03/21/2023 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s): Department of Family and Community Services | |
| HB57 | |
| HB46 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | HB 57 | TELECONFERENCED | |
| + | HB 46 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
March 21, 2023
3:03 p.m.
DRAFT
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Dan Saddler
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
Department of Family and Community Services
Kim Kovol Anchorage
- CONFIRMATION(S) ADVANCED
HOUSE BILL NO. 57
"An Act relating to review organizations and permitting an
emergency medical services provider to establish a review
organization; and relating to patient records."
- HEARD & HELD
HOUSE BILL NO. 46
"An Act allowing child care providers that receive state aid to
organize and collectively bargain with the Department of Health;
and establishing the child care provider fund."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 57
SHORT TITLE: EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
SPONSOR(s): REPRESENTATIVE(s) WRIGHT
02/03/23 (H) READ THE FIRST TIME - REFERRALS
02/03/23 (H) L&C, HSS
02/17/23 (H) L&C AT 3:15 PM BARNES 124
02/17/23 (H) Heard & Held
02/17/23 (H) MINUTE(L&C)
03/03/23 (H) L&C AT 3:15 PM BARNES 124
03/03/23 (H) Moved HB 57 Out of Committee
03/03/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT 4DP 1NR
03/06/23 (H) DP: SADDLER, PRAX, RUFFRIDGE, SUMNER
03/06/23 (H) NR: CARRICK
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 46
SHORT TITLE: CHILD CARE PROVIDER COLLECTIVE BARGAINING
SPONSOR(s): REPRESENTATIVE(s) FIELDS
01/25/23 (H) READ THE FIRST TIME - REFERRALS
01/25/23 (H) L&C, STA, FIN
01/30/23 (H) L&C AT 3:15 PM BARNES 124
01/30/23 (H) Heard & Held
01/30/23 (H) MINUTE(L&C)
02/10/23 (H) L&C AT 3:15 PM BARNES 124
02/10/23 (H) Heard & Held
02/10/23 (H) MINUTE(L&C)
02/20/23 (H) L&C AT 3:15 PM BARNES 124
02/20/23 (H) Heard & Held
02/20/23 (H) MINUTE(L&C)
02/27/23 (H) HSS REPLACES STA REFERRAL
02/27/23 (H) BILL REPRINTED
03/01/23 (H) L&C AT 3:15 PM BARNES 124
03/01/23 (H) Moved CSHB 46(L&C) Out of Committee
03/01/23 (H) MINUTE(L&C)
03/06/23 (H) L&C RPT CS(L&C) NEW TITLE 2DP 2NR 2AM
03/06/23 (H) DP: FIELDS, WRIGHT
03/06/23 (H) NR: PRAX, RUFFRIDGE
03/06/23 (H) AM: SADDLER, SUMNER
03/21/23 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
KIM KOVOL, Commissioner Designee
Department of Family and Community Services
Anchorage, Alaska
POSITION STATEMENT: Testified as Commissioner Designee of the
Department of Family and Community Services.
DAVID IGNELL, representing self
Juneau, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JASON FLOYD, representing self
Kenai, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
YVETTE DEBLOIS, representing self
(No address provided)
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JARED KOSIN, President & CEO
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
BILL GALIC, representing self
(No address provided)
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
CHRIS KOLEROK, Public Policy Director
Cook Inlet Housing Authority
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
JASMINE BOYLE, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
LAURIE VANDENBERG, representing self
(No address provided)
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
LINDA BREINER, representing self
Talkeetna, Alaska
POSITION STATEMENT: Testified during the confirmation hearing
for commissioner of the Department of Family and Community
Services.
REPRESENTATIVE STANLEY WRIGHT
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 57 as prime sponsor.
PI RIORDAN-RANDALL, Staff
Representative Stanley Wright
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Assisted in presenting HB 57 on behalf of
Representative Wright, prime sponsor.
BRIAN WEBB, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 57.
DR. JOSEPH LIVENGOOD, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified in support of HB 57.
CANDACE RICHEY, Owner
Candi's Tot Stop
North Pole, Alaska
POSITION STATEMENT: Testified in support of HB 46.
