Legislature(2003 - 2004)
03/02/2004 03:07 PM House HES
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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES
STANDING COMMITTEE
March 2, 2004
3:07 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Carl Gatto, Vice Chair
Representative John Coghill
Representative Paul Seaton
Representative Kelly Wolf
Representative Sharon Cissna
MEMBERS ABSENT
Representative Mary Kapsner
COMMITTEE CALENDAR
HOUSE BILL NO. 471
"An Act relating to the funding of public education; and
providing for an effective date."
- MOVED CSHB 471(EDU) OUT OF COMMITTEE
HOUSE BILL NO. 511
"An Act relating to the certificate of need program for health
care facilities; and providing for an effective date."
- HEARD AND HELD
HOUSE BILL NO. 338
"An Act relating to attendance at public school; and providing
for an effective date."
- SCHEDULED BUT NOT HEARD
PREVIOUS COMMITTEE ACTION
BILL: HB 471
SHORT TITLE: INCREASE AMT OF BASE STUDENT ALLOCATION
SPONSOR(S): EDUCATION
02/16/04 (H) READ THE FIRST TIME - REFERRALS
02/16/04 (H) EDU, HES, FIN
02/17/04 (H) EDU AT 11:00 AM CAPITOL 124
02/17/04 (H) Heard & Held
02/17/04 (H) MINUTE(EDU)
02/19/04 (H) EDU AT 11:00 AM CAPITOL 124
02/19/04 (H) Moved CSHB 471(EDU) Out of Committee
02/19/04 (H) MINUTE(EDU)
02/23/04 (H) EDU RPT CS(EDU) 7DP
02/23/04 (H) DP: WILSON, SEATON, WOLF, GARA,
02/23/04 (H) KAPSNER, OGG, GATTO
03/02/04 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 511
SHORT TITLE: CERTIFICATE OF NEED PROGRAM
SPONSOR(S): REPRESENTATIVE(S) SAMUELS
02/16/04 (H) READ THE FIRST TIME - REFERRALS
02/16/04 (H) HES, FIN
03/02/04 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
KRIS MOORE, Member
Valley Voices for Children (VVFC)
Wasilla, Alaska
POSITION STATEMENT: Testified on HB 471.
DEBRA GERMANO, School Board Member
Kenai Peninsula Borough School District
Homer, Alaska
POSITION STATEMENT: Testified on HB 471.
TIM STEELE, School Board Member
Anchorage School District
Anchorage, Alaska
POSITION STATEMENT: Testified on HB 471.
JENNIE HAMMOND
Nikiski, Alaska
POSITION STATEMENT: Testified on HB 471.
MELODY DOUGLAS, Chief Financial Officer
Kenai Peninsula School District
Soldotna, Alaska
POSITION STATEMENT: Testified on HB 471.
AMY LUJAN, Business Manager
Nome Public School District
Nome, Alaska
POSITION STATEMENT: Testified on HB 471.
MARY FRANCIS, Ph.D., Executive Director
Council of School Administrators
Juneau, Alaska
POSITION STATEMENT: Testified on HB 471.
MARY HAKALA, Coordinator
Alaska Kids Count
Juneau, Alaska
POSITION STATEMENT: Testified on HB 471.
CARL ROSE, Executive Director
Association of Alaska School Boards
Juneau, Alaska
POSITION STATEMENT: Testified on HB 471.
CATHERINE REARDON
Juneau, Alaska
POSITION STATEMENT: Testified on HB 471.
REPRESENTATIVE RALPH SAMUELS
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as sponsor of HB 511.
LISA WOLF, Director of Planning
Providence Health System
Anchorage, Alaska
POSITION STATEMENT: Testified on HB 511.
ROBERT BRIDGES, M.D.
Medical Director
Alaska Open Imaging Center
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to HB 511.
SAM KORSMO, Chief Operating Officer
Alaska Open Imaging Center
Wasilla, Alaska
POSITION STATEMENT: Testified in opposition to HB 511 and
answered questions from the members.
DAVID McGUIRE, M.D.
Anchorage, Alaska
POSITION STATEMENT: Testified on HB 511.
MIKE POWERS, Hospital Administrator
Fairbanks Memorial Hospital
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 511.
CHARLIE FRANZ, Administrator
South Peninsula Hospital;
Chairman of the Board
Alaska State Hospital Association,
Homer, Alaska
POSITION STATEMENT: Testified in support of HB 511 and answered
questions from the members.
STEVE GONZALES, Owner
Gonzales Marketing
Chugiak, Alaska
POSITION STATEMENT: Testified on HB 511.
BRIAN SLOCUM, Administrator
Tanana Valley Clinic
Fairbanks, Alaska
POSITION STATEMENT: Testified on HB 511 and answered questions
from the members.
EDDIE JEANS, Finance Manager
School Finance and Facilities Section
Department of Education and Early Development
Juneau, Alaska
POSITION STATEMENT: Testified on HB 471 and answered questions
from the members.
ACTION NARRATIVE
TAPE 04-16, SIDE A
Number 0001
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:07 p.m.
Representatives Wilson, Gatto, Coghill, and Seaton were present
at the call to order. Representatives Wolf and Cissna arrived
as the meeting was in progress.
HB 471-INCREASE AMT OF BASE STUDENT ALLOCATION
Number 0050
CHAIR WILSON announced that the first order of business would be
HOUSE BILL NO. 471, "An Act relating to the funding of public
education; and providing for an effective date."
CHAIR WILSON announced for the record that Representative Wolf
has joined the meeting.
Number 0100
REPRESENTATIVE GATTO moved to adopt CSHB 471, version 23-
LS1645\I, as the working document. There being no objection,
version I is before the committee as the working document.
REPRESENTATIVE GATTO summarized the CSHB 471 increases the base
student allocation from $4,169 to $4,379 this year, and provides
for a 2 percent annual increase beginning July 1, 2005. He told
the members that as Chair of the House Special Committee on
Education, he appointed three members to a subcommittee on
education funding. The subcommittee took public testimony and
asked each individual school district what its shortfall would
be and what funding would be necessary to return the districts'
funding levels to that of the previous year. The conclusion was
that there needed to be a $210 increase [to the base student
allocation] to keep the districts at the previous year's level
of funding. Representative Gatto pointed out that this figure
does not include the PERS/TRS shortfall. It was decided to
address that issue in a separate bill, he commented.
