03/13/2007 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Overview: Division of Childrens Services, Citizen Review Panel | |
| HB100 | |
| HCR1 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HCR 1 | TELECONFERENCED | |
| += | HB 100 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
March 13, 2007
3:04 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Bob Roses, Vice Chair
Representative Anna Fairclough
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Mark Neuman
Representative Paul Seaton
OTHER LEGISLATORS PRESENT
Senator Bettye Davis
Representative John Coghill
COMMITTEE CALENDAR
OVERVIEW: CITIZEN REVIEW PANEL OF THE OFFICE OF CHILDREN'S
SERVICES
- HEARD
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 100
"An Act relating to exempting certain air ambulance services
from insurance regulation and requiring certain air ambulance
services to provide services."
- HEARD AND HELD
HOUSE CONCURRENT RESOLUTION NO. 1
Relating to public health and a health compact.
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 100
SHORT TITLE: AIR AMBULANCE SERVICES
SPONSOR(s): REPRESENTATIVE(s) COGHILL
01/16/07 (H) READ THE FIRST TIME - REFERRALS
01/16/07 (H) HES, L&C
02/15/07 (H) SPONSOR SUBSTITUTE INTRODUCED
02/15/07 (H) READ THE FIRST TIME - REFERRALS
02/15/07 (H) HES, L&C
02/22/07 (H) HES AT 3:00 PM CAPITOL 106
02/22/07 (H) <Bill Hearing Canceled>
03/01/07 (H) HES AT 3:00 PM CAPITOL 106
03/01/07 (H) Heard & Held
03/01/07 (H) MINUTE(HES)
03/13/07 (H) HES AT 3:00 PM CAPITOL 106
BILL: HCR 1
SHORT TITLE: PUBLIC HEALTH AND HEALTH COMPACT
SPONSOR(s): REPRESENTATIVE(s) CISSNA
01/22/07 (H) READ THE FIRST TIME - REFERRALS
01/22/07 (H) HES
03/13/07 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
FRED VAN WALLINGA, Chair
Citizen Review Panel
for the Office of Children's Services
Department of Health & Social Services
Willow, Alaska
POSITION STATEMENT: Provided the presentation by the Citizen
Review Panel.
SUSAN HEUER, Member
Citizen Review Panel
for the Office of Children's Services
Department of Health & Social Services
Anchorage, Alaska
POSITION STATEMENT: Testified during the presentation by the
Citizen Review Panel.
SENATOR BETTYE DAVIS, Member
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during the presentation by the
Citizen Review Panel.
KARLEEN JACKSON, Commissioner
Department of Health & Social Services
Juneau, Alaska
POSITION STATEMENT: Testified as the commissioner of the
Department of Health & Social Services.
KAREN LIDSTER, Staff
to Representative John Coghill
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions regarding the amendments
to SSHB 100.
IRIS MATTHEWS, Staff
to Representative Berta Gardner
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on
SSHB 100.
ART WARBELOW, President
Warbelow's Air Ventures, Inc.
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to SSHB 100.
PAUL HARRIS, General Manager
Guardian Flight, Inc.
Fairbanks, Alaska
POSITION STATEMENT: Testified during the hearing on SSHB 100.
ERIC STERLING, Owner
Guardian Flight, Inc.
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of SSHB 100.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:04:13 PM.
Representatives Wilson, Roses, Fairclough, and Gardner were
present at the call to order. Representative Cissna arrived as
the meeting was in progress.
^OVERVIEW: DIVISION OF CHILDRENS SERVICES, CITIZEN REVIEW PANEL
3:04:50 PM
CHAIR WILSON announced that the first order of business would be
a presentation by the Citizen Review Panel for the Office of
Children's Services (OCS), Department of Health & Social
Services (DHSS).
3:05:27 PM
FRED VAN WALLINGA, Chair, Citizen Review Panel ("panel"), asked
each volunteer Panel Review Member to stand and introduce
themselves to the committee.
3:07:30 PM
CHAIR WILSON asked about the origin of the Citizen Review Panel.
