was                                                                    
changed the prescription  was paid for each  week as opposed                                                                    
to a  once a month  or more for typically  prescribed larger                                                                    
quantities. She noted  the safety of only having  a one week                                                                    
supply of narcotic medications available  in a home. Current                                                                    
regulations  restricted   Medisets  to   pharmacies  already                                                                    
supplying large volumes  of Medisets which did  not apply to                                                                    
small communities. The legislation  expanded coverage to all                                                                    
pharmacies in the state. She  asked the committee to support                                                                    
the legislation.                                                                                                                
9:24:34 AM                                                                                                                    
                                                                                                                                
MIKE COONS, SELF, PALMER  (via teleconference), was confused                                                                    
about the legislation. He wondered  if the bill pertained to                                                                    
Medicare or Medicaid.  He spoke to the  packaging of Mediset                                                                    
medications for  one week.  He thought  that the  bill would                                                                    
reduce the number of patients  that had multiple doctors and                                                                    
multiple prescriptions. He favored  the monitoring aspect of                                                                    
the  program.  He  wondered  why  nursing  staff  could  not                                                                    
accomplish the  same service. He  felt that the  program was                                                                    
not  cost-effective.  He spoke  from  his  perspective as  a                                                                    
paramedic.  The bill  would help  from the  standpoint of  a                                                                    
medical  care provider;  a provider  or emergency  responder                                                                    
could  easily determine  what  medications  the patient  was                                                                    
taking.  He asked  for more  information  about the  Mediset                                                                    
program.                                                                                                                        
                                                                                                                                
Representative Costello  replied that the bill  pertained to                                                                    
both Medicare and Medicaid recipients.  She pointed out that                                                                    
a  recipient's  medication  was packaged  as  a  Mediset  if                                                                    
prescribed  by a  physician. She  related that  fiscal notes                                                                    
did  not   provide  information  on  overall   savings  from                                                                    
programs if  applicable but believed  the program  saved the                                                                    
state money.  The Mediset packaging prevented  patients from                                                                    
moving into more costly  assisted or institutionalized care.                                                                    
She offered that  the value of the program  was the enhanced                                                                    
quality of life for the patients and their families.                                                                            
                                                                                                                                
Representative   Costello  wondered   whether  the   Mediset                                                                    
packaging  indicated  the   prescriptions  included  in  the                                                                    
Mediset.                                                                                                                        
                                                                                                                                
Co-Chair  Stoltze related  personal experience.  He believed                                                                    
that  the  prescriptions could  be  easily  included in  the                                                                    
Mediset packaging to assist emergency responders.                                                                               
                                                                                                                                
Representative  Guttenberg asked  if the  daily portions  of                                                                    
Medisets were labeled for contents.                                                                                             
                                                                                                                                
JEFF JESSEE,  CHIEF EXECUTIVE OFFICER, ALASKA  MENTAL HEALTH                                                                    
TRUST AUTHORITY  (via teleconference), testified  in support                                                                    
of the  bill. He stated  that the bill benefited  seniors or                                                                    
others  requiring   a  complicated   medical  pharmaceutical                                                                    
regimen.  He stated  that not  all individuals  lived in  an                                                                    
environment providing nursing care nor  did they need to be.                                                                    
Many  trust   beneficiaries  needed  the   Mediset  service.                                                                    
Mediset  was  essential   for  beneficiaries  attempting  to                                                                    
maintain an independent  lifestyle. Mediset's were organized                                                                    
by dose and  combination making it easier  for the emergency                                                                    
responder or healthcare provider  to determine the patient's                                                                    
prescription  information  and  protocol.  He  believed  the                                                                    
legislation was  important for  many trust  beneficiaries in                                                                    
order  to  avoid  more costly  nursing  oversight  in  their                                                                    
living  environments.  He  reiterated  his  support  of  the                                                                    
legislation.                                                                                                                    
                                                                                                                                