BRIAN HOLST, Executive Director
Juneau Economic Development Council
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 46.
EVAN ANDERSON, Staff
Representative Zach Fields
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 46 on behalf of Representative
Fields, prime sponsor.
BRANDON SPANOS, Deputy Director
Tax Division
Department of Revenue
Juneau, Alaska
POSITION STATEMENT: Answered questions relating to HB 46.
ACTION NARRATIVE
3:03:11 PM
CHAIR MIKE PRAX called the House Health and Social Services
Standing Committee meeting to order at 3:03 p.m.
Representatives McCormick, Ruffridge, Sumner, Fields, Mina, and
Prax were present at the call to order. Representative Saddler
arrived as the meeting was in progress.
^CONFIRMATION HEARING(S): DEPARTMENT OF FAMILY AND COMMUNITY
SERVICES
3:04:19 PM
CHAIR PRAX announced that the first order of business would be
confirmation hearings on the governor's appointee to the
Department of Family and Community Services.
3:05:27 PM
KIM KOVOL, Commissioner Designee, Department of Family and
Community Services, shared that she has been acting commissioner
since July 1, 2022, which was when the Department of Health and
Social Services reorganized. She said that, prior to being
commissioner, she served as the governor's special assistant.
She stated that she has spent 25 years working in private and
non-profit organizations. She said she's been told that she has
a "lovingly firm" leadership style. She shared that she grew up
in a traditional military family, traveled nationally and
internationally, as her father retired from the U.S. Navy and
her mother working in civil service; they helped many refugees
during Operation Eli on Grande Island, Philippines. She said
she has pursed administrative certification in early child
education while she was seeking her bachelor's degree and that,
upon returning to higher education, she attended the University
of Alaska Anchorage (UAA) to attain a master's in social work,
as well as designation as a Leadership, Education,
Neurodevelopmental and Related Disabilities (LEND) fellow,
focused on service access and availability for families and
individuals living with autism. She commented that two of her
three children were diagnosed with autism in preschool. She
explained that the department is new, but the divisions are not,
and that the re-organization pledged to Alaskans an intensive
level of engagement, focus, attention, redress, and corrections.
3:09:44 PM
MS. KOVOL relayed that she has visited divisions across the
state, and acknowledged staff that are enduring through the
current workforce crisis. She relayed a visit with Office of
Children's Services (OCS) staff in the Bethel office where a
caseworker talked about her travels to remote sites to visit
families and children. She said that her vision for the
Department of Family and Community Services (DFCS) is to be
person-focused, as well as ensure a high standard of care and
engagement to patients. She added that other priorities include
addressing the needs of staff, workforce training, wellness
training, wages, and retention. She said that addressing the
needs of youth and adults in their care is an absolute priority,
requiring both public and private sectors to work together. She
explained that, after the department reorganization, she
received feedback that reinforces her observation that the
divisions and its partners have had more opportunities to:
collaborate and focus on delivery services and exchanges;
establish both divisional/department cross-programming
opportunities; encourage more internships/mentorships in
educational systems; and examine the department's role in the
child welfare and elder care systems in the state. She stressed
that adequate housing, access to nutrition, healthcare, safe
childhood experiences, and educational opportunities are part of
the overall system for healthy children, elders, families, and
communities.
3:13:01 PM
CHAIR PRAX opened public testimony on the confirmation hearing
for commissioner of the Department of Family and Community
Services.