MR. VAN WALLINGA answered that, in 1996, the federal government
mandated the oversight of children's services by a citizens
review panel in each state. The panels are funded by the states
and are directed to observe the policies and procedures of
children's services offices, and to ensure that every state is
in compliance with regulatory procedures. The Alaska panel has
been most active in the last two and one-half years, and closely
reviews areas of concern that are brought to its attention. In
addition, the panel writes an annual review that is submitted to
the deputy commissioner of OCS, and to the legislature. The
panel also publishes its findings on a website for the public.
3:09:47 PM
MR. VAN WALLINGA explained that the panel is the only group in
Alaska mandated by the federal government and funded by the
state. Volunteer members are selected from all areas of the
state for unlimited terms. He also pointed out that travel and
written reviews demand much of the member's time.
3:11:01 PM
CHAIR WILSON asked how many hours members have worked during the
past year.
MR. VAN WALLINGA responded that thousands of volunteer hours are
devoted to the duties of the panel.
3:11:50 PM
CHAIR WILSON informed the committee that OCS will have an
opportunity to comment on the panel's report during its
presentation at a later date.
3:12:03 PM
SUSAN HEUER, Member, Citizen Review Panel, relayed that the
federal mandate to review the policies and procedures of OCS is
a large job to be competed by eight volunteers. In 2006, the
panel began its work in the Matanuska-Susitna (Mat-Su) valley by
beginning a site review among service providers. Contacts were
made with the troopers, the child advocacy centers, children's
services contractors, the schools, the Anchorage Police
Department (APD), and the Department of Juvenile Justice (DJJ).
The panel then issued its annual report to the federal
government and to the legislature. As a result of the panel's
site review report, the commissioner of DHSS hired an outside
auditor to provide an external audit. The additional report was
issued last year on the panel's findings; however, the report
has not been made available to the panel. Ms. Heuer expressed
the panel's desire to review the OCS report. She explained that
the review panel traveled to Juneau with the following goals:
reviewing the OCS external report, reporting its findings to
this committee, and voicing its concerns to OCS regarding the
breakdown of children's services in the Mat-Su valley.
3:16:03 PM
MS. HEUER further explained that the panel recently received
notification that OCS employees in the Wasilla and Mat-Su areas
have filed a grievance against OCS. However, following a
lengthy meeting with OCS department heads on 3/12/07, these
concerns were put to rest. The panel, she said, is now
confident that the department is responding to issues and is in
accord with what the panel has reported. The department agreed
to release its report for the panel's review, and the panel is
confident that the department will act on its promises. The
panel will continue to closely monitor the situation in the Mat-
Su valley.
3:19:06 PM
MS. HEUER further informed the committee that the panel also met
with the Tribal/State Collaboration Group (T/SCG) which is
working with OCS to assist Native children whose parents or
guardians are on welfare. The tribes and OCS will be working
together and the panel will assist in this effort. She stated
that fifty-nine percent of the children in state custody are
Native. Ms. Heuer said that she is encouraged by the many
people working on this problem. The bureaucracies that have not
spoken meaningfully on this topic are beginning to have
dialogue, and successful models are being created in the state
for other areas to follow. She opined that, although funds are
available, many children in the state suffer in difficult
situations.
3:22:07 PM
MS. HEUER relayed that the Alaska National Indian Child Welfare
Act Association (ICWA) is presently working well with OCS, and
will serve as a model for agencies throughout the state. Ms.
Heuer said that the panel will issue a new report in June, and
expects to report significant changes. She expressed her belief
that OCS will be open with the changes that are needed. The
panel's two year goal is to improve tribal relationships and
foster parent relationships with OCS. To accomplish this panel
members will travel across the state to identify the problems in
rural areas.
3:23:53 PM
REPRESENTATIVE CISSNA expressed her concern that the panel, as
late as yesterday, did not have adequate communication with OCS.
It is also troubling, she said, to hear how the panel seems to
be the leading agency searching for solutions to problems within
OCS. She asked what efforts were made to communicate with the
department.
