Legislature(2019 - 2020)ADAMS 519

03/18/2020 09:00 AM FINANCE

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09:03:09 AM Start
09:03:09 AM Consideration of Governor's Appointee for the Alaska Mental Health Trust Authority: Anita Halterman
09:18:15 AM Consideration of Governor's Appointee for the Alaska Mental Health Trust Authority: Rhonda Boyles
09:23:55 AM HB268
09:40:47 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Consideration of Governor's Appointees: TELECONFERENCED
Alaska Mental Health Trust Authority -
Anita Halterman & Rhonda Boyles
+ Bills Previously Heard/Scheduled TELECONFERENCED
Moved CSHB 268(FIN) Out of Committee
                  HOUSE FINANCE COMMITTEE                                                                                       
                      March 18, 2020                                                                                            
                         9:03 a.m.                                                                                              
9:03:09 AM                                                                                                                    
CALL TO ORDER                                                                                                                 
Co-Chair  Johnston   called  the  House   Finance  Committee                                                                    
meeting to order at 9:03 a.m.                                                                                                   
MEMBERS PRESENT                                                                                                               
Representative Neal Foster, Co-Chair                                                                                            
Representative Jennifer Johnston, Co-Chair                                                                                      
Representative Dan Ortiz, Vice-Chair                                                                                            
Representative Ben Carpenter                                                                                                    
Representative Andy Josephson                                                                                                   
Representative Gary Knopp                                                                                                       
Representative Bart LeBon                                                                                                       
Representative Kelly Merrick                                                                                                    
Representative Cathy Tilton                                                                                                     
MEMBERS ABSENT                                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
Representative Adam Wool                                                                                                        
PRESENT VIA TELECONFERENCE                                                                                                    
Anita  Halterman,  Appointee,  Alaska  Mental  Health  Trust                                                                    
Authority  Board  of  Trustees;  Rhonda  Boyles,  Appointee,                                                                    
Alaska  Mental Health  Trust  Authority  Board of  Trustees;                                                                    
Myron Dosch, Chief Financial  Officer, University of Alaska;                                                                    
Deven  Mitchell, Executive  Director, Alaska  Municipal Bond                                                                    
Bank   Authority,  Department   of  Revenue;   Luke  Welles,                                                                    
Chairman, Alaska Native Tribal Health Consortium.                                                                               
HB 268    MUNI BOND BANK: UA, LOAN AND BOND LIMITS                                                                              
          CSHB 268(FIN)  was REPORTED out of  committee with                                                                    
          four  "do  pass"   recommendations  and  four  "no                                                                    
          recommendation" recommendations  and with  one new                                                                    
          indeterminate note  from the University  of Alaska                                                                    
          and one new fiscal impact note from the                                                                               
          Department of Revenue.                                                                                                
CONSIDERATION OF GOVERNOR'S APPOINTEES: ALASKA MENTAL                                                                           
HEALTH TRUST AUTHORITY:                                                                                                         
     ANITA HALTERMAN                                                                                                            
     RHONDA BOYLES                                                                                                              
Co-Chair Johnston reviewed the meeting agenda.                                                                                  
^CONSIDERATION OF GOVERNOR'S APPOINTEE FOR THE ALASKA                                                                         
MENTAL HEALTH TRUST AUTHORITY: ANITA HALTERMAN                                                                                
9:03:09 AM                                                                                                                    
ANITA HALTERMAN, APPOINTEE, ALASKA MENTAL HEALTH TRUST                                                                          
AUTHORITY   BOARD   OF    TRUSTEES   (via   teleconference),                                                                    
introduced herself and read from a prepared statement.                                                                          
     My name is  Anita Marie Halterman. I  have been married                                                                    
     for  over 35  years and  my  husband and  I have  three                                                                    
     daughters and  two grandchildren  that we've  raised in                                                                    
     Alaska.  I  am  happy  to be  a  recent  selection  for                                                                    
     appointment to the Alaska Mental  Health Trust Board of                                                                    
     Trustees.  I actively  took  my role  on  the board  of                                                                    
     trustees  in August  of 2019  and recently  assumed the                                                                    
     role  of chair  of  Audit and  Risk Committee.  Despite                                                                    
     already  starting my  work at  the trust,  I have  been                                                                    
     anxiously awaiting my confirmation this session.                                                                           
     Serving on  the board  of trustees so  far has  been an                                                                    
     amazing  journey, one  that has  expanded my  knowledge                                                                    
     and afforded  me new  opportunities to  pay it  back to                                                                    