3:13:32 PM
DAVID IGNELL, representing self, shared that he is a forensic
journalist living in Juneau and spent 10 years as a litigator in
equity courts. He informed members that he submitted numerous
written comments and exhibits to the committee [hardcopies
included in committee packet]. He said the topic of his
testimony will discuss how bad the children are doing in the
state's care today and under Ms. Kovol's leadership. He offered
an example: a child named Lawrence was diagnosed with fetal
alcohol syndrome, autism, and attention-deficit/hyperactivity
disorder (ADHD); he was well taken care of in his family until
being taken by OCS at 11 years of age, and since then has been
moved 18 times. He offered another example: a child named
David who was diagnosed with fetal alcohol syndrome, autism,
ADHD, depression, and bi-polar disorder; he was also being well
cared for in a family until being taken by OCS at 15 and has
been moved seven times in the last two years. He said that,
following his testimony in the Senate last week, someone at OCS
enticed David to miss a family Zoom call by bribing him with
$200. He offered another example: George was diagnosed with
fetal alcohol syndrome, autism, ADHD, and disruptive behavior;
he was also in a good family before being taken by OCS a day
before his fourteenth birthday and has been moved 15 times in
the last two years. He said that, three months ago, Ms. Kovol
had George moved into a home that was not informed of his
diagnosis. He relayed that George, after the foster family
incorrectly disciplined him, left and walked 10 miles in the
dark in 10-degree weather.
MR. IGNELL said that one further person he wished to discuss is
Katelyn Shelhamer, who was murdered two months after turning 18
years old, was in OCS care, and trafficked since about 14 years
old. He said that after Katelyn left OCS care she sought to
turn her life around. He asked if Katelyn was killed because
she knew too much. He directed attention to exhibit C in the
provided materials, which is a class action lawsuit filed in
federal court where Lawrence, David, and George are three of the
13 named plaintiffs.
3:18:17 PM
MR. IGNELL asked why Ms. Kovol wants the case dismissed, and
noted the state is attempting to dismiss the class-action
lawsuit. He questioned why, if Ms. Kovol is sympathetic to
autism, she has not picked up a phone and returned Lawrence,
David, and George to their mothers. He said that he and Thomas
Garber have been attempting to get grand jury investigations
into OCS off the ground this fall but the effort was hijacked by
state officials. He recounted that six years ago former
representative Tammie Wilson complained about the grand jury
investigations into OCS being hijacked. He asked whether, if
the investigations had gone forward, Katelyn would be alive
today. Further, he questioned who would be the next Katelyn to
be murdered if the injustice isn't stopped.
CHAIR PRAX said the committee is unable to discuss active cases.
MR. IGNELL said that is the same thing he was told in the Senate
last week. He said there is a patten that members need to
investigate.
3:19:10 PM
JASON FLOYD, representing self, said he was previously an
employee of OCS, executive director of a department related to
the Indian Child Welfare Act (ICWA), and served two terms on the
Board of Social Work Licensing Examiners. He asked why the
state continues to seek to exempt itself from its own laws,
specifically AS 08.95, and AAC 12.18, which both are cited by
the board as the governing law for people practicing social
work. He explained that social workers will often say they are
not social workers, but rather, case managers. He said that the
OCS website states that they follow the National Association of
Social Work Code of Ethics for direction. He stated that a
person should not be commissioner if they don't know what the
law is, and those that do, know that best practices are guided
and overseen by the licensing authority. He stressed that
workers change their job titles so that they exempt themselves
from the letter of the law through stating that they don't do
social work. He said he was a social worker with OCS and
carried a license for 11 years; he knows what best practice is,
and OCS is not completing best practice. He shared his last
case he had as a social worker working for a tribe, and the
tribe had fought against OCS for two years to make the right
placement for an ICWA child. He further shared that the judge,
during her final disposition in Palmer, said she had never seen
such a miscarriage of justice and abuse of power in her entire
career.
3:22:44 PM
MR. FLOYD concluded that, while he appreciates Ms. Kovol's
desire to help people, a position as important as commissioner
requires someone that is "boots on the ground," ethical,
experienced, and has committed themself to the licensure
process.
3:23:31 PM
YVETTE DEBLOIS, representing self, said her testimony will cover
how OCS victimized her family. She shared that her brother's
name is Thomas Jack, and that he was a foster parent; however,
because of OCS worker manipulation, he is now in prison. She
suggested members review the website "Powered by Justice," which
details Jack's case. She said it is important to expose these
issues through a grand jury, and that, if grand juries were
stronger, there would be a desire to fix the problems. She said
she does not have confidence in Ms. Kovol's ability to do the
job, and that grand juries should not be rubber stamps for
prosecutors.