3:25:09 PM
MR. VAN WALLINGA replied that the panel traveled to Juneau to
present its findings and he said that he felt angry due to the
lack of communication with OCS. As an administrator, he was
frustrated that progress was minimal and that excuses were being
made. When the OCS commissioner and deputy commissioner met
with the panel, a new atmosphere of accord became apparent. The
department presented a clear plan of how improvements will be
made. The panel will hold the department accountable for the
implementation of the plan, and include in its annual report
progress, or the lack of progress. The panel represents the
people of Alaska and its mandate is to oversee the service to
children that is provided by the state, in a confidential
manner.
3:28:34 PM
MR. VAN WALLINGA stated that the panel's major concern continues
to be facilitating better communication and partnership between
OCS and the tribes of Alaska. The panel recommends improving
communication by having the deputy commissioner visit the
outlying villages, not just the hub communities. In addition,
caseworkers and families in the rural areas need support. Also,
consistent full reporting from OCS is vital. Further, the panel
recommends continuity in the interpretation of laws across the
state. Mr. Van Wallinga concluded by saying that the panel
recognizes that OCS does have successful outcomes.
3:30:48 PM
REPRESENTATIVE CISSNA observed that there is a disconnect
between the panel and OCS.
MR. VAN WALLINGA responded that the panel was invited to a
senior management meeting and that was helpful in improving
communication. He also suggested that panel members can
accompany OCS officials to villages for further support.
Working closely on that level, and shoulder to shoulder, would
be an important tool to improve communication between the panel
and OCS.
3:32:58 PM
CHAIR WILSON asked why some villages are working better with OCS
than others.
MR. VAN WALLINGA stressed that it is just the communication
factor. The nature of a bureaucracy blocks communication and
that is why the deputy commissioners must travel to the Bush.
In the Tribal/State caucus members speak of the differences
between villages that are 20 minutes outside of a regional hub
such as Barrow.
3:35:07 PM
REPRESENTATIVE GARDNER spoke of her experience as a Guardian ad
Litem (GAL), and asked members to imagine what it is like to be
a family, in this type of system, that is not working well.
Even as frustrating as it is for the caseworker and the
agencies, it is even more difficult for the families.
MR. VAN WALLINGA said that, in the past, the deputy commissioner
put out a policy simply to return phone calls. But,
unfortunately, officials do not always return phone calls.
REPRESENTATIVE GARDNER added that recruitment and retention of
foster families is difficult and that returning phone calls
becomes crucial.
MR. VAN WALLINGA also noted that foster families are not paid in
a timely manner.
3:37:50 PM
REPRESENTATIVE FAIRCLOUGH asked whether the audit referred to
was an internal, or external, audit and the dates thereof.
MR. VAN WALLINGA answered that the external audit completion
date was in November, 2006, and the panel requested to see the
audit in January, 2007.
3:39:29 PM
SENATOR BETTYE DAVIS, Alaska State Legislature, stated that
minority children are over represented in the statistics of
children in OCS custody. She stressed the importance of keeping
children out of the system and pointed out that the report does
not address that.
3:40:40 PM
MS. HEUER replied that OCS must collaborate with partner
agencies, such as, tribes, GALs, therapists, and educators, both
before and after children come into custody. Many children may
not come into OCS custody if the community network around them
is more supportive.
3:42:03 PM
SENATOR DAVIS added that other minority children are also over
represented. She invited the panel chair to meet with her for
recommendations to address the problem.
MR. VAN WALLINGA opined that there are too many children in
custody period.
3:43:10 PM
CHAIR WILSON stated that it is important to put money into
prevention. She added that the appointment of Karleen Jackson
as the commissioner of DHSS will provide continuity for the
department.
3:44:49 PM
REPRESENTATIVE GARDNER expressed her concern about the slow
process necessary to return a child to his/her home.
MR. VAN WALLINGA opined that there is no answer to that problem
at this time; however, the panel will focus on this issue in the
near future.
REPRESENTATIVE GARDNER recalled that, as a court-appointed
special advocate (CASA), she advocated for a boy who was placed
out of state at 7 years of age. When he returned, at age 14,
his father was dead, and he did not know his land. She feels
that he was forgotten when he was sent to Utah.