     society and  to learn about new  strategies and funding                                                                    
     opportunities  that can  help  shape meaningful  reform                                                                    
     for our  program. I  would very  much like  to continue                                                                    
     that journey.                                                                                                              
     Some of  you know  me from my  brief tenure  working in                                                                    
     the  Alaska State  Legislature during  the 29th  Alaska                                                                    
     legislative  session. While  I met  many of  you during                                                                    
     that time period,  some of you are new and  we have not                                                                    
     yet met.  While I have  reached out  to some of  you by                                                                    
     text, email, or phone already,  I have not been able to                                                                    
     connect with all of you, but that time will come.                                                                          
     For those  of you that  don't know me, I  first arrived                                                                    
     in  Alaska  in the  1980s  after  discharging from  the                                                                    
     United States  Army and I  followed my husband  who was                                                                    
     active  duty and  stationed at  Fort  Greely and  Delta                                                                    
     Junction. We  raised our  eldest daughter  there during                                                                    
     the first few  years of her life and fell  in love with                                                                    
     Alaska. While  we watched the  economy suffer,  and had                                                                    
     to leave Alaska for a brief  time, we came back as soon                                                                    
     as we  were able,  and we've lived  in Eagle  River for                                                                    
     over 25 years since moving back.                                                                                           
     I  earned my  MBA  from Wayland  Baptist University  in                                                                    
     Anchorage and  I have  an extensive  background working                                                                    
     mainly  within  the  Department of  Health  and  Social                                                                    
     Services  Medicaid program  for both  Iowa and  Alaska.                                                                    
     Spending  my  last  seven years  with  them,  I  worked                                                                    
     within  senior and  disability  service  programs as  a                                                                    
     program  manager   and  a   supervisor.  I   also  have                                                                    
     experience working  with child support,  the Department                                                                    
     of  Corrections, public  safety  and public  assistance                                                                    
     I  have worked  for the  State of  Alaska for  about 19                                                                    
     years and  I have  over 6  years of  experience working                                                                    
     with the State  of Iowa. I have  worked through welfare                                                                    
     reform initiatives  in two states  and helped  kick off                                                                    
     Alaska's first  food stamp reinvestment plan  after the                                                                    
     Alaska  Department   of  Health  and   Social  Services                                                                    
     program  had been  sanctioned for  high error  rates in                                                                    
     the 1990s. I trained  staff on regulations, program and                                                                    
     policy  in  the  welfare   offices  in  and  throughout                                                                    
     Alaska, developing programs and reducing error rates.                                                                      
     I  have   devoted  my  life's  work   to  working  with                                                                    
     populations  that   are  underserved  and  I   find  it                                                                    
     rewarding  to improve  the  programs  and systems  that                                                                    
     they  utilize  in order  to  provide  the provision  of                                                                    
     services to the beneficiaries of those programs.                                                                           
9:07:48 AM                                                                                                                    
Ms. Halterman continued to review her background with a                                                                         
prepared statement:                                                                                                             
     After leaving the Alaska Legislature,  I started my own                                                                    
     consulting business,  joining the ranks of  the private                                                                    
     sector. I  obtained licenses  as an  insurance producer                                                                    
     with  lines  of  authority  for  accidents  in  Alaska,                                                                    
     health  and  life  and  with  lines  of  authority  for                                                                    
     Washington  with  life  and disability.  I  also  began                                                                    
     working with an  information technology company working                                                                    
     as  an account  executive. Positioning  risk management                                                                    
     and human  resource solutions for businesses  has given                                                                    
     me  a new  perspective about  the healthcare  needs for                                                                    
     privately insured  individuals and  it has  expanded my                                                                    
     understanding  of  more  global workforce  issues  that                                                                    
     Alaska faces as we move forward.                                                                                           
     I  very  much hope  to  take  my experiences  and  help                                                                    
     reform  the  program for  the  future  so that  we  can                                                                    