3:25:55 PM
CHAIR PRAX reminded those testifying that the committee cannot
talk about specific cases currently in the court system.
3:26:14 PM
JARED KOSIN, President & CEO, Alaska Hospital and Healthcare
Association, expressed support on the appointment of Ms. Kovol.
He said that she is the perfect nominee to lead the department,
as she has made it clear that improving the lives of Alaska
children, adults, and families is her highest priority. He
stated that he is proud to offer her the association's
unwavering support for her confirmation.
3:27:37 PM
BILL GALIC, representing self, explained that he holds a
master's degree in social work and is retired as a clinical
social worker in Alaska. Further, he was a frontline supervisor
in the Kenai office for 19 years, as well as retired as an
assistant professor with the University of Anchorage (UAA)
School of Social Work. He said that Ms. Kovol was a student in
three of his master level classes and had a full career in the
social services field before returning to school for her
master's degree. He added that she also has experience managing
business in the private sector; therefore, she understands the
needs, problems, and costs associated with providing services.
He added that he was her Master of Social Work (MSW) field
supervisor as she interned on the governor's staff for two
years, with the governor later appointing her as a special
assistant focused on social service areas. He opined that Ms.
Kovol has both the personality and work ethic that suits her
well to the position. He stated that he wholeheartedly
recommends confirming her as commissioner.
3:30:18 PM
CHRIS KOLEROK, Public Policy Director, Cook Inlet Housing
Authority, said that he is honored to voice his support to
confirm Ms. Kovol as commissioner. He said that balancing
public service and completion of a master's degree in social
work speaks to her dedication.
3:33:03 PM
JASMINE BOYLE, representing self, testified in support of Ms.
Kovol's appointment as commissioner of DFCS. She said that she
has over 20 years in senior and executive experience in child
welfare and family services. She stated that OCS is a
challenging beast in great need of improvement, and that
families deserve better. She stated that she supports Ms.
Kovol, and that she has personally worked for over five years in
a variety of professional roles relating to work she would be
responsible for as commissioner. She said that Ms. Kovol is a
businesswoman who transitioned into social work, and that she
herself worked side-by-side with Ms. Kovol during a humanitarian
crisis regarding Anchorage homelessness. She offered her
understanding that they share the belief that it is possible to
build systems to care for the most vulnerable in a sustainable
way with a budget rooted in reality, and with a heart committed
to people.
3:36:59 PM
LAURIE VANDENBERG, representing self, shared that she is a
registered nurse and a prior foster parent. She said that,
while it sounds like Ms. Kovol has done much, she has not seen
any of the action. She stated that her own heart breaks to hear
that she has two children who are autistic and has not stepped
up to the injustices occurring in the OCS system, as there are
changes that could be made. She urged that OCS be fixed, and
that she would like to talk with Ms. Kovol about what changes
could be done to help the program.
3:38:47 PM
LINDA BREINER, representing self, shared that for two years she
has been working with a mother who lost her five children to OCS
due to OCS claiming things that were not true and that have yet
to be proven. She explained that the five children have been
separated and moved over 55 times. She stated that OCS
continually disregards its own regulations, and if Ms. Kovol is
accepted, she asked that she look into cases where children are
being taken by OCS with no proof.
3:40:12 PM
CHAIR PRAX, after ascertaining that no one further wished to
testify, closed public testimony.
3:40:34 PM
REPRESENTATIVE FIELDS thanked Ms. Kovol for her work. He said
that last year the Department of Justice (DOJ) released an
investigative report addressing the overabundance of Alaska
children being institutionalized, like in out-of-state, for-
profit facilities in some cases. He explained that the problems
identified in the DOJ report predate Ms. Kovol's appointment as
acting commissioner, and he asked that she explain her, as well
as the department's, role in fixing the problems found in the
report.