3:47:36 PM
REPRESENTATIVE ROSES expressed his belief that the DHSS
commissioner is willing to address problems in her department
with openness, candor, and sincerity. He assured the panel that
the department will be held accountable to follow through on its
promises.
3:49:36 PM
REPRESENTATIVE FAIRCLOUGH recognized the panel members for their
service.
3:50:19 PM
KARLEEN JACKSON, Commissioner, Department of Health & Social
Services (DHSS), stated that "this is a new day." She said that
the audit report will be available to the committee and the
panel in two weeks. She explained why the external review was
commissioned, and how that data is to be used. Commissioner
Jackson said that the department should be held accountable and
pledged to be honest on the progress and attainment of goals.
She expects to see changes and improvement over the next four
years and described her meeting with the panel as beneficial to
all parties.
3:53:51 PM
REPRESENTATIVE ROSES reiterated the importance of the timeliness
of reports and described how people become disenfranchised
easily when delays occur.
3:55:15 PM
REPRESENTATIVE CISSNA expressed her hope that the volunteers on
the panel will be appreciated for their efforts.
COMMISSIONER JACKSON observed that the deputy commissioners have
begun to meet more often with the panel. She stated that the
panel members are a valuable resource to her department and she
embraces the offer of the members to travel to villages with the
deputy commissioners. Commissioner Jackson concluded by saying
that her department will work with the panel in its role as a
review board, and also as a partner in improving services to
children.
HB 100-AIR AMBULANCE SERVICES
3:57:58 PM
CHAIR WILSON announced that the next order of business would be
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 100, "An Act relating to
exempting certain air ambulance services from insurance
regulation and requiring certain air ambulance services to
provide services."
3:58:50 PM
KAREN LIDSTER, Staff to Representative John Coghill, Alaska
State Legislature, sponsor, offered to answer questions
regarding the amendments to SSHB 100.
4:00:12 PM
REPRESENTATIVE ROSES moved to adopt Amendment 1, 25-LS0373\E.1,
Bailey, 3/13/07, which read:
Page 1, line 7, following "person.":
Insert "In this section, "air ambulance service"
means an organization certified by the department
under AS 18.08.082 to provide medically assisted
transportation, by air, to persons who are ill or
injured."
Page 1, line 9, following "service":
Insert ", as defined in AS 18.08.095,"
CHAIR WILSON objected.
4:01:41 PM
MS. LIDSTER informed the committee that the definition of air
ambulance service was suggested by Shelly Owens of the Emergency
Medical Service (EMS) unit.
4:02:13 PM
CHAIR WILSON removed her objection. There being no further
objection, Amendment 1 was adopted.
4:02:23 PM
REPRESENTATIVE GARDNER moved Amendment 2, 25-LS0373\E.2, Bailey,
3/13/07, which read:
Page 1, line 1, following "regulation":
Insert ", limiting the duration of air ambulance
service subscriptions,"
Page 1, line 5, following "services.":
Insert "(a)"
Page 1, following line 7:
Insert a new subsection to read:
"(b) An air ambulance service may not issue a
subscription for a period greater than two years."
REPRESENTATIVE ROSES objected.
4:02:30 PM
REPRESENTATIVE GARDNER stated that the purpose of Amendment 2 is
to minimize the risk exposure, for individuals who are not
sophisticated insurance consumers, by limiting the length of the
subscription to two years. She added that subscriptions for air
ambulance services are not regulated.
4:03:58 PM
REPRESENTATIVE ROSES asked how limiting the subscription to two
years will help the consumer. The risk to the consumer is that
the service that they have paid for may not be available.
CHAIR WILSON noted that the current subscription limit is for
one year.
REPRESENTATIVE GARDNER explained that the limit prohibits a flat
rate subscription for a life-time membership.
4:05:01 PM
CHAIR WILSON corrected her statement and said that the amendment
specifies [not] "for a period greater than two years."
REPRESENTATIVE ROSES clarified that the subscriptions would be
limited to a maximum of two years, and the original bill did not
have a time limit.
4:05:55 PM
REPRESENTATIVE CISSNA noted that a consumer living in rural
Alaska may be at fish camp or elsewhere during part of the year.
