Legislature(2021 - 2022)DAVIS 106

02/22/2022 03:00 PM House HEALTH & SOCIAL SERVICES

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Audio Topic
03:21:29 PM Start
03:22:25 PM HSCR2
04:10:23 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to 3:15 pm --
*+ HSCR 2 DISAPPROVING EXECUTIVE ORDER 121 TELECONFERENCED
Heard & Held
-- Invited & Public Testimony --
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                       February 22, 2022                                                                                        
                           3:21 p.m.                                                                                            
                                                                                                                                
                             DRAFT                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Liz Snyder, Co-Chair                                                                                             
Representative Tiffany Zulkosky, Co-Chair                                                                                       
Representative Ivy Spohnholz                                                                                                    
Representative Zack Fields                                                                                                      
Representative Ken McCarty                                                                                                      
Representative Mike Prax                                                                                                        
Representative Christopher Kurka                                                                                                
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
OTHER LEGISLATORS PRESENT                                                                                                     
                                                                                                                                
Representative Andy Josephson                                                                                                   
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE SPECIAL CONCURRENT RESOLUTION NO. 2                                                                                       
Disapproving Executive Order No. 121.                                                                                           
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HSCR 2                                                                                                                  
SHORT TITLE: DISAPPROVING EXECUTIVE ORDER 121                                                                                   
SPONSOR(s): HEALTH & SOCIAL SERVICES                                                                                            
02/22/22       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/22/22       (H)       HSS                                                                                                    
02/22/22       (H)       HEALTH & SOCIAL SERVICES at 03:00 PM                                                                   
                         DAVIS 106                                                                                              
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
ANDREW DUNMIRE, Legislative Counsel                                                                                             
Legislative Legal Services                                                                                                      
Legislative Affairs Agency                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Answered questions  during the  hearing on                                                             
HSCR 2.                                                                                                                         
                                                                                                                                
STACIE KRALY, Director                                                                                                          
Civil Division (Juneau)                                                                                                         
Department of Law                                                                                                               
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Answered questions  during the  hearing on                                                             
HSCR 2.                                                                                                                         
                                                                                                                                
ADAM CRUM, Commissioner                                                                                                         
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION  STATEMENT:   Answered questions  during the  hearing on                                                             
HSCR 2.                                                                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:21:29 PM                                                                                                                    
                                                                                                                                
CO-CHAIR LIZ SNYDER  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:21   p.m.                                                               
Representatives  Spohnholz,  Fields,  McCarty, Prax,  and  Snyder                                                               
were present  at the  call to order.   Representatives  Kurka and                                                               
Zulkosky arrived  as the meeting  was in progress.   Also present                                                               
was Representative Josephson.                                                                                                   
                                                                                                                                
             HSCR 2-DISAPPROVING EXECUTIVE ORDER 121                                                                        
                                                                                                                                
3:22:25 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SNYDER announced  that the only order  of business would                                                               
be  HOUSE  SPECIAL  CONCURRENT  RESOLUTION  NO.  2,  Disapproving                                                               
Executive Order No. 121.                                                                                                        
                                                                                                                                
3:23:24 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SNYDER, in response  to Representative McCarty, reviewed                                                               
that in  order to  make any  changes to  an executive  order, the                                                               
legislature must  draft legislation, and  that is the  purpose of                                                               
HSCR 2.                                                                                                                         
                                                                                                                                
3:25:25 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ  asked whether the administration  could still                                                               
introduce a bill after the personal legislation deadline.                                                                       
                                                                                                                                
3:25:46 PM                                                                                                                    
                                                                                                                                
ANDREW DUNMIRE, Legislative  Counsel, Legislative Legal Services,                                                               
Legislative  Affairs  Agency,  confirmed that  the  governor  may                                                               
introduce bills after the personal legislation deadline.                                                                        
                                                                                                                                
3:26:01 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SNYDER   noted  that  the  committee   had  heard  from                                                               
Legislative Legal  and Research  Services, the Department  of Law                                                               
(DOL), and  the Department of  Health and Social  Services (DHSS)                                                               
during the  previous meeting  on Saturday.   She  highlighted the                                                               
issue of potential additions and  subtractions to EO 121 that may                                                               
broaden or reduce legislative authority.                                                                                        
                                                                                                                                
CO-CHAIR SNYDER  highlighted Sections 28,  29, 133, and 65.   She                                                               
questioned whether  a change  in wording of  Section 28  would be                                                               
considered a broadening  of authority.  She noted that  DOL had a                                                               
response and  asked Mr. Dunmire to  give a brief overview  of the                                                               
concerns outlined in his memorandum ("memo").                                                                                   
                                                                                                                                