Co-Chair   Austerman  asked   about   the   basis  for   the                                                                    
legislation.  He  understood   that  currently  Mediset  was                                                                    
available through the  department administered by regulatory                                                                    
oversight. The  department changed the payment  schedule and                                                                    
planned  to  continue  the  program.  He  wondered  why  the                                                                    
legislation was necessary.                                                                                                      
                                                                                                                                
Mr.  Jesse  replied that  the  bill's  advantage placed  the                                                                    
program   in  statute   which   established   a  clear   and                                                                    
predictable set  of criteria for implementation.  He was not                                                                    
aware of  any substantive  differences between  the policies                                                                    
of the  department and  the bill,  but felt  the legislation                                                                    
was valuable.                                                                                                                   
                                                                                                                                
Co-Chair Stoltze  believed that  the sponsor would  not have                                                                    
introduced the  bill if the  program was not in  jeopardy of                                                                    
being  eliminated. He  thought the  department's positon  on                                                                    
the program "evolved."                                                                                                          
                                                                                                                                
9:37:23 AM                                                                                                                    
                                                                                                                                
Mr.   Christensen   addressed  Representative   Guttenberg's                                                                    
question regarding  labeling. He related that  Medisets were                                                                    
governed  by  pharmacy  regulation. The  packaging  included                                                                    
information about  the medications  and the  dosing schedule                                                                    
and was clearly labeled. He  reminded the committee that the                                                                    
legislation  authorized that  any pharmacy  billing Medicaid                                                                    
can   fill   Mediset  prescriptions.   Current   regulations                                                                    
restricted  Mediset to  pharmacies that  fill a  high volume                                                                    
(greater  than  75 percent  of  total  business) of  Mediset                                                                    
prescriptions.                                                                                                                  
                                                                                                                                
Representative  Guttenberg asked  for a  description of  the                                                                    
packaging.                                                                                                                      
                                                                                                                                
Mr.  Christensen  referred to  the  packaging  as a  "bubble                                                                    
pack."  The  medication  had  to  be  "pushed  out"  of  the                                                                    
packaging that was separated by dose.                                                                                           
Co-Chair Stoltze CLOSED public testimony.                                                                                       
                                                                                                                                
Representative   Guttenberg   asked   about   the   previous                                                                    
unpublished   fiscal  note   from   DHSS   (copy  on   file)                                                                    
distributed  in  the  prior  committee.  He  referenced  the                                                                    
analysis on  page 2,  which assumed  that the  program would                                                                    
increase by  approximately 20  percent. The  calculation for                                                                    
postage  costs  for 522  new  recipients  was $457  thousand                                                                    
which assumed that all of  the Medisets would be mailed from                                                                    
outside the recipients' community.                                                                                              
                                                                                                                                
Representative   Costello    appreciated   the   committee's                                                                    
scrutiny  of   the  previous  fiscal  note.   She  expressed                                                                    
surprise at  the expensive fiscal  note for a  state program                                                                    
that was  already in  existence. She  reported that  she met                                                                    
with the  commissioner to examine  the costs.  She explained                                                                    
that under the  previous version of the  bill the department                                                                    
assumed  that the  transportation  charges  applied to  each                                                                    
Mediset. The current  version of the bill did  not contain a                                                                    
separate  component   for  transportation.   The  department                                                                    
assumed that  the program would  expand to other  areas. The                                                                    
bill required that all pharmacies  were eligible for Mediset                                                                    
reimbursement.  The inclusion  drastically reduced  the need                                                                    
for much of the shipping  costs. She declared that she never                                                                    
agreed  with the  assumptions of  the previous  fiscal note.                                                                    
She felt that  the program benefitted the state  and that in                                                                    
2012 Mediset  served 2,611 individuals. She  discovered that                                                                    
many  people who  need the  service had  never heard  of the                                                                    
program.                                                                                                                        
                                                                                                                                