Often they may not have the logistical means to receive mail or
to maintain telephone connections. She suggested that a longer
term would benefit consumers and the business selling the
service.
4:08:34 PM
CHAIR WILSON pointed out that an air ambulance service can not
sell a membership to a subscriber unless it has been in business
in Alaska for two years.
CHAIR WILSON stated that Representative Cissna's comments
pertain to a different issue that can be set aside for later
consideration.
REPRESENTATIVE CISSNA reiterated that, from the consumer's point
of view, it would be difficult to subscribe for only two years.
Consumers need to get the best kind of service available and may
have a difficult time renewing every two years. Representative
Cissna offered an amendment to Amendment 2 which replaces "two"
with "five" years.
REPRESENTATIVE GARDNER objected for discussion purposes. She
opined that most of the consumers, who will be served by SSHB
100, have seasonal work and travel patterns and will, thereby,
be available for renewal within a two year period.
REPRESENTATIVE ROSES expressed his doubt about the intent of
SSHB 100 and emphasized that this subscription is not an
insurance policy. Consumers do not have the protection of
insurance regulation and are subscribing, with good faith, that
the seller will continue to be in business for the duration of
the contract. It is more comfortable to consider that a
business will still be available in two, rather than five,
years. He opposed the amendment to Amendment 2.
4:12:35 PM
REPRESENTATIVE CISSNA withdrew her amendment to Amendment 2.
4:12:45 PM
REPRESENTATIVE ROSES removed his objection to Amendment 2.
There being no further objection, Amendment 2 was adopted.
4:13:06 PM
REPRESENTATIVE GARDNER offered Amendment 3, labeled 25-
LS0373\E.3, Bailey, 3/13/07, which read:
Page 1, line 1, following "regulation":
Insert ", prohibiting sale of air ambulance
services to persons already covered,"
Page 1, line 5, following "services.":
Insert "(a)"
Page 1, following line 7:
Insert a new subsection to read:
"(b) An air ambulance service may not sell a
subscription to a person who has full coverage for air
ambulance services from another source, including the
Indian Health Service, Medicaid, or private
insurance."
REPRESENTATIVE ROSES objected.
REPRESENTATIVE GARDNER explained that Amendment 3 will protect
the consumer who already has full coverage insurance benefits
for air ambulance services. She added that it will be up to the
company selling the subscription to make that determination.
4:14:21 PM
REPRESENTATIVE ROSES confirmed that the burden of responsibility
is on the person selling the subscription.
REPRESENTATIVE GARDNER noted her agreement.
4:14:50 PM
CHAIR WILSON asked whether consumers always know the extent of
their insurance coverage.
REPRESENTATIVE GARDNER responded that consumers and the
subscription sellers are responsible for that determination.
4:16:03 PM
REPRESENTATIVE FAIRCLOUGH observed that SSHB 100 will regulate
an insurance product that should be governed under the insurance
laws in the state. She referred to previous testimony by
[director, Division of Insurance, Department of Commerce,
Community & Economic Development] Hall and expressed her belief
that this committee should not be attempting to address this
issue.
REPRESENTATIVE GARDNER responded that the state has determined
that the subscriptions are not an insurance product. She quoted
Ms. Hall, who said "the sales of memberships are not insurance".
4:17:56 PM
CHAIR WILSON stated that SSHB 100 will be held for further
clarification of this question.
4:18:16 PM
MS. LIDSTER stated her agreement with Ms. Hall's testimony. She
said that SSHB 100 takes air ambulance services out from under
the insurance code, and allows them to sell memberships. The
memberships are not subject to the conditions and code
regulations in that statute. She said that small businesses
cannot bear the burden of the bonding and audit requirements of
the insurance code. Ms. Lidster added that other states have
taken this action to encourage service in underserved regions.
CHAIR WILSON said the state has not acknowledged that.
4:19:40 PM
REPRESENTATIVE ROSES encouraged the committee to hear additional
discussion on this bill and to continue with the public
testimony.
4:20:10 PM
REPRESENTATIVE GARDNER continued to say that if the bill passes
and the insurance regulations are removed, Amendment 3 will
protect consumers who do not need air ambulance service
memberships.