     sustain them  for our populations that  need them most.                                                                    
     I look  forward to  continuing to  work to  improve the                                                                    
     lives  of  the  trust   beneficiaries  as  we  work  in                                                                    
     partnership with  the Department  of Health  and Social                                                                    
     Services   and  other   stakeholders,  to   build  that                                                                    
     comprehensive mental  health program that  better meets                                                                    
     our  trust beneficiaries'  needs. I  want to  thank you                                                                    
     all for  your consideration. I appreciate  your support                                                                    
     and  I look  forward  to  working with  all  of you  to                                                                    
     protect the  trust and maximize  the benefits  to solve                                                                    
     Alaska's mental health problems.                                                                                           
9:08:55 AM                                                                                                                    
Co-Chair Johnston acknowledged  Representative Carpenter had                                                                    
joined the meeting.                                                                                                             
Representative   Knopp  thanked   Ms.   Halterman  for   her                                                                    
testimony. He  remarked on her  testimony that she  had been                                                                    
in Alaska  since the  80s and  worked for  the state  for 19                                                                    
years. He  was curious  about her  experience with  the Iowa                                                                    
Medicaid system  for a  period of six  years. He  asked when                                                                    
her work in Iowa had taken place.                                                                                               
Ms. Halterman  answered that  she and  her husband  had left                                                                    
Delta Junction  for six years  in the late 1980s  during the                                                                    
recession. She  detailed that  they had  moved back  to Iowa                                                                    
for nine years,  where she had worked  for state government.                                                                    
She elaborated  that at  the time,  welfare reform  was just                                                                    
beginning  to hit  the nation,  and Iowa  had just  finished                                                                    
some sanctions  for error rates. She  had come on at  a time                                                                    
when   they  were   aggressively  learning   public  policy,                                                                    
understanding the  federal guidelines,  food stamp  law, and                                                                    
Medicaid  law. She  had worked  in emergency  assistance and                                                                    
emergency  relief programs  in Iowa.  Additionally, she  had                                                                    
done  a  significant amount  of  appeals  work in  Iowa  and                                                                    
Alaska.  After   approximately  six  years  with   the  Iowa                                                                    
Department of Health and Social  Services, she began working                                                                    
with  the  Iowa  Department  of  Corrections  as  an  inmate                                                                    
grievance officer  for a brief  time before her  husband had                                                                    
taken a position with the State of Alaska in early 1995.                                                                        
Ms. Halterman  continued that they  had brough all  three of                                                                    
their daughters  to Alaska (two  of them currently  lived in                                                                    
Eagle River and  one lived in Hawaii). She had  spent a good                                                                    
number  of  years  working  out  of  state  because  of  the                                                                    
recession.  There  had  been no  opportunities  for  her  in                                                                    
Alaska at that time.                                                                                                            
9:11:22 AM                                                                                                                    
Representative  Tilton  referenced  the extensive  work  Ms.                                                                    
Halterman  had  done  in telehealth  and  telemedicine.  She                                                                    
asked for brief remarks on the subject.                                                                                         
Ms.  Halterman  replied  that  she   had  been  involved  in                                                                    
telehealth  since  approximately  1999 when  AFHCAN  [Alaska                                                                    
Federal  Health  Care  Access   Network]  and  ATAC  [Alaska                                                                    
Telehealth Advisory  Council] helped  form a  foundation for                                                                    
Alaska  Medicaid to  build  reimbursement methodologies.  In                                                                    
1999 she  had drafted  the first  telemedicine reimbursement                                                                    
methodologies   for  Medicaid   programs  anywhere   in  the                                                                    
country. The  regulations had  been mirrored  throughout the                                                                    
country and served many Medicaid populations globally.                                                                          
Ms.  Halterman continued  that  she had  carried  HB 234,  a                                                                    
mental health parity bill, in  the 2016 legislative session.                                                                    
She  detailed that  the bill  had encouraged  better use  of                                                                    
technology  for mental  health services,  which had  already                                                                    
been  proven very  valuable for  a Medicaid  population. She                                                                    
had  been   introduced  to  the  Alaska   Collaborative  for                                                                    