Number 0281
REPRESENTATIVE COGHILL asked whether there would be public
testimony before or after the presentation of amendments. He
told the members that he plans to propose an amendment that
removes the language which provides for a 2 percent increase in
funding annually.
CHAIR WILSON announced that the committee will hear public
testimony before the amendments are presented.
Number 0359
KRIS MOORE, Member, Valley Voices for Children (VVFC), and
parent of four children in the Matanuska-Susitna Borough School
District, testified in support of HB 471. She said that basic
needs are not being met and that the quality of education is
suffering. She urged the committee to not only address the cuts
from this year, but also repair the damage done to the education
system in prior years.
Number 0559
DEBRA GERMANO, School Board Member, Kenai Peninsula Borough
School District, testified in support of education funding. She
told the members that she is disappointed to hear about a
suggested amendment which would take funds away from education
funding. Ms. Germano commented that while she appreciates the
efforts of the committee, the only thing the proposed level of
education funding does is provide for education to almost remain
at the present level. She explained that last year the Kenai
Peninsula Borough School District lost 56 teachers and 14
custodians. Ms. Germano shared that at a school board meeting
she attended the previous night she heard about more people
leaving the community because of the uncertainty in the
direction of public education. She said she believes this is a
big contributor in declining enrollment that is being
experienced in school districts. Ms. Germano urged the members
to do more than provide for a $210 increase and support a cost
of living increase.
Number 0718
REPRESENTATIVE GATTO commented that he understands the
disappointment that education funding has decreased for several
years. He pointed out that the retirement shortfall has been
separated from the base student allocation. He said he agrees
that $210 is not enough, but it does prevent further
deterioration from the previous year.
MS. GERMANO responded that she appreciates the efforts of the
members. In the Kenai Peninsula Borough School District there
are losses of programs, she said. For instance, the district
does not have a foreign language program or a gifted program any
more.
Number 0859
REPRESENTATIVE WOLF agreed with Ms. Germano that the Kenai
Peninsula Borough School District has been dealing with this
issue for a long time, and now the issue has spread to other
parts of the state and is now being addressed.
Number 0904
REPRESENTATIVE SEATON told Ms. Germano that he is concerned that
the 2 percent increase in the base student allocation could be
viewed as "the deal." Basically, this could mean the $86
increase in following years could be considered both the maximum
and minimum amount of an escalator by the legislature. He said
he believes that could present problems for the district. He
asked if Ms. Germano has any comments on the 2 percent
escalator.
MS. GERMANO replied that the 2 percent increase is only a
beginning, but at least it is something the districts can plan
on when developing a budget.
Number 0943
TIM STEELE, School Board Member, Anchorage School District,
testified on HB 471. He told the members he appreciates the
work done in funding education; however, there have been serious
cuts in Anchorage including 332 jobs and cuts to programs and
activities. He agreed with Debra Germano's comments that
Kenai's school district has been hurting for a long time.
Anchorage School District has also had cuts, but since it is a
much larger district, it has been possible to absorb some of
those cuts.
MR. STEELE said now the district, like everyone else, is feeling
the pain, and the pain is a result of a failure to fund cost of
living allowances (COLA) for decades. Since 1999 the district
has lost $253 in purchasing power, he explained. The $210
increase almost gets the district to where it was last year,
which was almost to point the year before. There is a
cumulative effect, he said. Mr. Steele told the members that
districts need a significant increase to the funding formula
this year to make progress toward adequacy. The 2 percent
increase would be progress toward sustainability. Without it
the districts will be much worse off in five years.
MR. STEELE told the members that last night there was a school
board meeting which focused on a six-year plan. There was
overriding gloom that dominated the discussion that the goals
could not be met. He stated that he wants to get back to
focusing on educating kids and spend less time begging for
money.
Number 1166
JENNIE HAMMOND testified on HB 471. She told the members that
the quality of education provided to students in Kenai is going
down, and that failure is not based on the lack of
professionalism of the teachers, but due to the lack of funding
being received from the state. Ms. Hammond said she does not
believe $4,600 per student is a small price to pay compared to
what is being done to the children.
CHAIR WILSON agreed with Ms. Hammond. She shared that she has
had parents who were educated in the same school district their
children are attending now, and who have come to her with
concerns that there were better course offerings and better
educational opportunities afforded to them many years ago.
Chair Wilson stated that she believes that is a sad statement.
Number 1249
MELODY DOUGLAS, Chief Financial Officer, Kenai Peninsula School
District, testified in support of HB 471. She commended the
members in taking the lead in providing increased education
funding. She said that the increase of $210 in the base student
allocation is significant and does not want to take away from
that, but echoed the earlier comments by Kenai residents.
MS. DOUGLAS told the members she opposes the proposed amendment
that would remove the 2 percent incremental increase in funding.
She said that while she understands why it might be removed, an
incremental increase of 2 percent annually is an important place
to start. Ms. Douglas told the members that Kenai is
experiencing significant facilities increases, such as utilities
costs. She urged the members to keep the 2 percent annual
increases in education funding.
Number 1363
AMY LUJAN, Business Manager, Nome Public School District,
testified on HB 471. She stated that she is supportive of
increases of the base student allocation so that the district
can maintain parity with the current year. This would be
especially true if PERS/TRS is addressed in a separate bill.
Ms. Lujan explained that while this helps, it does not help with
the programs that have been cut over the past two years. For
example, there are fewer junior and senior course offerings,
larger class sizes which is problematic at the elementary level,
no school nurse, no social worker, and no assistant principal at
the elementary level, fewer aides, growing deferred maintenance
needs, and no professional development. Ms. Lujan said she
appreciates the increase in the base student allocation and
urged the members to maintain the 2 percent annual increase as a
starting point.
Number 1449
MARY FRANCIS, Ph.D., Executive Director, Council of School
Administrators, testified on HB 471. She provided the following
statement:
The school administrators are strongly in support of
an increased base student allocation. We prefer that
the amount be sufficient to include the increased
TRS/PERS costs, so that this ongoing cost of doing
business doesn't have to be fought for each year.
Provided, of course, that the districts have an
eroding funding floor would be equally taken care of
with the other districts. We also think including the
TRS/PERS costs in the formula will then allow those
communities with taxing powers to contribute more to
schools, should they choose to do so.