3:41:44 PM
MS. KOVOL, regarding the DOJ report, said that the Department of
Health and the Department of Family and Community Services are
in the final stages of answering the questions presented by DOJ;
therefore, it would be preemptive to comment as it is still
being finalized and reviewed. In addressing the out-of-state
facilities question, she explained that facilities in different
communities are not sufficient throughout the state, and so are
used only as a last resort. She said she does not look to
whether the facility is for-profit or not, rather, the
department is looking for facilities that can accept the
condition of the child and provide the best medical health
treatment. She reported that the number of children currently
out of state is 25, and the goal is to bring them home, but to a
treatment center in Alaska that could meet their needs; there
are not enough treatment centers in the state whether private,
public, or partnership.
3:43:42 PM
REPRESENTATIVE FIELDS said it will be his goal to be supportive
of the department.
3:43:54 PM
REPRESENTATIVE MINA asked what Ms. Kovol's vision is for the
Tribal Child Welfare Compact Program.
MS. KOVOL answered that the department is looking at adding one
more tribe at the end of the fiscal year, and another next year.
She said that the most meaningful engagements from tribal
partners are around prevention work, which is done in
collaboration between the compact and the state to decide what
is best for communities.
3:45:26 PM
REPRESENTATIVE SADDLER commented that some strong allegations
were made during the public testimony period. He asked that,
while he is unsure as to whether the committee is being
presented with multiple cases or the same cases from multiple
perspectives, Ms. Kovol address the allegations as broad or as
narrow as she would like.
MS. KOVOL stated that they do not comment on litigation to
protect due process; further, commissioners are not involved
personally in the cases, which are done at the division level
and in congruence with law.
3:46:43 PM
REPRESENTATIVE RUFFRIDGE said he shares concerns about the
direction the department is going as it relates to the safety of
children. He asked what Ms. Kovol's vision is for the division
going forward, and what it is she hopes to see happen.
MS. KOVOL explained that the department has four divisions: the
Alaska Psychiatric Institute, the Division of Juvenile Justice,
the Alaska Pioneer Home, and OCS. She said it is imperative
that the department is person-first centered and focused, always
looking at what's in the best interest of the
client/patient/resident, as well as staff. She answered that,
regarding OCS, she is currently in conversation with the
governor as to how the department is going to address whether
there are other mechanisms and ways to restructure how the
division operates so that there is the best alignment for
children and families. She reiterated that it would be
preemptive for her to talk specifics, but stated that things
cannot remain status quo, and that the ship can be turned
around.
REPRESENTATIVE RUFFRIDGE congratulated Ms. Kovol for recently
attaining her master's degree in social work. He asked if she
plans on pursuing being licensed.
MS. KOVOL responded that she is not pursuing her license, but
did enroll for her master's in public health (MPH), which has
been put on hold for the next few years.
REPRESENTATIVE RUFFRIDGE asked what "person-first" looks like
for Alaska's kids. He clarified that the report indicates to
him that sometimes there are struggles in having a person-first
mentality.
MS. KOVOL answered that "person-centered" means they are looking
at the individual needs for each individual, and not lumping
them in cohorts based on characteristics; rather, the department
is looking into the complex nature of the person's individual
needs. She said that often when a child is presenting complex
behaviors or medical needs there are different "communities"
involved.
3:53:53 PM
REPRESENTATIVE MINA recounted that one of the presentations that
stood out to her was one made by the Alaska Psychiatric
Institute (API), and in looking at all the vacancies across
different divisions, there's potential for retainment. She
asked if Ms. Kovol's vision on addressing the vacancies relate
to the progress made by API.
MS. KOVOL commented that API did amazing work to come from a
very low bed count, but now has 77 beds, which is considered
full. Further, staff and patient assault reduced by 50 percent
due to programing being redesigned. She said to replicate this,
it comes down to training and communicating expectations of
safety.
3:56:05 PM
REPRESENTATIVE SADDLER posited that the human services world is
very challenging and the state has responsibilities to care for
the less fortunate. He asked if Alaska faces special challenges
in dealing with the disabled, aged, foster children, and
mentally ill.
MS. KOVOL shared that she lived in third-world countries where
there is not a plethora of folks. She said that trauma is
different for everyone, as are disabilities, and while they may
demonstrate similar needs and traits, the communities' and
families' treatments set the tone on whether they will be
successful.