Telemedicine and  Telehealth (AKCTT) through  those efforts.                                                                    
She  had  been exposed  to  the  Alaska State  Hospital  and                                                                    
Nursing Home Association's  (ASHNHA) involvement with AKCTT.                                                                    
She was currently  serving as the director of  AKCTT and had                                                                    
served  as president  and  treasurer in  the  past. She  was                                                                    
watching  with bated  breath that  the  COVID-19 crisis  was                                                                    
creating an  atmosphere that would  encourage better  use of                                                                    
technology and  Medicare rules were being  loosened. She was                                                                    
sharing insight daily about activities  on a national level.                                                                    
She  was on  notice  that  AMHTA would  be  stepping in  and                                                                    
providing funding  opportunities to advance  some solutions.                                                                    
She  was  hoping  to  know  more in  the  near  future.  She                                                                    
concluded that telemedicine had been  in her blood since its                                                                    
inception in Alaska and she was  excited to be a part of it.                                                                    
She  believed it  would provide  some meaningful  relief for                                                                    
numerous beneficiaries served by the trust.                                                                                     
Representative Tilton thanked Ms. Halterman for her work.                                                                       
9:14:14 AM                                                                                                                    
Vice-Chair Ortiz  stated that when  Ms. Halterman  had begun                                                                    
with  the AMHTA  board, COVID-19  had not  yet occurred.  He                                                                    
observed that  the virus  was front and  center in  terms of                                                                    
the immediate future. He set  the issue aside and asked what                                                                    
her  observations   had  been   about  current   and  future                                                                    
challenges facing AMHTA.                                                                                                        
Ms.   Halterman   replied   that   there   was   significant                                                                    
uncertainty  with   regards  to   what  the   mental  health                                                                    
structure  would  look  like going  forward.  Although,  the                                                                    
trust  had  currently   made  numerous  recommendations  for                                                                    
crisis intervention  and funding for  homelessness programs,                                                                    
she would continue to study  the issues. With her background                                                                    
with the Department of Health  and Social Services she hoped                                                                    
to  have a  laser view  and focus  to redirect  some of  the                                                                    
trust's  funding efforts  to focus  on populations  that had                                                                    
been underserved by  the trust over the  years. She reported                                                                    
that  the trust  did well  at  some things  and some  things                                                                    
needed improvement.                                                                                                             
Ms.  Halterman  highlighted  that the  trust  administrative                                                                    
staff worked  very hard and were  very talented individuals.                                                                    
She   equated  trying   to  absorb   the  large   amount  of                                                                    
information about the  trust's responsibilities, governance,                                                                    
and  audit requirements  and timing  to  drinking through  a                                                                    
fire hose.  She wanted to  ensure some of the  mistakes made                                                                    
in the  past were not  repeated. She  would like to  see the                                                                    
trust  move more  in  creative  ways, working  cooperatively                                                                    
with   other   departments   to  solve   the   problems   of                                                                    
beneficiaries that crossover between  all state agencies and                                                                    
burden all of the state systems.                                                                                                
Ms.  Halterman  wanted  to  find   solutions  that  did  not                                                                    
continue to  burden the systems. Additionally,  she hoped to                                                                    
get people back  on their feet and  highlighted that dealing                                                                    
with substance  abuse and mental health  issues was critical                                                                    
to  solving many  of the  problems that  followed suit  with                                                                    
populations in  need of services.  She hoped to  continue to                                                                    
learn from the current  AMHTA leadership. She would continue                                                                    
to read as much information  as possible and would reach out                                                                    
to others for  advice and input on what had  worked well and                                                                    
what had not.  She had learned in her many  years of working                                                                    
with health and social  services programs that the complaint                                                                    
department  was  the  place  to  identify  ways  to  improve                                                                    
programs.  She highlighted  the importance  of listening  to                                                                    
people who  had used  the programs  because they  raised the                                                                    
issues  that need  to  be resolved  and they  may  do it  in                                                                    
creative  ways.   She  concluded   that  listening   to  the                                                                    