That said, it is our wish that the base student
funding also be adequate to provide a comprehensive
educational program for all kids. As a school
administrator of over 20 years, I've watched the
steady erosion of educational programs. Starting in
1986, when a 10% across the board reduction was
imposed, school districts have reduced services to
balance budgets year after year. Watching the
schoolhouse crumble is not what I thought I'd spend my
career doing!
Recently I heard that a philanthropic organization is
planning to provide funding for the arts in public
schools. This is terrific news! But how sad is it
that a critical component of educating the "whole
child" is now dependent on someone's generosity?
Isn't it the State's responsibility to provide a
comprehensive educational program? Shall we next turn
to the National Basketball League to fund
extracurricular programs? Shall we turn to Microsoft
to fund workplace preparation programs? Vocational
programs, the arts and music, are some of the many
programs falling by the wayside as school districts
prepare budgets on inadequate funding.
Alaska's students deserve a quality comprehensive
educational program. Please help get us back on
course by supporting a substantial increase to the
base student allocation.
Thank you for your time.
Number 1559
REPRESENTATIVE WOLF asked why the state should not ask Microsoft
to contribute. Alaska owns $240 million worth of stock in that
company.
Number 1591
MARY HAKALA, Coordinator, Alaska Kids Count, testified on HB
471. She told the members that Alaska Kids Count is a non-
partisan group of parents, grandparents, educators, and
community members who have joined together to advocate for
schools and safeguard children's education. She told the
members that about a month ago a few of us got together to start
the initiative, and now there are over 400 in a statewide e-mail
network. She pointed out that the growth reflects the level of
concern out there. The group works along side Valley Voices for
Children, other parent groups, and PTAs, she added. She asked
the members to remember that each time a Representative hears
from one of them, it often reflects the perspective of many
people. It is tough for a parent to approach the legislature;
it is not a common day experience for most people.
MS. HAKALA explained that the group she represents are the
volunteers in the school, the ones who set up bake sales, help
with the valentine parties, and increasingly raise funds. For
example, in Juneau it is the PTA that funds the art supplies,
and field biology, which is a long way from what it use to do.
She emphasized that this funding is for core subjects. Ms.
Hakala reiterated that the current funding is adequate and the
additional cuts are unacceptable. She said that this bill is a
step forward in the right direction, but believes that much more
is needed.
MS. HAKALA commented that between the PERS/TRS solution and this
bill would be about $78 million. She urged the members to
invest $100 million in education.
Number 1719
CARL ROSE, Executive Director, Association of Alaska School
Boards, testified on HB 471. He told the members that this past
weekend he had the opportunity to revisit the Molly Hootch
decision made 30 years ago which provided that people were
allowed to educate their children at home, rather than sending
them away to boarding schools. Much of the discussion that
surrounded the gathering he attended focused on the kinds of
education options available given the shortage of funding. He
added that the people in attendance do not want to go back to
the pre-Molly Hootch days. Mr. Rose explained that although the
people support boarding schools as an option for many of the
students, it was clear there was no support for mandated
boarding schools.
MR. ROSE told the members that in rural areas of Alaska there
have been tremendous reductions in services across the state due
to the lack of funding. He pointed out that six state senators
represent the entire landmass of Alaska with the exception of
the Railbelt, and 28 representatives represent the Railbelt
proper, while the other 12 represent the rest of the state. Mr.
Rose told the members there is a tremendous crisis with the lack
of capacity to deal with the issues being presented.
Number 1831
MR. ROSE explained that the decision for Molly Hootch and
Bullock vs. Lind was largely due to what many people felt was a
preponderance of evidence that suggested that the state was
operating two systems of education that were not equal. He told
the members that he believes that can be said about the state
today. He urged the members to look at the state of rural
education and how the state addresses the needs of those
children. There is serious need for increased investments. He
added that there is a serious need for water and sewer and other
amenities that many of us take for granted. Mr. Rose stated
that everyone is covered by the same constitution. That is just
a backdrop to what is involved, he added.
MR. ROSE told the members that for the last 17 years he has been
involved in managing the decline of public education. Every
year education has been provided with less money. Now that
shortages in funding is being felt in the Railbelt, there is an
awareness of the problem in the state. He urged the members to
look at the entire system with a sense of conscience of what is
being done for and to our kids. He summarized his comments by
saying "if we do not model what we teach, then we are teaching
something else." Mr. Rose suggested that if it is being said
that educating our youth is our highest priority, then it is
important to take every step to do that.
Number 1907
MR. ROSE said the association supports this bill. He
understands the hard work that was involved in producing the
increase in funding, and urged the members to support the 2
percent annual increase as well. It is a good place to start,
he commented. Mr. Rose told the members that everywhere that he
goes he hears people say they are willing to pay for better
education for their children. He said even though his children
finished their education, he would be willing to pay a tax to
educate children for the future of the state of Alaska.
Number 1911
REPRESENTATIVE GATTO commented that the total base student
allocation in the bill is $4,379 or close to $4,400. The 2
percent annual increase would mean an additional $88 more next
year. Neither he nor Mr. Rose will be satisfied with $88 next
year, he said. Representative Gatto said he understands that
there could be some thought that next year someone could say
that education funding has already been addressed with a 2
percent increase, and would question why there would be a
request for more funds. Representative Gatto asked Mr. Rose to
comment on this.
MR. ROSE replied that he believes 2 percent is a starting point.
Often there are supplementals that will add funds later as needs
are identified. He suggested that since all the testimony has
addressed the loss in buying power, there is no addressing that
unless there is a step increase in funds. He reiterated that he
is willing to start at 2 percent, but guaranteed the members
that 2 percent will be inadequate this year, and it will be
inadequate next year as well.
REPRESENTATIVE SEATON pointed out that this bill states that
there will be a 2 percent increase, not that an increase will
start at 2 percent. He asked Mr. Rose if he is really in
support of the language that says funding will be increased by 2
percent.
MR. ROSE responded that he is supportive of that language
because he has never known the legislative body to be limited by
what a previous legislature had passed. The language giving 2
percent is better than nothing. He encouraged the members to
work for progress. The door is not closed on this subject, he
added.
Number 2020
CATHERINE REARDON testified as a parent of a kindergartener and
a four-year old. She asked for a significant increase in the
base student allocation and an annual inflation factor to
address the loss in purchasing power. She told the members that
she believes strongly that it is important to put money in the
education system that can allow it to help all the children of
the state. She said her testimony represents many parents who
find it difficult to testify. Most parents would be willing to
pay taxes to fund education. She stated that she finds
education more important than the permanent fund dividend.