3:58:51 PM
CHAIR PRAX stated that the House Health and Social Services
Standing Committee has reviewed the qualifications of the
governor's appointees and recommends that the following names be
forwarded to a joint session for consideration: Kim Kovol,
Department of Family and Community Services. He said that
signing the report regarding appointments to boards and
commissions in no way reflects an individual member's approval
or disapproval of the appointee, and the nomination is merely
forwarded to the full legislature for confirmation or rejection.
3:59:14 PM
The committee took an at-ease from 3:59 p.m. to 4:02 p.m.
HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS
4:02:06 PM
CHAIR PRAX announced that the next order of business would be
HOUSE BILL NO. 57, "An Act relating to review organizations and
permitting an emergency medical services provider to establish a
review organization; and relating to patient records."
4:02:31 PM
REPRESENTATIVE STANLEY WRIGHT, Alaska State Legislature, as
prime sponsor, paraphrased the sponsor statement [hardcover in
committee packet], which read as follows [original punctuation
provided]:
House Bill 57 gives EMS agencies protections for peer
review activities.
Peer review is an intensive self-evaluation process
used within healthcare organizations in order to
continuously monitor and improve patient care. Peer
review activities are non-discoverable this
important protection is provided by states to
healthcare organizations to establish an environment
conducive to improvement, without fear of discovery
and litigation. The current status provides a chilling
effect on the openness and educational process that
EMS peer review provides.
This proposed legislation will promote candor and
objectivity in EMS system review and discussion. It is
essential that allowing EMS medical practitioners to
frankly discuss care and conduct in a confidential
setting, without worry about external access to the
information, would enhance the quality of pre-hospital
medical practice.
Past legal decisions have asserted that the existing
statutory provisions which provide this protection to
medical facilities, institutions, or hospital
governing bodies and their committees, provide the
same protections to emergency medical services (EMS)
and fire-based pre-hospital agencies. This is an
untested theory and places pre-hospital medical
agencies in an unprotected status which other entities
enjoy.
HB 57 changes the definition of "review organization"
to include EMS groups who perform quality improvement
functions. By doing so, they are afforded equitable
immunity and confidentiality protection that hospitals
and other healthcare workers enjoy. Peer review
protection is essential if Alaska's EMS systems are to
be used to their maximum potential. Passage of this
legislation enhances the safety of the public and the
educational process for EMS through the peer review
program.
4:04:35 PM
PI RIORDAN-RANDALL, Staff, Representative Stanley Wright, Alaska
State Legislature, on behalf of Representative Wright, prime
sponsor of HB 57, read the sectional analysis [included in the
committee packet], which read as follows [original punctuation
provided]:
Section I:
Amends AS 18.23.070(1) to Include EMT's, dispatchers,
and paramedics in the definition of "health care
provider" for the purpose of peer review protection.
Section II:
Amends the definition of "healthcare provider" in AS
18.23.070(3) to include EMS agencies and employees who
are conducting peer review activities.
Section III:
AS 18.23.070(5) is amended to include emergency
medical services agencies and employees under the
definition of a "review organization"
4:07:28 PM
BRIAN WEBB, representing self, referred to his written testimony
[included in committee packet]. He noted that he had previously
spoken to the importance of recruitment and retention of
emergency medical services (EMS) medical directors, and he
called HB 57 a request to provide protections to EMS services,
the fire departments that engage in EMS quality assurance
programs, and individual EMS responders, including many
volunteers. He said EMS committees not only review patient care
activities but also openly challenge medical directors and
training officers to defend the care given. He said Alaska EMS
is just asking the legislature to provide a level of equity in
statute for EMS.
4:12:18 PM
DR. JOSEPH LIVENGOOD, representing self, shared that he is an
acute care surgeon that works in Fairbanks and Ketchikan, and
also serves as EMS director for several agencies. He said it is
important to have the information necessary to improve patient
care. He said that HB 57 clarifies that EMS agencies are
identified as a covered entity under the Health Insurance
Portability and Accountability Act (HIPPA) privacy rules, which
allow for the sharing of patient information for the purpose of
quality management and for discussion to occur without
discoverability that may be misconstrued or presented out of
context during an outside review. He relayed to members that
such protections are in place already for hospitals and clinics,
but for EMS they are not.