CHAIR WILSON opined that there are many people who do not have
insurance and they could subscribe to this service. Many people
in rural areas could utilize this service in the case of a
Medivac. Chair Wilson shared that she owns a subscription to a
service.
REPRESENTATIVE GARDNER clarified that Amendment 3 applies only
to consumers with 100 percent coverage.
4:23:00 PM
REPRESENTATIVE ROSES expressed his understanding of the intent
of the bill and the amendment. He then asked for the
consequence of selling a policy to a consumer with full
coverage.
4:23:33 PM
MS. LIDSTER explained that a complaint from a consumer would be
referred to the consumer protection agency.
4:24:53 PM
REPRESENTATIVE ROSES further observed that the consumer
protection agency would intervene if someone bought a
subscription and the service was not provided, but not if a
subscription was sold to someone in error. He recommended
tabling the bill.
4:25:40 PM
REPRESENTATIVE GARDNER deferred the question to her aide.
4:26:08 PM
IRIS MATTHEWS, staff to Representative Berta Gardner, Alaska
State Legislature, informed the committee that the answer to
this question has not been determined by the Division of
Insurance, Department of Commerce, Community & Economic
Development (DCCED).
4:27:05 PM
REPRESENTATIVE GARDNER requested moving forward on the amendment
and referring further questions to the next committee.
4:27:37 PM
REPRESENTATIVE FAIRCLOUGH expressed her support for the
amendment; however, she reiterated her concern about whether the
sale of this service should be regulated under the insurance
statutes. She also requested further testimony from the
director of the Division of Insurance regarding the impact of
this legislation.
4:29:14 PM
REPRESENTATIVE ROSES asked whether the intent is to make the
service not part of an insurance policy. He opined that the
amendment directly connects the service to insurance.
REPRESENTATIVE FAIRCLOUGH added that there will be a
confidentiality issue regarding the release of information on
the consumer's existing coverage.
4:30:22 PM
REPRESENTATIVE GARDNER stated her indecision about the final
passage of the bill. However, she opined that a consumer could
sign a release to allow the subscription provider access to
confidential information.
REPRESENTATIVE FAIRCLOUGH expressed her doubt that a release
will satisfy regulations under the Health Insurance Portability
and Accountability Act (HIPPA).
CHAIR WILSON opined that a signed waiver is sufficient.
REPRESENTATIVE GARDNER expressed her belief that an insurance
policy is not subject to HIPPA.
4:32:08 PM
CHAIR WILSON announced that the committee will finish with this
amendment and take public testimony.
4:32:33 PM
REPRESENTATIVE ROSES moved to table Amendment 3. There being no
further discussion, Amendment 3 was tabled.
4:33:37 PM
ART WARBELOW, President, Warbelow's Air Ventures, Inc., informed
the committee that his business is the oldest certified air
support service in Fairbanks, and that he is opposed to SSHB
100. His concern is the increase in costs of gearing up to
compete in a membership program. The small operators will not
be able to compete at the state level. This bill will reduce
competition and determine success by who has the best marketing
and salesmanship versus the best medical service. Mr. Warbelow
said that the memberships will increase costs to consumers and
decrease the quality of patient care. He referred to previous
testimony by the representative from Guardian Flight, Inc., and
noted that Guardian has forecasted sales of memberships greatly
exceeding the amount of the deductibles paid normally by
consumers. The result is that air ambulance providers are well
compensated and take large write-offs for uncollectible service.
His primary concern is that the memberships are a insurance and
have been illegally sold in the state for the past six years.
He read from a related article in the "The Fairbanks Daily News-
Miner" dated 2/1/01, and concluded by saying that it is
problematic that a law is posed for passage to support a company
that has been operating outside of regulation.
4:40:12 PM
REPRESENTATIVE GARDNER requested that Mr. Warbelow provide the
committee with a copy of the news article.
4:40:35 PM
CHAIR WILSON asked whether Mr. Warbelow reports non-payments to
a collection agency.
MR. WARBELOW answered that the law requires that the services
attempt to collect; however, one-third of the bills are never
paid.