MS. REARDON told the members that the Juneau School District,
like many other school districts, has been looking at ways to
cut its budget. The Charter School where her daughter attends
will be cut to the statutory minimum which really brings into
question the existence of the school. This is an example of
what is happening statewide, she said.
REPRESENTATIVE GATTO commented that it would be nice to index
education funding as the permanent fund is indexed. He asked if
Ms. Reardon knows what it takes to inflation proof the permanent
fund.
MS. REARDON replied 3 to 3.5 percent.
REPRESENTATIVE GATTO asked if Ms. Reardon would be happy with
only a 2 percent increase per year.
MS. REARDON responded that she would guess that the inflation
costs for some things in education, such as PERS/TRS, have a
higher escalation in inflation. Inflation goes up and down.
While it is low at this time, next year it could be higher. Ms.
Reardon said she would be more comfortable with indexing than 2
percent, but appreciates what has been done.
CHAIR WILSON announced that public testimony is now closed.
Number 2233
REPRESENTATIVE COGHILL moved to adopt Amendment 1, [original
punctuation provided] which read as follows:
Page 1, Line 6:
Delete: "However, the department shall, on July 1 of
each year, beginning July 1, 2005 increase the base
student allocation by two percent"
Number 2241
REPRESENTATIVE GATTO objected.
Number 2245
REPRESENTATIVE COGHILL told the members that there are two sides
to the question of a 2 percent annual increase to education
funding. Is this a sufficient amount, he asked. He said he
believes the answer is "no", so the starting point should always
be the formula. This is a very complex formula. When
discussing adequate funding it is clear that the issue must be
addressed and funded by the legislature every year,
Representative Coghill added.
REPRESENTATIVE COGHILL said that he believes there are other
important issues that must be addressed as well. For example,
he told the members he believes public safety rises to the same
level of importance as education, and there are no escalating
clauses in legislation for funding that. Representative Coghill
acknowledged that he has a bill that requests more funding for
education and is working to find more funds.
REPRESENTATIVE COGHILL agreed that Mr. Rose makes a good point
that it is an interesting time where there is declining income
and increased expenses. He told the members that there is a
bigger debate going on and that is to use some of the permanent
fund to fund state government. He told the members that he
would not support indexing education funding and is not even a
big fan of inflation proofing the permanent fund even though it
is statutorily required. The growth factor is market driven and
an income that is revenue driven from royalty oil and lease
sales. He added that he would rather see the [funds for
inflation proofing] be placed in education funding. If indexing
were included for education funding, it could then be included
in every budget because each one is important. Representative
Coghill summarized that since he has been in the legislature,
the education funding issue has risen to the top every year.
This amount is not enough for education funding, he stated, and
is surprised that there is not an amendment to increase the
funding. The question is where can the money be found.
TAPE 04-16, SIDE B
Number 2364
REPRESENTATIVE COGHILL explained that this is just one more
layer the House Finance Committee must go over to determine what
is adequate educational funding. He told the members if it is
believed that the amount for the base student allocation should
be higher, then raise the amount. He stated no one is fooled
that the 2 percent annual increase will do anything.
Number 2351
CHAIR WILSON announced for the record that Representative Cissna
joined the meeting some time ago.
CHAIR WILSON commented that she has been in the legislature for
four years and has been fighting for increased education funding
all that time. The schools in her district have been
experiencing serious shortfalls in funding long before the
larger schools districts felt the pain, she said. Chair Wilson
told the members that she agrees with what has been said about
the 2 percent increase being only a start. The schools have
been expected to provide everything that is requested of them
even though there has been a steady erosion in funding. She
stated that she believes the inclusion of a 2 percent increase
may be viewed by some as a conclusive solution to the funding
shortage.
Number 2291
REPRESENTATIVE GATTO said that every year about this time the
school districts try to issue contracts and right now the
schools do not know how much money will be funded for education.
The districts expect that it will be less than what was received
last year. He said he hopes this 2 percent increase will
provide the districts with the assurance that it will not be
necessary to issue so many pink slips. This kind of assurance
for the previous year's allocation, plus a 2 percent increase,
may make it easier for the districts' to issue teaching
contracts, plan on insurance and utility increases, and plan for
maintenance costs. Representative Gatto told the members that
he hopes the percentage will be 4 percent, but at least it will
be 2 percent under Alaska statute rather than nothing. He
agreed with Mr. Rose's statement that over the last seven years
all that has been done is to "manage the decline." The $210
increase is only arresting the decline and is not repairing the
damage. He summarized his comments by saying that the 2 percent
annual increase provides the districts with some hope that there
will not be further decline.
Number 2207
REPRESENTATIVE SEATON told the members that he is concerned
about the 2 percent increase language in the bill for two
reasons. The first is that it may be a magnet for drawing
negative votes for the bill because there are a number of people
who are opposed to inflation proofing any budgets. So this
language would provide a good excuse for some members not to
support the bill, he said. The second concern is that the
language says "by 2 percent." He told the member that if this
amendment fails, he will be offering an amendment that would say
"by at least 2 percent" so that the mind set is changed that the
increase will be 2 percent.
REPRESENTATIVE SEATON said he would like to get some
clarification from the administration on the effect of this
language on the base student allocation. The committee has been
told that fully funding education means meeting the base student
allocation. Representative Seaton questioned whether this
change would mean that fully funding education means meeting the
base student allocation last year or the previous year, plus 2
percent.
Number 2140
EDDIE JEANS, Finance Manager, School Finance and Facilities
Section, Department of Education and Early Development,
testified on HB 471 and answered questions from the members. He
responded that the department's interpretation of the 2 percent
provision would be to build that 2 percent into the budget which
would be submitted to the legislature in December. That would
be the full funding amount, he said.
REPRESENTATIVE GATTO said he believes that if steps and columns
didn't change, there were no raises, no insurance increases, and
no PERS/TRS shortfall then education funding could probably
manage with the 2 percent annual increase. He asked if Mr.
Jeans would agree with that statement.
Number 2110
MR. JEANS replied that he could not answer that questions. He
added that he did look at the Anchorage Consumer Price Index
(CPI) over the last five years, and over that period the CPI has
averaged about 2 percent. Mr. Jeans commented that 2 percent
seems like a reasonable number at this point.