populations  the  programs  were intended  to  serve  helped                                                                    
focus on meaningful solutions.                                                                                                  
9:17:34 AM                                                                                                                    
Co-Chair Johnston  OPENED and  CLOSED public  testimony. She                                                                    
thanked Ms. Halterman for her testimony.                                                                                        
^CONSIDERATION  OF  GOVERNOR'S   APPOINTEE  FOR  THE  ALASKA                                                                  
MENTAL HEALTH TRUST AUTHORITY: RHONDA BOYLES                                                                                  
9:18:15 AM                                                                                                                    
RHONDA  BOYLES,   APPOINTEE,  ALASKA  MENTAL   HEALTH  TRUST                                                                    
AUTHORITY BOARD OF  TRUSTEES (via teleconference), discussed                                                                    
her background.  She shared that  she had lived  in Interior                                                                    
Alaska for 44  years. She relayed that three  years back she                                                                    
had  brought her  husband to  Phoenix due  to his  diagnosis                                                                    
with a very  difficult form of dementia  called diffuse lewy                                                                    
body. She  detailed that  he had  worsened rapidly,  and she                                                                    
had not been able to bring  him home to Alaska. They built a                                                                    
home in  Phoenix where  she had hired  staff and  could keep                                                                    
him  at home  with her  under  the care  of their  Alzheimer                                                                    
research. Her husband  had passed away on April  1, 2019 and                                                                    
she had  gone back  to Alaska  immediately. She  had decided                                                                    
she  wanted to  live  closer  to her  son  in Anchorage  and                                                                    
purchased a townhome there.                                                                                                     
Ms. Boyles detailed that when  she had moved back to Alaska,                                                                    
the  governor's office  had asked  if she  would submit  her                                                                    
resume for  the AMHTA.  She shared that  she had  known very                                                                    
little about the trust when she  had been asked to apply due                                                                    
to the constant  training she had undergone  when caring for                                                                    
her  husband. Prior  to that,  she had  owned three  Wendy's                                                                    
restaurants and had  served as mayor of  the Fairbanks North                                                                    
Star Borough.  She expressed gratitude to  elected officials                                                                    
for the  challenging work  they took on.  After her  work as                                                                    
mayor she had  returned to her previous work  in nursing and                                                                    
had worked in  the state Pioneer Home for  almost four years                                                                    
taking  care of  Alaskans  without  supervising anyone.  She                                                                    
highlighted  that  her  favorite   wing  was  dementia.  She                                                                    
explained  that   her  interest   in  AMHTA  was   that  its                                                                    
beneficiaries  were  in  that  category,  as  well  as  many                                                                    
Ms. Boyles  detailed that her resume  was quite diversified.                                                                    
She had  experience in land management,  formal and personal                                                                    
trust  management, and  financial  management. She  believed                                                                    
the current  market conditions would  be a  short-term issue                                                                    
with regard to AMHTA. She had  been educated at Yale and was                                                                    
born and raised  in Maine. She loved Alaska  and was anxious                                                                    
to  contribute  to the  state.  She  wanted  to serve  in  a                                                                    
substantive capacity.  She had volunteered over  40 years in                                                                    
the state  on many commissions  and boards. She  stated that                                                                    
serving on the  AMHTA was different than any  other work she                                                                    
had done in  the past and it was more  substantive than many                                                                    
things she had done, which had piqued her interest.                                                                             
9:22:21 AM                                                                                                                    
Representative  LeBon shared  that he  had known  Ms. Boyles                                                                    
for  many  years.  He   referenced  their  strong  business,                                                                    
professional,  and personal  friendship history.  He thanked                                                                    
her for her willingness to serve.                                                                                               
Co-Chair Johnston OPENED and CLOSED public testimony.                                                                           
Co-Chair  Foster   read  a   statement  pertaining   to  the                                                                    
forwarding of  the governor's appointees' names  to a future                                                                    
joint session for confirmation:                                                                                                 
     The   House   Finance   Committee  has   reviewed   the                                                                    
     qualifications   of  the   governor's  appointees   and                                                                    
     recommends that  the following names be  forwarded to a                                                                    
     joint session for consideration:                                                                                           
      Anita Halterman, Alaska Mental Health Trust                                                                            