3:28:32 PM                                                                                                                    
                                                                                                                                
MR.  DUNMIRE responded  that under  AS  44.29.020(a), DHSS  shall                                                               
administer "state  programs including" [emphasis  on "including"]                                                               
and  observed that  under  current Alaska  state  law, the  legal                                                               
definition of including - "including  but not limited to"   means                                                               
the  proposed  Department  of  Health  (DOH)  would  be  able  to                                                               
administer any state program.                                                                                                   
                                                                                                                                
CO-CHAIR  SNYDER  asked  if  the  word  "including"  was  a  less                                                               
concerning issue than the removal  of the specification of public                                                               
health and social services related programs under EO 121.                                                                       
                                                                                                                                
MR. DUNMIRE responded that Co-Chair  Snyder was correct; however,                                                               
if that phrase is removed, the issue wouldn't be present.                                                                       
                                                                                                                                
3:30:18 PM                                                                                                                    
                                                                                                                                
MR. DUNMIRE,  in response to Representative  McCarty, offered his                                                               
understanding that statute currently  lists the programs assigned                                                               
to  departments;   however,  he   reiterated  that  the   use  of                                                               
"including" does  not limit the  department to what  is currently                                                               
listed.  In  response to a follow-up question,  he indicated just                                                               
one section in EO 121 laid out  the programs that would be run by                                                               
DOH.                                                                                                                            
                                                                                                                                
3:33:59 PM                                                                                                                    
                                                                                                                                
STACIE KRALY,  Director, Civil  Division (Juneau),  Department of                                                               
Law,   in   response   to  Representative   McCarty's   question,                                                               
highlighted Section  41 of  EO 121,  which provides  a multi-page                                                               
list  of  items  that  DOH  would  manage  as  a  result  of  the                                                               
reorganization.   She mentioned the instructions  to the advisor,                                                               
which  are  in Section  134  and  135.    She stated  that  every                                                               
division has  its own statutory  scheme under which  it operates.                                                               
For example, she stated that  the Division of Healthcare Services                                                               
operates the  Medicaid system,  and all  of the  provisions under                                                               
the statute  relating to  Medicaid are  currently found  under AS                                                               
47.05 and  AS 47.07.   She stated, "Those references  are further                                                               
clarified  and reassigned  and  reorganized  under the  executive                                                               
order through  instructions to  the advisor,  so it's  clear that                                                               
those  duties  ...  [would  be]  assumed  by  the  Department  of                                                               
Health."  She offered further  examples of where the instructions                                                               
for  other divisions  are  found under  statute  and how  further                                                               
instructions  to the  advisor clarifies  the  management role  of                                                               
DOH.  In  response to Representative McCarty,  she confirmed that                                                               
"the  totality of  the  executive order  frames  the duties  that                                                               
apply to each one of the departments."                                                                                          
                                                                                                                                
3:37:57 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SNYDER  observed that  the language  in that  section is                                                               
"loose," and  some may be  concerned that it  may open up  a door                                                               
for DOH to engage in activities  within DFCS, for example.  Other                                                               
sections in EO 121 may point  to more specific duties.  She asked                                                               
if that summation was correct.                                                                                                  
                                                                                                                                
MS.  KRALY responded,  "That's exactly  right."   She added  that                                                               
when  looking  at  the  entirety  of EO  121,  how  statutes  are                                                               
constructed,  and  how  the administration  has  reallocated  the                                                               
divisions under  the executive order,  "it would be kind  of hard                                                               
to ... add those additional  far-flung ideas to the Department of                                                               
Health."                                                                                                                        
                                                                                                                                
3:39:45 PM                                                                                                                    
                                                                                                                                
MR. DUNMIRE, in  response to Co-Chair Snyder,  confirmed that the                                                               
only  way to  change  the  executive order  would  be  to pass  a                                                               
concurrent resolution; there is no way to amend EO 121 directly.                                                                
                                                                                                                                
MS. KRALY concurred.                                                                                                            
                                                                                                                                
3:40:27 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  FIELDS  suggested it  would  make  more sense  to                                                               
address EO 121 and HSCR 2 simultaneously.                                                                                       
                                                                                                                                
MS. KRALY responded  that that is one way to  do it; however, she                                                               
explained that the administration  wants to ensure everything has                                                               
been identified "through this process"  so that "we are not doing                                                               
successive companion bills."                                                                                                    
                                                                                                                                
REPRESENTATIVE FIELDS  opined that  it would  be "cleaner"  to do                                                               
both at the same time.                                                                                                          
                                                                                                                                