CHAIR WILSON said she is sure that for some schools that 2
percent would not be enough.
REPRESENTATIVE SEATON explained to the members that based on Mr.
Jeans' response to questions, he will not be offering the
amendment he mentioned earlier because the 2 percent can be
built into the formula. He said that if he changed the language
to "at least 2 percent" he does not believe it would be possible
for the department to build it into the formula.
REPRESENTATIVE COGHILL questioned how this will affect the
hiring practices that Representative Gatto mentioned. He said
that he was under the assumption that hiring decisions were
based on student count. The committee has discussed forward
funding of education and there has always been a snag because
the student count needed to be taken into consideration, he
recalled.
CHAIR WILSON said that it has always been very difficult for
schools to know how many teachers to hire because of the
uncertainty of funding. Tenured teachers must be notified by
March 15 if there is a possibility of a layoff. She explained
that for many of the schools where funding has been severely cut
all that remains are tenured teachers.
REPRESENTATIVE COGHILL said that he does not believe that the 2
percent annual increase would make a difference in determining
how many teachers may be retained.
Number 2000
CHAIR WILSON clarified that the schools also must determine if
there will be the same number of students. If there are fewer
students, the schools will receive less money. She commented
that when the schools do not have enough money to provide good
educational opportunities, people move away.
MR. JEANS commented that the members know the budgeting process
is a difficult one. He explained that school districts base
there budgets on the base student dollar amount in statute. The
districts assume that is what will be received. He said most
districts will not budget based on a higher dollar amount
because that is the element that is unknown. If there is a 2
percent increase automatically built into the foundation program
the school districts will budget for it, expect it, and pressure
will be put on the legislature to fund it, Mr. Jeans said. He
added that the foundation program has been fully funded since
1987. There was a huge decline in oil revenue that year and the
state took a 10 percent cut across the board including the
foundation program. He clarified that was after the budgets
were approved and appropriated by the legislature.
Number 1961
MR. JEANS told the members that the 2 percent annual increase
would help the school districts determine how many pink slips
need to be issued. For example, if a school district knew today
that it could count on $4,010 then pink slips would need to be
issued because it could not assume there would be more funding.
If there is a 2 percent increase, then it is likely that fewer
pink slips would be issued, he said.
REPRESENTATIVE WOLF said he agrees with Representative Gatto's
statement. He explained that he had the opportunity to work
with the superintendent of schools while decisions were being
made about the issuance of pink slips. Representative Wolf
commented that the 2 percent increase could make a big
difference in some people's lives.
REPRESENTATIVE COGHILL commented that he does not disagree with
Representative Wolf's statement. He said, however, that if the
base student allocation were set at an adequate level then
school districts could plan appropriately. Representative
Coghill pointed out that there could be an argument that if an
annual percentage increase is placed in statute for the
foundation formula, then there are other areas of the budget
where annual budgeting processes also impact people's jobs. He
commented that if this is something the legislature really wants
to do, then perhaps there should be a 2 percent escalator on the
budget bill as a whole.
REPRESENTATIVE COGHILL stated that he believes the better way to
approach the problem is to look at the formula to see what the
real number is and if it really works. Every two years there is
an election process where the people of Alaska tell us what they
want. He commented that he rides the breaks on education
funding even though he has a bill which asks for more funding.
Representative Coghill commented that he will likely get slapped
around for that. In summary, he said that if the funding is not
accurate it is because the people who elect legislators do not
reflect that increased funding is necessary.
Number 1800
REPRESENTATIVE GATTO commented that as the chair of the House
Special Committee on Education if he could be king for a day and
come up with a number that meets the needs for education, there
would be no need for a 2 percent escalator. He stated that
there was a great deal of time and effort from committee members
this year to come up with an additional $210, exclusive of the
PERS/TRS shortfall which is addressed in a separate bill.
Representative Gatto explained that the committee came up with
the right number which does nothing more than stop the decline.
It is for this reason that he is opposing the amendment, he
said.
A roll call vote was taken. Representative Coghill voted in
favor of Amendment 1. Representatives Wilson, Wolf, Seaton,
Cissna, and Gatto voted against it. Therefore, Amendment 1
failed to be adopted by a vote of 1-5.
REPRESENTATIVES SEATON proposed that a memorandum be drawn up to
accompany the bill which would say that the House Health,
Education and Social Services Standing Committee recognizes the
need to identify sources of available funds to cover the
increase in education funding. It would go on to say that the
committee has identified the remaining authorized CBR draw for
2004 and the Alaska Permanent Fund earnings as sources that can
be used for the education funding increase.
REPRESENTATIVE COGHILL objected for purposes of discussion and
clarification.
REPRESENTATIVE SEATON read the following text which he suggests
be included in a memorandum which would accompany HB 471:
The House Health, Education and Social Services
Standing Committee recognizes the need to identify
sources of available funds for this increase in
education funding. We identify the remaining
authorized CBR draw for 2004 and the permanent fund
earnings reserve as sources that can be used for this
educational funding increase.
REPRESENTATIVE SEATON added that the language is conceptual and
would not object to the language being slightly modified.
CHAIR WILSON commented that this language was developed in the
House Special Committee on Education, but did not come with the
bill in error.
Number 1657
REPRESENTATIVE GATTO explained that the letter should accompany
the bill when it goes to the House Finance Committee so that the
members there are not faced with a bill that has a $42.3 million
fiscal note without identifying some available funding sources.
He clarified that the letter was written by the House Special
Committee on Education to accompany the bill, but not be a part
of the bill.
CHAIR WILSON asked what the committee wishes with respect to the
letter to accompany the bill.
REPRESENTATIVE COGHILL said that he maintains his objection
because it narrows down the sources of funding from last year's
CBR draw. He said he is open to a suggestion.
REPRESENTATIVE SEATON clarified that the only reason this letter
specifies the CBR draw and the permanent fund earnings is due to
the fact that these are the only funds currently available to
this legislature that can be appropriated. He said that future
tax sources require another bill to pass which may or may not
pass. He said that he believes it is important for the
committee to say that this education funding is important enough
to us that sources have been identified to fund this bill.