        Authority, Member                                                                                                       
      Rhonda Boyles, Alaska Mental Health Trust Authority,                                                                   
     This does not reflect intent by any of the members to                                                                      
     vote for or against these individuals during any                                                                           
    further sessions for the purposes of confirmation.                                                                          
There being NO OBJECTION, it was so ordered.                                                                                    
Co-Chair Johnston  thanked Ms. Halterman and  Ms. Boyles for                                                                    
calling in.                                                                                                                     
HOUSE BILL NO. 268                                                                                                            
     "An Act relating to the Alaska Municipal Bond Bank                                                                         
9:23:55 AM                                                                                                                    
Co-Chair Johnston  asked for a  brief reintroduction  of the                                                                    
REPRESENTATIVE  BART LEBON,  SPONSOR, detailed  that HB  268                                                                    
would remove  the project scope limitation  on projects with                                                                    
the  University  of  Alaska and  gave  them  an  opportunity                                                                    
during  the   current  low  interest  rate   environment  to                                                                    
potentially  refinance some  of their  debt. The  bill would                                                                    
also  increase  the  [project participation]  cap  from  $87                                                                    
million to  $500 million [for  the university].  In relation                                                                    
to regional  health organizations,  HB 268 would  remove the                                                                    
49 percent  project participation  limitation on  the Alaska                                                                    
Municipal   Bond  Bank   and   increased  participation   to                                                                    
100 percent, which would  save regional health organizations                                                                    
money in refinancing or placing  money through the bond bank                                                                    
without having  to find  partners that  increased complexity                                                                    
and expense. The bill would  increase the project limit from                                                                    
$102.5 million to $250 million  for a single regional health                                                                    
organization  project. Additionally,  HB 268  would increase                                                                    
the  total  funding  for regional  health  organizations  to                                                                    
$500  million. He  listed  individuals  available online  to                                                                    
9:26:19 AM                                                                                                                    
Co-Chair Johnston requested a fiscal note review.                                                                               
MYRON DOSCH,  CHIEF FINANCIAL OFFICER, UNIVERSITY  OF ALASKA                                                                    
(via teleconference),  shared that the University  of Alaska                                                                    
supported the bill and had  previously submitted a letter of                                                                    
support.  He  spoke to  the  benefits  of  the bill  if  the                                                                    
university  were  to  use the  mechanism  to  obtain  credit                                                                    
through the bond bank. For  example, a $50 million bond over                                                                    
30 years  at interest rates  as of  March 5 would  provide a                                                                    
benefit of about  $50,000 per year or $1.5  million over the                                                                    
life of the bond.                                                                                                               
9:27:55 AM                                                                                                                    
DEVEN  MITCHELL, EXECUTIVE  DIRECTOR, ALASKA  MUNICIPAL BOND                                                                    
BANK AUTHORITY, DEPARTMENT  OF REVENUE (via teleconference),                                                                    
reviewed  the fiscal  note from  the Department  of Revenue,                                                                    
OMB Component  Number 121. The  fiscal note included  a "not                                                                    
to exceed" amount  for the activity that  could be generated                                                                    
by  the proposed  legislation. He  explained  that the  bond                                                                    
bank  had a  floor of  annual expenditures  and expenditures                                                                    
increased  as lending  activity  took  place. He  elaborated                                                                    
that there was  a not to exceed amount rather  than a budget                                                                    
the  bond bank  fully  expected to  expend  during a  fiscal                                                                    
cycle. The authorization  for up to $360,000  per year would                                                                    
be  directly  related  to any  additional  lending  activity                                                                    
undertaken  by  the   bond  bank  as  a   result  of  making                                                                    
additional  loans  to  the  university  or  regional  health                                                                    
organizations. He  furthered they would be  provided for out                                                                    
of  cost of  issuance  accounts that  were  funded from  the                                                                    
proceeds  of  the bond  issuance.  He  elaborated that  they                                                                    
would  be   incorporated  into  the  interest   expense  the                                                                    
borrower would  be repaying.  Program receipts,  not general                                                                    
fund  receipts,  would  provide  for  the  potential  annual                                                                    