4:14:39 PM
REPRESENTATIVE MINA noted that podiatrists are not included in
statute. She asked, with the chilling effect happening with
quality assurance for EMS, whether that is happening with
podiatry.
MR. WEBB answered that, in 2015, podiatrists had the same
concern as EMS. He said that there was an amendment to the
original bill adding podiatrists, and that, during the drafting
of HB 57, it was decided that it would be left in.
4:15:55 PM
CHAIR PRAX announced that HB 57 was held over.
4:16:12 PM
The committee took a brief at-ease.
HB 46-CHILD CARE PROVIDER COLLECTIVE BARGAINING
4:16:16 PM
CHAIR PRAX announced that the final order of business would be
HOUSE BILL NO. 46, "An Act allowing child care providers that
receive state aid to organize and collectively bargain with the
Department of Health; and establishing the child care provider
fund." [Before the committee was CSHB 46 (L&C).]
4:17:53 PM
CANDACE RICHEY, Owner, Candi's Tot Stop, shared that she has
been in business at Candy's Tot Stop for 17 years. She said
that providers get asked what they need, but when they talk,
they are not heard. She said that HB 46 offers support to
providers. She thanked members who helped pass similar
legislation through the House last year, which she said was then
blocked by one senator; however, with new leadership in the
senate, there is now an opportunity to get childcare legislation
to the governor. She explained that the bill covers topics of
concern in the childcare industry in Alaska, including wages,
provider voice, benefits, and retirement. She said that the
wages earned in the industry are hard to live off, and there is
high staff turnover because providers can't afford to pay their
employees higher wages. She shared that her wait list consists
of many service members needing care, showing how the lack of
childcare is impacting preparedness. She explained that
benefits are not possible because of the unaffordable premiums
to get insurance as a small business. She said that the bill
will give providers a say as to where the state funds go for
childcare.
4:21:56 PM
BRIAN HOLST, Executive Director, Juneau Economic Development
Council, explained that childcare is an important economic
development issue for the state and provides a high return on
public investment. He said that high quality early care is
critical, and that the Heckman curve shows that investment has
diminishing returns as the child gets older. He stated that the
lack of childcare hurts the economy, and that chamber of
commerce data from 2019 showed that $165 million is lost
annually in the Alaska economy due to child care related issues,
and that 77 percent of Alaska parents missed school or work for
child care in a three-month period; 36 percent of Alaska parents
postpone school or training due to such issues; and 47 percent
of families rely on other family or friends for childcare. He
said that every state ranks childcare readiness, and that two-
thirds of the state's students are not ready for kindergarten.
He explained that the Journal of Education Psychology identified
that, if 50 first graders have problems reading, 44 of them
still have problems reading by the time they are in fourth
grade. He stated that a lack of access to affordable high-
quality childcare has an impact on the workforce, and that while
employers want more childcare options, there are significant
barriers such as cost and scarcity. He explained that the
current model of childcare in the state is broken, as wages are
uncompetitive since many could earn more in an entry level
retail job instead. He pointed out that operators are small due
to cost of rent and requirements around child to adult ratios,
and that programs cannot raise wages without increasing prices.
4:27:19 PM
REPRESENTATIVE RUFFRIDGE asked, with CSHB 46(L&C) adding tax
incentives to childcare services, what Mr. Holst thinks would
the uptake be.
MR. HOLST answered that, when businesses were surveyed, they
said they are interested in supporting childcare operations, but
the challenge is the size of the business.
4:28:43 PM
REPRESENTATIVE ZACK FIELDS, Alaska State Legislature, as prime
sponsor, thanked the committee for hearing HB 46. He explained
that that CSHB 46(L&C) has three provisions: Establish
opportunity for childcare providers to enter intersectoral
bargaining with the state, which would allow them to manage
money for the state for investing money; establish a child care
trust fund, which would allow saving some money to trickle out
to pay for child care; and add tax credits for companies if they
give out vouchers for existing childcare or build on-site
childcare.