REPRESENTATIVE COGHILL suggested that the language including the
CBR draw for 2004 be removed and just have the permanent fund
earnings reserve in the letter. He commented that House Health,
Education and Social Services Standing Committee is not going to
be advising the House Finance Committee of any new revenue
sources. He commented that if the committee really wants to be
daring why not insert an income tax as a source of revenue.
REPRESENTATIVE SEATON explained that the reason he is suggesting
this letter and the language in it is due to the fact that the
committee was told that if it put forth a bill that included
increased funding, the House Finance Committee would like those
sources of funding to be identified. This letter would reflect
the members' commitment to education funding, he added.
Number 1490
REPRESENTATIVE COGHILL commented that while he is the majority
leader, nine times out of ten he is in the minority. He told
the members he maintains his objection. Representative Coghill
said he believes the committee chair's statement before the
House Finance Committee would be adequate, unless the committee
wants to promote a head tax or income tax.
A roll call vote was taken. Representatives Wilson, Seaton,
Cissna, and Gatto voted in favor of including the letter of
intent with HB 471. Representatives Coghill and Wolf voted
against it. Therefore, the letter of intent was included with
HB 471 by a vote of 4-2.
Number 1399
REPRESENTATIVE GATTO moved to report CSHB 471(EDU), 23-LS1645\I,
out of committee with individual recommendations, the
accompanying fiscal notes, and an accompanying letter of intent.
There being no objection, CSHB 471(EDU) was reported out of
House Health, Education and Social Services Standing Committee.
HB 511-CERTIFICATE OF NEED PROGRAM
Number 1300
CHAIR WILSON announced that the next order of business would be
HOUSE BILL NO. 511, "An Act relating to the certificate of need
program for health care facilities; and providing for an
effective date."
Number 1310
REPRESENTATIVE RALPH SAMUELS, Alaska State Legislature,
testified as sponsor of HB 511. He told the members that HB 511
closes some loopholes in the certificate of need (CON) language
in the statutes and it allows the state to use CON as a
management tool for residential psychiatric facilities. This
bill would enable the state to addresses the problem of the
large number of youths who are in facilities outside of Alaska,
would ensure that there are the right number of beds, and that
Medicaid costs are kept under control.
Number 1219
LISA WOLF, Director of Planning, Providence Health System,
testified in support of HB 511. She told the members that she
has been involved in the CON law for over 20 years, has written
over 20 CON applications, and has been involved in the review
process on far more that. The CON law was established to ensure
that the state of Alaska and individual communities are not
financially burdened with excess health care equipment and
facilities. The premise is that having more than the community
needs would increase the cost of care, as providers would need
to increase charges to cover the additional expenses that would
not be covered by adequate volume [of patients]. The CON law
was designed to ensure a high quality of care by ensuring that
there would be adequate volume so that the practitioners would
be proficient in performing the procedure or exam.
Number 1050
MS. WOLF told the members that in recent years there have been
studies done in other states to see if the CON law was actually
achieving its purpose. For example, one study compared the cost
and quality of heart procedures done in a state which had a CON
law with the cost and quality of another state which had
eliminated the law a few years earlier. It was found that the
clinical outcome was better in the state with the CON law, than
the non-CON state. The outcome was linked to higher volumes in
facilities with CON approval.
MS. WOLF explained that leasing has become a common way of
getting around the CON process. If a health care facility or
provider wants to add a piece of equipment that costs over $1
million, a CON is required. However, if the equipment is leased
the $1 million threshold is not reached and the entire CON
process is avoided. Often when this happens the local providers
and the state are unaware of the overall impact to the community
or the state as a whole, she said. Ms. Wolf added that this
also makes it difficult for the state to make an adequate review
on a CON application. The question is then whether the state
rewards those who go around the CON process or potentially adds
unneeded services by approving CONs.
MS. WOLF Summarized that the CON process levels the paying field
for all providers and provides the oversight that is needed.
She encouraged the members to support HB 511.
Number 0940
ROBERT BRIDGES, M.D., Medical Director, Alaska Open Imaging
Center (AOIC), testified in opposition to HB 511. He told the
members that it has imaging centers in Wasilla, Soldotna, and
Anchorage. Dr. Bridges emphasized that presently Alaska Open
Imaging Center is the only independent diagnostic testing
facility in Alaska. He told the members that he graduated from
the University of Washington School of Medicine in 1980 and has
degrees in chemistry and nuclear engineering, and has been
awarded medical specialties in diagnostic radiology and nuclear
medicine.
DR. BRIDGES said that for over two years the Alaska Open Imaging
Center has provided quality, affordable health care for
Alaskans. He told the members of the advances in medical
technology the center has brought to Alaska. While others have
talked about advances, the center has brought that vision into
reality. The center has given patients a choice and has
provided these services efficiently and at a lower cost than
other providers. Dr. Bridges emphasized that this is a story of
success, not of elitist medical groups or large medical
conglomerates, but Alaskans who are technologists and hospital
employees who saw the need for a new and better form of health
care. The market place determines the center's success. he
commented. It is earned by taking personalized care of every
patient, one at a time. Since opening its doors the center has
taken care of Medicare and Medicaid patients, and patients who
have been abandoned by the hospitals because the patient's
problems seemed too complicated or too time consuming.
DR. BRIDGES summarized his comments that HB 511 is not about
health care, but about health control. This bill stifles
competition and does not confront the challenges of cost and
quality medicine. The bill favors those with offices of lawyers
and lobbyists with large bank accounts to ensure they get what
they want, he stated.
Number 0785
DR. BRIDGES commented that the bill strikes on one of the true
major cost challenges in medicine today, and that is the abuse
of unfettered and uncontrolled self-referral which has created
over-utilization of services nationwide by up to 250 percent in
some specialties. He said he believes this over regulation is
an abuse of the people's time and resources. Dr. Bridges asked
the members to give AOIC the freedom to grow.
Number 0720
SAM KORSMO, Chief Operating Officer, Alaska Open Imaging Center,
testified in opposition to HB 511. He told the members that
several years ago it embarked on a venture to provide the
largest independent radiology businesses in Alaska. There are
36 employees, 3 doctors, and an array of technological advances
that have set new levels in quality. Mr. Korsmo said that the
business has prospered and grown based on core values of
service. The physicians there place care and compassion for the
patients' benefit first and foremost. He explained that AOIC
has brought a large array of new technology to Alaska including
the open MRI, virtual colonoscopy and cardiac scoring for the
comfort of patients.