9:29:43 AM                                                                                                                    
Representative Josephson  asked the bill sponsor  to provide                                                                    
a  hypothetical  scenario  relative  to  a  regional  health                                                                    
organization's use of the bill.                                                                                                 
Representative LeBon  complied. He relayed that  a number of                                                                    
projects were in the design  or developmental stage. He used                                                                    
a  hypothetical   small  regional  health   organization  in                                                                    
Cordova (one  of the locations  for a potential  project) as                                                                    
an example. The organization would  go through its period of                                                                    
underwriting and  showing justification for the  project and                                                                    
would seek  assistance from the Alaska  Municipal Bond Bank.                                                                    
The bond bank  would help in showing  the repayment ability,                                                                    
the  capacity to  perform.  The bond  bank  would work  with                                                                    
stakeholders,  potential  clients,  and potential  users  in                                                                    
surrounding   communities  that   would  benefit   from  the                                                                    
regional health organization. He  detailed that it would all                                                                    
need to  come together in  a way that justified  the project                                                                    
to  a  level  where   bond  purchasers  were  interested  in                                                                    
supporting  the  project.  It would  be  necessary  to  show                                                                    
capacity  to  repay and  establish  the  need and  clientele                                                                    
base.  The  idea  would  be  to  enable  a  regional  health                                                                    
organization  to have  a one-stop  shop with  the bond  bank                                                                    
instead of going out to find two or three other partners.                                                                       
Co-Chair  Johnston noted  that Luke  Welles from  the Alaska                                                                    
Native Tribal Health Consortium was available online.                                                                           
Representative LeBon  replied that  Mr. Welles  could answer                                                                    
Representative Josephson's question.                                                                                            
Co-Chair Johnston asked if Mr. Welles had anything to add.                                                                      
LUKE   WELLES,  CHAIRMAN,   ALASKA   NATIVE  TRIBAL   HEALTH                                                                    
CONSORTIUM,     (via    teleconference),     replied    that                                                                    
Representative  LeBon   had  provided  a  good   answer.  He                                                                    
explained  that the  bill offered  another financing  option                                                                    
for  the projects.  He elaborated  there were  five upcoming                                                                    
joint venture  projects that represented about  $700 million                                                                    
in  potential  construction over  the  next  few years.  The                                                                    
Indian  Health Service  would cover  the cost  of operating,                                                                    
maintenance, and staffing after  the projects were built. It                                                                    
was incumbent  on the regional health  organizations to fund                                                                    
the  capital   infrastructure,  which  would  open   up  new                                                                    
incoming  revenues  along  with opening  up  new  healthcare                                                                    
facilities in rural Alaska.                                                                                                     
Co-Chair Johnston  asked Mr. Welles  to put his name  on the                                                                    
Mr. Welles complied.                                                                                                            
9:32:38 AM                                                                                                                    
AT EASE                                                                                                                         
9:34:29 AM                                                                                                                    
Co-Chair  Foster  MOVED  to  REPORT  CSHB  268(FIN)  out  of                                                                    
committee   with   individual    recommendations   and   the                                                                    
accompanying fiscal notes.                                                                                                      
Representative  Carpenter   OBJECTED.  He   understood  that                                                                    
adding tools  to the toolbox  is a  good thing and  that the                                                                    
bond bank staff would make  good decisions on how to finance                                                                    
things.  However,  the  bill was  asking  the  committee  to                                                                    
accept an  increased risk  to the  state. Under  the current                                                                    
circumstances,  where the  future  was unknown,  he did  not                                                                    
believe it  would be prudent  to increase the  state's risk.                                                                    
He  highlighted  that  no  one knew  how  long  the  current                                                                    
financial  crisis  would  last.  He  reasoned  that  if  the                                                                    
discussion had taken place ten  years earlier when the state                                                                    
was flush with oil money it  may have been a wiser decision.                                                                    
He did  not support increasing  risk to the state  under the                                                                    
current circumstances.                                                                                                          
Representative   LeBon   understood  and   appreciated   the                                                                    