MS.  KRALY disagreed.   She  said the  idea that  [EO 121]  is an                                                               
overreach is broad.   There are technical issues that  need to be                                                               
addressed.   She  speculated  this would  require  more than  one                                                               
companion bill  because "this is  a big  fix" to a  big document,                                                               
and the intent is "to get it right."   She added that some of the                                                               
things Legislative  Legal Services  thinks need  to be  fixed may                                                               
not  need to  be  fixed  because they  are  "more operational  in                                                               
implementation."                                                                                                                
                                                                                                                                
3:42:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRAX  expressed a conceptual obstacle  that "if we                                                               
do nothing,  this executive order  becomes effective."   He said,                                                               
"We  want to  do something  and nothing  at the  same time."   He                                                               
concluded, "We've got  a whole bunch of stuff to  go through, and                                                               
it might be good to just put this  in a parking lot and deal with                                                               
it later."                                                                                                                      
                                                                                                                                
3:43:29 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  ZULKOSKY expressed  that  there seems  to  be a  shared                                                               
desire  to remedy  programs  that  seem to  be  in  crisis.   She                                                               
acknowledged the  concern about  protecting the  institution with                                                               
respect  to  the  legislature  and  ensuring  the  constitutional                                                               
obligation to  set policy  is protected.   She asked  Mr. Dunmire                                                               
and  Ms. Kraly,  because an  executive order  cannot be  amended,                                                               
what  tools  are available  to  the  legislature to  protect  the                                                               
institution from  ceding its authority  to set policy.   She said                                                               
she understands the  concern expressed by Ms. Kraly  at the prior                                                               
meeting on  Saturday, regarding the cumbersome  process of making                                                               
this proposed change via legislation,  but she also expressed her                                                               
concern about any unintended  consequence regarding separation of                                                               
powers.                                                                                                                         
                                                                                                                                
3:46:30 PM                                                                                                                    
                                                                                                                                
MR. DUNMIRE  responded that EO  119 had been far  more egregious,                                                               
with blatant  statutory changes.   He said  he does not  think EO                                                               
121 "rises to  a level that it would risk  being invalidated by a                                                               
court ...  if the  legislature were  to not  disapprove it."   He                                                               
recommended  that the  legislature, in  protecting its  statutory                                                               
authority,  could  either  disapprove  EO 121  outright  or  make                                                               
changes by drafting a companion bill.                                                                                           
                                                                                                                                
3:47:55 PM                                                                                                                    
                                                                                                                                
CO-CHAIR ZULKOSKY asked Ms. Kraly  whether DOL or [DHSS] has made                                                               
recommendations on statute the legislature might consider.                                                                      
                                                                                                                                
MS. KRALY  responded that [DOL]  has an  idea of the  things that                                                               
may need some technical revision  but has not drafted a companion                                                               
bill to that  effect.  She expressed that some  of the issues can                                                               
be  fixed  through  a  revisor's   bill,  and  other  issues  may                                                               
necessitate  a  companion  bill.   In  response  to  a  follow-up                                                               
question,  she explained  that a  revisor's bill  is a  technical                                                               
bill that fixes things like typographical errors.                                                                               
                                                                                                                                
3:51:48 PM                                                                                                                    
                                                                                                                                
MR. DUNMIRE  added that  the revisor's ability  to change  law is                                                               
extremely  limited to  technical  matters.   Any  changes to  the                                                               
meaning  of  the  law  or  wording of  statute  would  require  a                                                               
companion bill.                                                                                                                 
                                                                                                                                
3:52:26 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   ZULKOSKY   highlighted   the  difficulty   with   time                                                               
constraints.  She  asked Ms. Kraly what the timeline  is in terms                                                               
of consideration of a companion bill.                                                                                           
                                                                                                                                
MS. KRALY  responded that she does  not have a date,  but that if                                                               
one looks at the history of  executive orders, some of which need                                                               
fixes, the  intention is  to make sure  that the  executive order                                                               
works, and any necessary fixes can  be made outside of the 60-day                                                               
timeline.                                                                                                                       
                                                                                                                                
3:55:43 PM                                                                                                                    
                                                                                                                                
ADAM  CRUM,   Commissioner,  Department  of  Health   and  Social                                                               
Services, to  the same line  of questioning, responded  that DHSS                                                               
would work to  address some of the large items  and get something                                                               
back to the legislature and ensure that options are presented.                                                                  
                                                                                                                                
3:56:26 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SPOHNHOLZ   offered   her   understanding   that                                                               
legislation is  the guidebook for  the thousands of  employees in                                                               
DHSS.   She expressed that  she is  reluctant to wait  until next                                                               
year  for companion  legislation for  the executive  order.   She                                                               
asked  Mr. Dunmire  for a  description  of the  process behind  a                                                               
revisor's bill versus a companion bill.                                                                                         
                                                                                                                                
MR. DUNMIRE  responded that he  is unable to answer  the question                                                               
because he has not worked as a revisor.                                                                                         
                                                                                                                                