MR. KORSMO urged the committee to ensure that any changes to the
CON laws be warranted. The mission statement on CON was to
promote responsive health facilities, service development,
rational planning and cost containment; and to ensure that these
services would be of good quality, acceptable to the public,
promote access, choice, and meet the public's needs while
preventing excessive unnecessary duplicative facilities and
services. Mr. Korsmo told the members that AOIC has met all of
the CON mission statement goals and has done it better and more
cost effectively than any other provider could do in the last
three years. There has been more duplication of AOIC's model by
other providers than any other period before, he said. The
mentality of "staying up with the Jones" has created a burden
which has been thrown on the backs of patients and families, he
added.
Number 0555
MR. KORSMO asked the members to reconsider the language which
defines a health care facility on page 3, line 21, which says:
independent diagnostic testing facility, secure
residential psychiatric treatment center,
MR. KORSMO told the members that currently AOIC is one of the
few if not the only, independent diagnostic testing facilities
in Alaska. He suggested that this definition is directed only
at AOIC. Mr. Korsmo urged the members to eliminate the CON
process and allow free market forces to provide a better health
care system.
Number 0508
CHAIR WILSON asked if this bill will affect AOIC now.
MR. KORSMO said yes. The bill will impact AOIC if it chooses to
upgrade equipment or expand services. It would be required to
request a CON.
CHAIR WILSON asked if the cost of services are lower than that
which is provided at a hospital.
MR. KORSMO said yes.
Number 0449
REPRESENTATIVE GATTO expressed concern for the consumer. While
it is clear that a patient could go to AOIC and get services
provided for less money, a week later that same patient may
require services that are only provided at the hospital, he
said. Because the hospital has lost business it will now charge
the patient more money to compensate and the consumer ends up
paying more. Representative Gatto questioned whether the
consumer will get a better deal with the services AOIC is
providing or not.
MR. KORSMO said yes.
REPRESENTATIVE GATTO clarified that what Mr. Korsmo is saying is
that the hospital will not have to change its rates even though
AOIC is taking some of the business away from it. The hospitals
have said that the most important patients are the ones who can
pay. He added that he would bet that AOIC is not taking too
many patients who do not have the ability to pay. He asked Mr.
Korsmo to comment.
MR. KORSMO told the members that AOIC takes all patients. It
has an equal percentage of those that cannot pay as the
hospital. It also takes Medicare and Medicaid patients, he
added.
Number 0330
REPRESENTATIVE COGHILL asked Mr. Korsmo what is an independent
diagnostic testing facility.
Number 0306
MR. KORSMO replied that AOIC was formed by a group of
individuals who have come together to build an imaging center
company.
REPRESENTATIVE COGHILL asked for clarification on the term
"independent".
MR. KORSMO responded that independent was the designation under
which it applied [for a license].
Number 0192
DAVID McGUIRE, M.D., testified on HB 511. He told the members
that he has testified on more than one occasion that he believes
the CON law does not work; and he added that he has not changed
his opinion. However, in the current application he said he
believes it is worse than it was intended to be. He explained
that the reason leasing has become an issue is due to the fact
that one large institution was granted the ability to install
radiology and oncology treatment facilities that cost as much as
$10 million and were not able to circumvent the CON process by
the precise language that is before the members. Specifically,
what was said is that as health care providers it was leasing
the equipment and space, while someone else owned it and
therefore it was not necessary to comply with a CON. Dr.
McGuire told the members that no matter how one views a CON, the
process should be the same for everyone. It should not be a
situation where some get special treatment over others which was
the end result, he added.
DR. McGUIRE commented that it was requested a number of years
ago to allow a facility to move to another site without having
to go through the CON process again. The department chose to
include language that is only clear to itself, that effectively
limited the options of the site from which this facility was
moved. He said he believes that if there is any limitation on
anyone, it should be on the person with the CON. Dr. McGuire
told the members the CON allows a facility to move once, but not
twice. It does not deal directly with the facility from which
the CON moved. Dr. McGuire summarized that there could be many
battles about whether or not the CON process works; however, it
should be fair to everyone.
TAPE 04-17, SIDE A
Number 0029
REPRESENTATIVE GATTO told the members that he served on the
Valley Hospital board during the time the hospital was trying to
get a CON. It took well over a year to do it. He asked if Dr.
McGuire would agree that if fairness is to prevail all providers
should be subject to the same rules.
DR. McGUIRE agreed that all providers should have to go through
the same process. He told the members that is the way it use to
be before the hospital got an oncology department.
Number 0133
MIKE POWERS, Hospital Administrator, Fairbanks Memorial
Hospital, testified in support of HB 511. He told the members
that he agrees with Dr. McGuire's comments that HB 511 addresses
some weakness in the current CON law. Mr. Powers took exception
to some comments in that he believes the CON process is very
valuable to communities. The weaknesses in the CON statute
provides tremendous exposure to community hospitals.
MR. POWERS said that there are three areas that need to be
clarified.
One is the matter of the freestanding diagnostic
imaging centers. He pointed out that the bill
recognizes that there should be a level playing field
for all. Two, the (indisc.)... Three, the issue of
the cost of leases for space [needs to be addressed].
MR. POWERS told the members it is his opinion that the
department will ensure that the CON law is applied equally. It
won't be possible to avoid CON review by leasing space and it
does require that everyone plays by the rules. He explained
that he believes it is important that the diagnostic imaging
centers be subject to CON because without it, it tears at the
fabric of those services that do not pay for themselves, such as
burns, mental health, neo-natal care, emergency visits, chronic
inebriants, Medicare, et cetera. Mr. Powers urged the members
to pass HB 511 because it is an important step in leveling the
playing field.
Number 0255
CHARLIE FRANZ, Administrator, South Peninsula Hospital, and
Chairman of the Board, Alaska State Hospital Association,
testified in support of HB 511 and answered questions from the
members. He told the members that both the South Peninsula
Hospital and the hospital association strongly supports HB 511
and the changes that are proposed. The changes will provide a
level playing field for community hospitals and entrepreneurs
such as the independent testing facilities whose representatives
testified earlier. Mr. Franz emphasize that it is important the
members think about the community hospitals as a resource for
the communities. He suggested that those who are familiar with
the fishing industry in Alaska think of the analogy between the
CON bill and the limited entry permits. There are resources
that need to be used appropriately. Fishing and health care are
probably the only two business in the state where there is an
effort to provide quality services or products, in a cost
effective manner, and then someone else decides how much will be
paid for that service or product. He pointed out that it is not
like the free market place and he does not believe that is an
appropriate way to consider health care. Mr. Franz encourage
the members to support HB 511 because it is a good bill. It
does not cost the state anything and protects community
resources, he added.