concerns expressed  by Representative Carpenter. He  saw two                                                                    
immediate benefits of the bill  including the opportunity to                                                                    
potentially  refinance university  debt  at a  significantly                                                                    
lower rate.  He pointed out  that the debt  already existed.                                                                    
He elaborated that it would be  up to the university to seek                                                                    
out  the opportunity  on a  case-by-case basis.  He informed                                                                    
the committee  that the university held  nearly $300 million                                                                    
in debt.  He explained that  the bill provided  an important                                                                    
potential  savings  on  existing   debt.  He  addressed  the                                                                    
regional  health organization  component and  highlighted it                                                                    
was  in  the  state  constitution  "that  we  take  care  of                                                                    
Representative   LeBon  believed   they  should   take  full                                                                    
advantage if the regional  health organization concept could                                                                    
be  used to  deliver  primary healthcare  services in  rural                                                                    
Alaska  at  a  cost  savings while  providing  for  improved                                                                    
services. The  bill would allow the  organizations to access                                                                    
the  bond bank  for 100  percent of  the project  instead of                                                                    
seeking out a  partner that could ask for  a higher interest                                                                    
rate   on  debt.   He  explained   that   when  forcing   an                                                                    
organization to split the  financing among several entities,                                                                    
there  was  not  always  parity  in  the  debt  pricing.  He                                                                    
expounded that  the bond  bank may  be cheaper  than another                                                                    
financial   institution.  He   did   not   want  to   hamper                                                                    
organizations.  He noted  that  an organization  may find  a                                                                    
partner  that   matched  the  rate,  which   was  great.  He                                                                    
concluded that the bill provided an option.                                                                                     
9:37:46 AM                                                                                                                    
Co-Chair  Johnston  shared  that  she  may  have  been  less                                                                    
interested  in   the  bill  ten   years  earlier.   She  was                                                                    
interested in the bill under  the existing circumstances and                                                                    
wanted to see  it move forward from  committee. She believed                                                                    
all of the  tools were needed in the coming  year. She would                                                                    
prefer  to  have  the  tools  with  a  fiscally  responsible                                                                    
organization that  would assess  risk and take  advantage of                                                                    
any  forthcoming financing  and  any  stimulus package.  She                                                                    
noted that  currently "our"  federal rate  was cut  to zero.                                                                    
She considered that she may have  been a "no" vote ten years                                                                    
earlier, but she supported the legislation at present.                                                                          
9:38:48 AM                                                                                                                    
A roll call vote was taken  on the motion to report the bill                                                                    
from committee.                                                                                                                 
IN FAVOR: Josephson,   LeBon,   Merrick,  Ortiz,   Johnston,                                                                    
OPPOSED: Carpenter, Tilton                                                                                                      
Representative  Sullivan-Leonard,  Representative Wool,  and                                                                    
Representative Knopp were absent from the vote.                                                                                 
The MOTION PASSED (6/2).                                                                                                        
There  being   NO  further  OBJECTION,  CSHB   268(FIN)  was                                                                    
REPORTED   out   of   committee    with   four   "do   pass"                                                                    
recommendations     and     four     "no     recommendation"                                                                    
recommendations  and with  one new  indeterminate note  from                                                                    
the  University of  Alaska and  one new  fiscal impact  note                                                                    
from the Department of Revenue.                                                                                                 
9:39:29 AM                                                                                                                    
Co-Chair   Johnston  shared   that   everything  [with   the                                                                    
schedule] would  be very fluid.  She asked for  patience and                                                                    
relayed  that the  agenda would  be changed  as needed.  She                                                                    
felt it was  incumbent upon the committee to  continue to do                                                                    
its  work.  She  reviewed  the schedule  for  the  following                                                                    
9:40:47 AM                                                                                                                    
The meeting was adjourned at 9:40 a.m.                                                                                          

Document Name Date/Time Subjects
Anita Halterman Resume_Redacted.pdf HFIN 3/18/2020 9:00:00 AM
AMHTA Appointee
Anita Halterman Board Application_Redacted.pdf HFIN 3/18/2020 9:00:00 AM
AMHTA Appointee
Rhonda Boyles Board Application_Redacted.pdf HFIN 3/18/2020 9:00:00 AM
AMHTA Appointee
Rhonda Boyles Resume_Redacted.pdf HFIN 3/18/2020 9:00:00 AM
AMHTA Appointee