Co-Chair  Austerman pointed  out  that  the original  fiscal                                                                    
note depicted a  50 percent match between the  state and the                                                                    
federal  government.  He  wondered   why  the  general  fund                                                                    
appropriation was  not contained in the  current zero fiscal                                                                    
note. He  questioned the issue  and noted that  general fund                                                                    
matches  were  common in  Medicaid  programs.  He wanted  to                                                                    
understand the  changes made from  the previous  version and                                                                    
how that affected the fiscal note.                                                                                              
                                                                                                                                
Representative Wilson wished to  hear from the Department of                                                                    
Administration (DOA) to determine  why the state's insurance                                                                    
plans  were  not covering  Mediset  since  it was  medically                                                                    
necessary.                                                                                                                      
                                                                                                                                
HB  134  was  HEARD  and   HELD  in  committee  for  further                                                                    
consideration.                                                                                                                  
                                                                                                                                
9:52:21 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:54:37 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
HOUSE BILL NO. 75                                                                                                             
                                                                                                                                
     "An  Act  repealing   certain  audit  requirements  for                                                                    
     entities  receiving contributions  from permanent  fund                                                                    
     dividends; requiring  each campus of the  University of                                                                    
     Alaska  to apply  to be  included  on the  contribution                                                                    
     list for  contributions from permanent  fund dividends;                                                                    
     and requiring  a university to  pay an  application fee                                                                    
     for each  campus separately listed on  the contribution                                                                    
     list for contributions from permanent fund dividends."                                                                     
                                                                                                                                
9:54:46 AM                                                                                                                    
                                                                                                                                
Representative   Costello  MOVED   to  ADOPT   the  proposed                                                                    
committee  substitute for  HB  75  (FIN), 28-LS0323\O,  Work                                                                    
Draft (Martin 3/17/14).                                                                                                         
                                                                                                                                
Co-Chair Stoltze OBJECTED for discussion.                                                                                       
                                                                                                                                
DANIEL   GEORGE,   STAFF,   REPRESENTATIVE   BILL   STOLTZE,                                                                    
explained the changes in the  legislation. He stated that on                                                                    
page  1, line  2 the  title  was changed  to "requiring  the                                                                    
three  main  campuses  of the  university"  instead  of  the                                                                    
previous language, "requiring each  campus of the university                                                                    
to apply  for contribution lists."  He cited page 1,  line 4                                                                    
that previously read, "and requiring  a university to pay an                                                                    
application  fee" that  was changed  to  "and requiring  the                                                                    
university to pay  an application fee." He  stated that page                                                                    
1, section 1  was new. He cited Section  one language, "each                                                                    
university campus  that applied under (m)  of this section…"                                                                    
and explained that each university  campus may apply for the                                                                    
Pick,  Click, and  Give program  rather than  requiring each                                                                    
campus to  do so. He noted  that page 2, Section  2 was new.                                                                    
Previously the bill  repealed the provision on  page 2, line                                                                    
29.  The  current bill  amended  the  audit requirements  in                                                                    
Section 2, item (8) to read:                                                                                                    
                                                                                                                                
     …this paragraph  applies only  to an  organization that                                                                    
     is  required by  the federal  government to  complete a                                                                    
     financial  audit  by  an independent  certified  public                                                                    
     accountant…                                                                                                                
                                                                                                                                
Mr.  George  indicated  that  the  audit  requirements  only                                                                    
applied  to   organizations  that  were  required   to  have                                                                    
financial audits by  federal law. He offered  that Section 3                                                                    
was formerly Section 1 and  was amended to require that each                                                                    
campus that  applied for the  Pick, Click, and  Give program                                                                    
was  charged the  $250  fee.  He added  that  Section 4  was                                                                    
formerly Section  2 and  specified that  each campus  of the                                                                    
University  of Alaska  "shall" apply  instead of  "must." He                                                                    
read  the  new  additional  language on  page  3,  lines  22                                                                    
through 24,                                                                                                                     
                                                                                                                                