Number 0414
REPRESENTATIVE GATTO commented that [Valley Hospital
Association] merged with Triad and is in the process of building
a much larger hospital, up to 70 beds, in another location. He
asked Mr. Franz how this bill would affect the hospital that is
going to be constructed and in general how it affect the
hospital in the valley.
MR. FRANZ responded that the new hospital would have to go
through the CON process, just as it does now. However, he said,
there would be an impact on the competitor across the street,
Open Imaging Center would have to go through the CON process
before adding services or upgrading its equipment.
Number 0481
CHAIR GATTO asked if he understands correctly that Mr. Franz is
saying that Open Imaging Center has a grandfather right, but the
new hospital does not because it is expanding and moving to a
new location.
MR. FRANZ replied that if HB 511 is not enacted, Valley Hospital
will be at a serious disadvantage when Open Imaging Center
decides to add a new service and does not have to go through the
CON process. It will allow Open Imaging Center to cherry-pick
services away from the hospital.
Number 0547
STEVE GONZALES, Owner, Gonzales Marketing, testified on HB 511.
He told the members that in addition to representing Alaska Open
Imaging Center, he is a supporter of consumer rights. He
commented that he does not agree with comments by the non-
profit's that this bill levels the playing field. As a
consumer, when a non-profit provides a service that is not
required by the public or cannot be paid for by the public, then
it is leveled on the shoulders of the consumers who pay taxes.
Mr. Gonzales pointed out that Alaska Open Imaging Center has
based its services on the needs of the community; and therefore,
either thrives or does not based on how that service is provided
and how it competes with other providers. The stockholders
carry the burden, not taxpayers. He asked the members to
recognized that this bill is being pushed forward as a
competitive impediment by non-profit hospitals who compete with
this particular service. Mr. Gonzales said he believes that
consumers should not be forced to pay higher and higher medical
bills and hundreds of dollars for minimal treatment because this
is a grandfathered organization. He urged the members not to
buy the smoke screen that is being put forth here because this
bill is simply a competitive strategy to eliminate Alaska Open
Imaging Center.
Number 0670
BRIAN SLOCUM, Administrator, Tanana Valley Clinic, testified on
HB 511 and answered questions from the members. He explained
that Tanana Valley Clinic was established in 1959 and currently
has about 35 providers, employs about 225 people, and one-third
of its patients are Medicare or Medicaid recipients, or have no
insurance. In 2003 the clinic provided just under $7 million
worth of unreimbursed care to community members. He added that
while the clinic is a private business, it does serve a
community need and offers some community benefit.
MR. SLOCUM spoke against the inclusion of diagnostic facilities
and a blanket prohibition of using leases for space and
equipment. He opposes the carving out of another area of health
care delivery as the exclusive realm of hospitals. A couple of
years ago there was debate about ambulatory surgical centers and
it was determined that ambulatory surgical centers would be
subject to CON. He said he understands that is a "dead issue"
at this point; however, he is concerned that once again the
hospital industry is asking the legislature to take a portion of
the services delivered to patients and make it exclusively
available to hospitals. If the members do not agree with him on
this point, he asked if it would be possible to work on the
definition of some of these terms.
Number 0825
MR. SLOCUM said for instance, that today was the first time he
had heard the definition of "independent diagnostic testing
facility." As HB 511 is drafted it does not refer to a Medicare
or state definition of independent diagnostic testing facility.
He commented that it might be wise to tie it to a very specific
definition. Mr. Slocum said his fear is that if it is not
clearly articulated, then it would fall to the CON office in the
Department of Health and Social Services to make that
determination without guidance from the legislature. He said he
believes that clinics such has Tanana Valley Clinic, because it
is not affiliated with a hospital, could be defined an
independent diagnostic testing facility. For example, the
clinic has a laboratory and some imaging facilities scattered on
four different floors of the five-story building where it is
located. It is inconvenient and there will be a time when the
clinic will want to try to consolidate all these services in one
space. There isn't space in the existing building, so the
clinic has purchased a lot across the street, and it has been
thought that the clinic would put all these testing facilities
in one building. This current lack of clarity in the definition
may require the clinic to go through the CON process just to
move existing services to a better building, he said.
Number 0918
MR. SLOCUM said he is concerned with the leasing portion of this
bill. He told the members that he finds it highly ironic that
some of the organizations that are supporting this bill are the
very organizations who used that loophole to build its $10
million facility. Once an organization has its own facility
then it wants to "slam the door in the face of others." He said
he doubted that those who are urging the support of this bill
have thought through all the implications. For example,
currently medical space in Fairbanks rents for $2.50 per square
foot per month for fully serviced space. That means that if
there were 2,500 square feet of medical space that someone
wanted to lease for ten years with two five year options to
renew, the total of those payments for 20 years would be $1.5
million. Even using the net present value calculation to bring
that back to today's dollars, that would be over $1 million and
would required a company to go through the CON process just to
rent the space.
MR. SLOCUM explained that the old law does not require the
addition of adding the value of telephones and computers. The
new language suggests strongly that the value of the space and
any equipment required to operate the facility be included. He
told the members that he believes that language is too broad and
urged the elimination of the "lease of space" language. If not,
then any minor project for clinics like Tanana Valley will
trigger that CON process and it will result in the inability for
the clinic to ever go forward. Mr. Slocum summarized that he
does not believe this was the intent of the sponsor or other
groups who support the bill.
Number 1056
REPRESENTATIVE GATTO asked how much it would cost the clinic to
obtain a CON on the most minimal of expenditures.
MR. SLOCUM responded that he does not know, because it would
depend on whether or not the CON request was contested or how
much information the department requested. He told the members
that a couple of years ago when the clinic was exploring the
idea of building an ambulatory surgery center, it was determined
that it would require a change to the law, and it cost the
clinic over $100,000 in direct costs. In response to
Representative Gatto's question, he responded that the CON
process took 18 months.
Number 1114
CHAIR WILSON announced the HB 511 will be held in committee.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:00 p.m.
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