4:42:44 PM
REPRESENTATIVE ROSES referred to previous testimony and to the
100,000 subscriptions that Guardian expects to sell. This, he
said, appears to cover the amount of uncollectible fares for one
year. Representative Roses asked Mr. Harris whether the sales
would enable Guardian to lower the rates for service.
PAUL HARRIS, General Manager, Guardian Flight, Inc., stated that
the funds would be used for community service; for example,
additional first responder and emergency medical training.
REPRESENTATIVE ROSES further asked for Mr. Harris' opinion of
Amendment 3.
MR. HARRIS responded that Amendment 3 will require his company
to rely on the consumer to ascertain whether he/she has full
coverage or not. It could be unenforceable, and will eliminate
some people who need this service. Mr. Harris gave the example
of a pregnant patient who is covered by Medicaid until the
delivery of her child. He added that the Indian Health Service
also has gaps in coverage.
4:46:35 PM
REPRESENTATIVE ROSES further asked whether Amendment 3 reduces
Guardian's ability to sell 100,000 subscriptions.
MR. HARRIS said yes, and he will provide estimates for the
committee.
4:47:35 PM
ERIC STERLING, owner, Guardian Flight, Inc., informed the
committee that everyone has the possibility of being denied
coverage for a Medivac, especially when covered by Medicare,
Medicaid, and Blue Cross. Dr. Sterling continued to say that
regulations require a flight service to attempt to collect from
insurance and the patient. That was the basis for supporting
legislation to enable the sale of subscriptions. Guardian has
not sold memberships; however, it honors certificates sold by
Critical Care Inc. He noted that this legislation is the third
attempt to legalize the sale of memberships and stressed that is
a benefit to the consumer.
4:51:54 PM
CHAIR WILSON asked whether Guardian would refund a subscription
fee if it was unable to provide transportation due to
unavailability, location, or mechanical problems.
DR. STERLING answered yes. He stressed that the cost of a
Medivac is always reviewed by the insurance company and many
times coverage is denied, adjusted or negotiated.
4:53:22 PM
REPRESENTATIVE ROSES asked whether Dr. Sterling is a board
member of the non-profit that sells the memberships.
DR. STERLING answered yes. However, Guardian has not received
money for uncompensated care.
4:54:15 PM
REPRESENTATIVE GARDNER asked for clarification of the reasons
for supporting this legislation.
4:54:41 PM
DR. STERLING explained that, in 2001, Linda Hall, representing
the Division of Insurance, DCCED, advised him that to sell
memberships, Guardian would need to test the law, or change the
law through the legislature.
4:55:27 PM
CHAIR WILSON acknowledged that she had misunderstood Linda
Hall's testimony.
4:55:38 PM
REPRESENTATIVE GARDNER confirmed that Guardian is a for-profit
business and is prohibited from selling memberships; however, a
non profit may sell memberships.
DR. STERLING replied that the non profit is an educational and
research organization. Guardian donates to the non profit in
the form of Medivac services.
REPRESENTATIVE GARDNER stated that Guardian wants to be able to
sell the memberships directly.
DR. STERLING said yes. He said that Guardian's donation to the
non profit this year is estimated to be $4.5 million in
uncompensated care.
4:57:40 PM
CHAIR WILSON announced that SSHB 100 would be held over.
HCR 1-PUBLIC HEALTH AND HEALTH COMPACT
CHAIR WILSON announced that the final order of business would be
HOUSE CONCURRENT RESOLUTION NO. 1, Relating to public health and
a health compact.
4:59:31 PM
REPRESENTATIVE SHARON CISSNA, Alaska State Legislature, sponsor,
presented HCR 1. She informed the committee that HCR 1 is
unique, and points to the fact that Alaska has many negative
health indicators. In addition, $1,996,000,000 is spent
annually addressing health issues. Representative Cissna said
that this resolution seeks to ask the governor, and the
legislature, to invite the people of Alaska to celebrate their
own personal health, and to begin a statewide conversation about
personal health.
5:02:04 PM
CHAIR WILSON announced that HCR 1 would be held over.
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 5:02:04 PM.
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