     …The  University of  Alaska may  apply for  each campus                                                                    
     other than the three main  campuses to be listed on the                                                                    
     contribution list for the current  dividend year in the                                                                    
     manner prescribed by the department.                                                                                       
                                                                                                                                
Mr.  George  turned to  page  3,  subsection (n),  lines  25                                                                    
through page 4, line 5. He  stated that the language was new                                                                    
and read:                                                                                                                       
                                                                                                                                
     In  addition to  the  application fee  in  (f) of  this                                                                    
     section, the  department shall withhold  a coordination                                                                    
     fee from  each organization, foundation,  or university                                                                    
     campus that  receives contributions under  this section                                                                    
     in  the   immediately  preceding  dividend   year.  The                                                                    
     coordination  fee for  an organization,  foundation, or                                                                    
     university  campus  that receives  contributions  under                                                                    
     this section  shall be seven  percent of the  amount of                                                                    
     contributions reported  by the department under  (j) of                                                                    
     this  section  for  the  organization,  foundation,  or                                                                    
     university   campus  for   the  immediately   preceding                                                                    
     dividend   year.   The   coordination  fee   shall   be                                                                    
     separately accounted  for under AS 37.05.142  and shall                                                                    
     be accounted  for separately  from the  application fee                                                                    
     collected  under  (f)  of   this  section.  The  annual                                                                    
     estimated balance  in the  account maintained  under AS                                                                    
     37.05.142  for coordination  fees collected  under this                                                                    
     subsection   may   be   appropriated   for   costs   of                                                                    
     administering this section.                                                                                                
                                                                                                                                
DAN   DEBARTOLO,   DIRECTOR,    PERMANENT   FUND   DIVIDEND,                                                                    
DEPARTMENT OF  REVENUE, explained that the  operational cost                                                                    
for the  division's work  was handled by  the $250  fee. The                                                                    
work carried out under the  7 percent coordination fee would                                                                    
be contracted out to an  eligible entity. The division could                                                                    
not provide the services for 7 percent.                                                                                         
                                                                                                                                
Co-Chair Austerman  wondered why  the repealer in  Section 3                                                                    
was  unnecessary. He  asked whether  the reason  was because                                                                    
the provision was amended.                                                                                                      
                                                                                                                                
Mr. George  answered in the  affirmative. He  explained that                                                                    
rather than  repealing the audit requirement  altogether the                                                                    
new provision  in Section 2,  item (8) required that  if the                                                                    
organization was required to provide  an audit under federal                                                                    
law the same  audit could be submitted as part  of its Pick,                                                                    
Click, and Give program application.                                                                                            
                                                                                                                                
Co-Chair  Stoltze WITHDREW  his  OBJECTION.  There being  NO                                                                    
OBJECTION, it was so ordered.  The committee substitute (CS)                                                                    
was adopted.                                                                                                                    
                                                                                                                                
JORDAN   MARSHALL,  RASMUSON   FOUNDATION,  ANCHORAGE   (via                                                                    
teleconference), testified  in favor  of the changes  in the                                                                    
CS. He  believed the CS  made the program stronger  and more                                                                    
sustainable.  He relayed  that the  program was  in its  6th                                                                    
year  and funneled  approximately $8  million to  charitable                                                                    
organizations.  The  program began  as  a  three year  pilot                                                                    
program. He reported  that the program had  no fiscal impact                                                                    
to  the  state.  He  felt  that  the  CS  would  propel  the                                                                    
charitable program  "toward long-term  self-sufficiency." He                                                                    
noted that  the coordination fee ensured  that participating                                                                    
organizations sustained the program well into the future.                                                                       
                                                                                                                                
Co-Chair Stoltze  noted the intent of  the audit requirement                                                                    
change  was  designed  to  "catch the  large  ones  and  not                                                                    
overregulate the small ones."                                                                                                   
                                                                                                                                