3:58:31 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MCCARTY speculated  on  the  amendments or  edits                                                               
that may need  to be made and the importance  of getting it right                                                               
at the beginning rather than waiting a year, for example.                                                                       
                                                                                                                                
3:59:53 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   SNYDER   asked    about   "potential   additions   and                                                               
subtractions."    She turned  attention  to  AS 44.29.020,  which                                                               
lists the duties  of DHSS.  She  noted that Section 29  of EO 121                                                               
states  that   DOH  would  establish  regulation   of  "scheduled                                                               
reasonable fees"  for services provided  by the department.   She                                                               
mentioned  there is  another section  that addresses  DFCS.   She                                                               
indicated it  would be  reasonable to think  the duties  from one                                                               
are transferred  to the other  without change, but in  the subset                                                               
of duties  directed to  DFCS, what  was "Child  Welfare Services"                                                               
under   AS  44.29.020(a)(12)   would   be   "Child  Welfare   and                                                               
Delinquency Services" under  EO 121.  She asked  where the change                                                               
came  from and  what the  implications might  be.   She clarified                                                               
that is in Section 36 of EO 121.                                                                                                
                                                                                                                                
4:03:04 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SNYDER,  in  response   to  Ms.  Kraly,  clarified  her                                                               
question.                                                                                                                       
                                                                                                                                
MS. KRALY responded  that within DFCS would be  the Pioneer Home,                                                               
the  Division  of  Juvenile Justice,  Delinquency  Services,  the                                                               
Office  of Children's  Services,  Child Welfare,  and the  Alaska                                                               
Psychiatric Institute.   She explained, "So, what  we were trying                                                               
to do was identify the  programs that would be administered under                                                               
the department,"  to "replicate  the intent  and the  language of                                                               
the  previous statute"  but "to  create this  new statute."   She                                                               
emphasized, "It's not an addition; it's  not a new program."  She                                                               
further  explained that  this  was  framed in  a  way that  would                                                               
describe what was  being assigned from the old  department to the                                                               
new one.                                                                                                                        
                                                                                                                                
CO-CHAIR SNYDER said she understood  but commented that "it seems                                                               
to  open  the  door  for   some  additional  programming."    She                                                               
questioned the rationale.                                                                                                       
                                                                                                                                
MS.  KRALY answered  that the  rationale was  to ensure  that the                                                               
provisions under AS  44.29 matched the duties under  AS 44.05 and                                                               
44.06,  because  there  was  no   reference  to  the  delinquency                                                               
programs, and  clearly those programs  are managed by DHSS.   She                                                               
concluded, "It's an  existing program in [a]  division within the                                                               
department  that needed  to be  allocated  within this  executive                                                               
order."   In response to  Co-Chair Snyder, she  further clarified                                                               
that it  reassigns all existing programs  to at least one  of the                                                               
two new departments [formed under EO 121].                                                                                      
                                                                                                                                
4:08:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SPOHNHOLZ  said she understands both  sides of the                                                               
discussion.   She pointed to  "management of  state institutions"                                                               
on  page 44,  line  2, of  EO  121, and  said  it references  the                                                               
Division  of  Juvenile  Justice;   line  3  includes  Delinquency                                                               
Services.  She said  it seems that two terms of  art were used to                                                               
describe the same services, but  she asked if they mean different                                                               
things.                                                                                                                         
                                                                                                                                
MS. KRALY  responded that there  was nothing intended  other than                                                               
to  clarify the  existing  programs being  allocated  to the  two                                                               
departments; "they are not intended for different purposes."                                                                    
                                                                                                                                
4:09:36 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SNYDER made brief closing comments.                                                                                    
                                                                                                                                
4:10:23 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 4:10 p.m.                                                                                                          

Document Name Date/Time Subjects
EO 121, Legislative Legal Department Memo, 2.14.22.pdf HHSS 2/22/2022 3:00:00 PM
EO 121
HSCR 2
EO 121 Packet 2.18.2022.pdf HHSS 2/22/2022 3:00:00 PM
EO 121
HSCR 2
Law response to 2.14.22 Leg Legal memo_Final1.pdf HHSS 2/22/2022 3:00:00 PM
EO 121
HSCR 2
HSCR02A.PDF HHSS 2/22/2022 3:00:00 PM
EO 121
HSCR 2
HHSS EO121 Legislative Communication Summary Response- (2-22-22).pdf HHSS 2/22/2022 3:00:00 PM
EO 121
HSCR 2
HB 308 LOS.pdf HHSS 2/22/2022 3:00:00 PM
HB 308
HB 308 Written Testimony as of 2-22-22.pdf HHSS 2/22/2022 3:00:00 PM
HB 308