4:32:46 PM
REPRESENTATIVE SUMNER asked what other states experienced with
intersectoral bargaining agreements.
REPRESENTATIVE FIELDS explained that the legislature only has
the ability to implement sectoral bargaining for childcare or
farmwork, as those are the only two areas excluded from the
National Labor Relations Act. He said that 10 states have
implemented such framework, some were successful and sustained.
He shared that last year the House Labor and Commerce Standing
Committee heard from providers in Washington state, which has
such bargaining; providers in Washington described how, over
time, they built up the profession to a living wage and thereby
increasing the supply of labor and childcare.
4:35:28 PM
EVAN ANDERSON, Staff, Representative Zack Fields, Alaska State
Legislature on behalf of prime sponsor Representative Fields,
read the sectional analysis for HB 46[included in committee
packet], which read as follows [original punctuation provided]:
Section 1: This section amends AS 23.05.360(f) to
allow the Alaska Labor Relations Agency board in the
Department of Labor & Workforce Development the
authority to include workers in the child care sector
for the purpose of holding hearings. This is a
conforming change to language added in Sec 4.
Section 2: This section amends AS 23.05.370(a) to
direct the Alaska Labor Relations Agency to serve as
labor relations agency for workers in the child care
sector covered by the new language added in Sec. 4.
Section 3: This section amends AS 23.05.380 to give
Department of Labor & Workforce Development the
authority to update regulations pertaining to
collective bargaining rights for workers in the child
care sector. This is a conforming change to language
added in Sec 4.
Section 4: This section amends AS 23.40 to give child
care providers the right to self-organize, join, or
assist an organization to bargain collectively and
engage in concerted activities for the purposes of
collective bargaining or other mutual aid or
protection. This section prohibits the Department of
Health from engaging in unfair labor practices, and it
provides a process for investigation and conciliation
of complaints. This section also provides definitions.
Section 5: This section establishes a child care
provider fund as a separate fund in the state
treasury. This section also establishes a child care
stakeholder group to recommend disbursements from the
fund.
4:41:59 PM
CHAIR PRAX mentioned that New Mexico has a $2 billion trust fund
for childcare. He asked if such a fund is designated or
dedicated.
REPRESENTATIVE FIELDS said he does not know if New Mexico has
the same designated fund restrictions as Alaska, and in talking
with Legislative Legal Services, the key phrase is "funds do not
last". He said there were hundreds of millions of additional
dollars last year, and there were $400 million put towards
capital funding, as an example.
CHAIR PRAX pointed out that the fiscal note contemplates just an
annual appropriation.
4:43:57 PM
MR. ANDERSON explained that the bill's two fiscal notes, one
from the Department of Health and another from the Department of
Revenue, clearly lay out protected deficits around the tax
credit program.
4:44:56 PM
BRANDON SPANOS, Deputy Director, Tax Division, Department of
Revenue, answered that there were three parts to the reduction
of revenue; there is no data on broadening what is allowed to be
an expenditure on credits and how many companies would take
advantage of that; there is data on expanding the program to $3
million, and companies regular contribute more they can take as
a credit; there is also data on extending the sunset date.
CHAIR PRAX asked if that then is only the anticipated loss in
tax revenue because the companies would donate money to the
program.
MR. SPANOS answered that's correct.
CHAIR PRAX asked if the tax credit is one-for-one, and if it
would be reasonable to assume that the money would go into the
childcare fund.
MR. SPANOS explained that the tax credit in current statute has
changed over the years, but in the first year, the first
$100,000, 50 percent is applied to the credit, therefore, a 5:1
ratio.
CHAIR PRAX inquired as to whether the proposed $15 million
appropriation to trust fund would be draining the fund each
year.
4:48:39 PM
REPRESENTATIVE FIELDS offered that a $15 million fund could be
managed, but it wouldn't be sufficiently large to make a
difference in the sector; however, it could be something to
establish and be built up over time.
4:48:55 PM
CHAIR PRAX announced that HB 46 was held over.
4:49:13 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:49 p.m.