Mr. DeBartolo  replied that  the previous  requirements were                                                                    
burdensome  to the  small organizations  and demonstrated  a                                                                    
positive change.                                                                                                                
                                                                                                                                
Representative Costello  reported that the bill  had one new                                                                    
zero fiscal note  from the University of Alaska  and one new                                                                    
indeterminate fiscal note from the Department of Revenue.                                                                       
                                                                                                                                
10:05:19 AM                                                                                                                   
                                                                                                                                
Representative Munoz  MOVED to REPORT  CSHB 75 (FIN)  out of                                                                    
committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal notes. There being NO OBJECTION, it was                                                                     
so ordered.                                                                                                                     
                                                                                                                                
CSHB  75 (FIN)  was REPORTED  out  of committee  with a  "do                                                                    
pass" recommendation  and with one new  indeterminate fiscal                                                                    
note from the Department of  Revenue and one new fiscal note                                                                    
from the University.                                                                                                            
                                                                                                                                
Co-Chair Stoltze                                                                                                                
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
10:06:57 AM                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:06 a.m.                                                                                         

Document Name Date/Time Subjects
HB 177 CFRLF Graphics.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 CFRLF Historical Information.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 CFRLF Overview with Example Programs.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 CSHB177(FSH) Sectional Summary 2.4.2014.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 CSHB177(FSH) Sponsor Statement.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 Current and HB177 Interest Rates.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 Division of Economic Development Follow Up Q & A.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 Explanation of Changes in CSHB177(FSH).pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 Product Quality and Engine Efficiency Loans as of 1.15.2014.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HB 177 Support Letters.pdf HFIN 3/24/2014 8:30:00 AM
HB 177
CSHB 134 (HSS) Explanation of Changes.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
CSHB134 (HSS)- Sectional Summary.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
HB 134 Letters of Support.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
HB134 Sponsor Statement.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
Mediset Legislative Research Request13-129.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
CSHB 210 T Version-Explanation of Changes.pdf HFIN 3/24/2014 8:30:00 AM
HB 210
CSHB210 T Version-Sectional Summary.pdf HFIN 3/24/2014 8:30:00 AM
HB 210
HB 210 Sponsor Statement Version.pdf HFIN 3/24/2014 8:30:00 AM
HB 210
HB 210 Supporting Document-DLC Letter of Support.pdf HFIN 3/24/2014 8:30:00 AM
HB 210
HCR 15 Supporting Document - Fbks Econ Dev Corp Jan 27.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
CSHCR15(L&C) v N Sponsor Statement - UAS Task Force.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HCR 15 Supporting Document - Fbks Econ Dev Corp Jan 27.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HCR 15 Supporting Documents - Legislative Task Force UAS Interim Report - Jan 15-2014.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HCR 15 Supporting Documents - Univresity of Alaska UAS Test Facility Award Jan 24.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HCR15 Supporting Document - Alaska Airmans Association.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HCR15 Supporting Documents - Unmanned Aircraft Resolution Fairbanks EDC.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HB 75 - CS(FIN) - 3.17.14 - Ver O.pdf HFIN 3/24/2014 8:30:00 AM
HB 75
CSHB 177(FIN) Power Point Presentation (2).pdf HFIN 3/24/2014 8:30:00 AM
HB 177
HCR 15 CS-NEW FN-LEG-COU-03-2014.pdf HFIN 3/24/2014 8:30:00 AM
HCR 15
HB 278 CS EDC HFIN 3.17 - 3.18 Followup.pdf HFIN 3/24/2014 8:30:00 AM
HB 278
HB 134 DHSS toHFIN - CSHB 134 (HSS) 3-26-2014.pdf HFIN 3/24/2014 8:30:00 AM
HB 134
HB134 Fiscal Note - HB134CS(HSS)-HCMS-3-27-13 (1).pdf HFIN 3/24/2014 8:30:00 AM
HB 134
HB 177 Opposition ABA.pdf HFIN 3/24/2014 8:30:00 AM
HB 177