Legislature(2013 - 2014)CAPITOL 106

04/06/2013 09:00 AM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Please Note Time Change --
+= HB 134 MEDICAID PAYMENT FOR MEDISET PRESCRIPTION TELECONFERENCED
Heard & Held
*+ HB 147 EXTEND AUTISM EARLY DIAGNOSIS TASK FORCE TELECONFERENCED
Moved Out of Committee
*+ HB 184 NEWBORN SCREENING FOR HEART DEFECTS TELECONFERENCED
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 6, 2013                                                                                          
                           9:02 a.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Pete Higgins, Chair                                                                                              
Representative Wes Keller, Vice Chair                                                                                           
Representative Benjamin Nageak                                                                                                  
Representative Lance Pruitt                                                                                                     
Representative Lora Reinbold                                                                                                    
Representative Paul Seaton                                                                                                      
Representative Geran Tarr                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 134                                                                                                              
"An Act requiring Medicaid payment for scheduled unit dose                                                                      
prescription drug packaging and dispensing services for                                                                         
specified recipients."                                                                                                          
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 147                                                                                                              
"An Act extending the reporting date for and the termination                                                                    
date of the Comprehensive Autism Early Diagnosis and Treatment                                                                  
Task Force; and providing for an effective date."                                                                               
                                                                                                                                
     - MOVED HB 147 OUT OF COMMITTEE                                                                                            
                                                                                                                                
HOUSE BILL NO. 184                                                                                                              
"An Act requiring screening of newborns for congenital heart                                                                    
defects."                                                                                                                       
                                                                                                                                
     - BILL HEARING CANCELED                                                                                                    
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 134                                                                                                                  
SHORT TITLE: MEDICAID PAYMENT FOR MEDISET PRESCRIPTION                                                                          
SPONSOR(s): REPRESENTATIVE(s) COSTELLO                                                                                          
                                                                                                                                
02/20/13       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/20/13       (H)       HSS, FIN                                                                                               
03/19/13       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/19/13       (H)       Heard & Held                                                                                           
03/19/13       (H)       MINUTE(HSS)                                                                                            
03/28/13       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/28/13       (H)       Heard & Held                                                                                           
03/28/13       (H)       MINUTE(HSS)                                                                                            
04/02/13       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/02/13       (H)       Heard & Held                                                                                           
04/02/13       (H)       MINUTE(HSS)                                                                                            
04/04/13       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/04/13       (H)       Scheduled But Not Heard                                                                                
04/06/13       (H)       HSS AT 9:00 AM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 147                                                                                                                  
SHORT TITLE: EXTEND AUTISM EARLY DIAGNOSIS TASK FORCE                                                                           
SPONSOR(s): REPRESENTATIVE(s) SADDLER                                                                                           
                                                                                                                                
03/01/13       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/01/13       (H)       HSS                                                                                                    
04/06/13       (H)       HSS AT 9:00 AM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
CHARLES GUINCHARD, Staff                                                                                                        
Representative Mia Costello                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 134 on behalf of                                                                            
Representative Costello, sponsor of the bill.                                                                                   
                                                                                                                                
REPRESENTATIVE DAN SADDLER                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 147 as the sponsor of the                                                                   
bill.                                                                                                                           
                                                                                                                                
PAUL VERHAGEN, Staff                                                                                                            
Representative Pete Higgins                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified during discussion of HB 147.                                                                   
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
9:02:30 AM                                                                                                                    
                                                                                                                                
CHAIR PETE  HIGGINS called the  House Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    9:02   a.m.                                                               
Representatives Higgins,  Seaton, Nageak,  Keller, and  Tarr were                                                               
present  at  the  call  to order.    Representatives  Pruitt  and                                                               
Reinbold arrived as the meeting was in progress.                                                                                
                                                                                                                                
        HB 134-MEDICAID PAYMENT FOR MEDISET PRESCRIPTION                                                                    
                                                                                                                                
9:03:24 AM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  announced that the  first order of  business would                                                               
be HOUSE  BILL NO.  134, "An Act  requiring Medicaid  payment for                                                               
scheduled unit  dose prescription  drug packaging  and dispensing                                                               
services for specified recipients."                                                                                             
                                                                                                                                
[In  front of  the  committee was  Version 28-LS0303\R,  Mischel,                                                               
4/1/13,  adopted as  the  working document  by  the committee  on                                                               
April 2, 2013.]                                                                                                                 
                                                                                                                                
9:03:50 AM                                                                                                                    
                                                                                                                                
CHARLES  GUINCHARD, Staff,  Representative  Mia Costello,  Alaska                                                               
State   Legislature,  said   that  the   sponsor,  Representative                                                               
Costello,  recognized  this  was  a  complicated  issue  and  was                                                               
willing  to  spend time  answering  questions  and concerns  with                                                               
committee members.   He  reported that there  were no  changes to                                                               
the current working draft, Version R.                                                                                           
                                                                                                                                
9:04:57 AM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS offered  his belief that the sponsor  had agreed to                                                               
hold the bill in the committee through the interim.                                                                             
                                                                                                                                
9:05:58 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON asked about the research requests.                                                                        
                                                                                                                                
CHAIR  HIGGINS  agreed to  distribute  these  responses from  the                                                               
department during the interim.                                                                                                  
                                                                                                                                
9:06:28 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR extolled that  the bill presentation had been                                                               
especially educational regarding Medicaid expansion.                                                                            
                                                                                                                                
[HB 134 was held over.]                                                                                                         
                                                                                                                                
        HB 147-EXTEND AUTISM EARLY DIAGNOSIS TASK FORCE                                                                     
                                                                                                                                
9:07:18 AM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS announced that the  next order of business would be                                                               
HOUSE BILL NO. 147, "An Act  extending the reporting date for and                                                               
the termination date of the  Comprehensive Autism Early Diagnosis                                                               
and Treatment Task Force; and providing for an effective date."                                                                 
                                                                                                                                
9:07:42 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE DAN SADDLER, Alaska  State Legislature, sponsor of                                                               
HB  147,  said  that  the   purpose  of  the  proposed  bill  was                                                               
straightforward,  as it  would extend  the authorization  date of                                                               
the  Comprehensive  Autism  Early Diagnosis  and  Treatment  Task                                                               
Force.    He  explained  that  autism  was  a  neural  behavioral                                                               
disorder, or  disease, characterized by  diminished communication                                                               
and social skills, which was often  manifested early in life.  He                                                               
stated  that although  it was  incurable, it  was treatable,  and                                                               
that treatment improved the life  prospects of those with autism.                                                               
He  declared that  treatment  also reduced  the  cost for  social                                                               
services, and helped improve the  outcomes.  He noted that Senate                                                               
Bill  74 [27th  Alaska  State Legislature]  had established  that                                                               
private  health  insurers  would  cover  the  cost  of  effective                                                               
treatment  for  autism;  although  it did  not  ensure  insurance                                                               
coverage for  autism to  every family,  the task  force provision                                                               
had been  added to investigate  ways to extend coverage  for more                                                               
Alaska families.   He listed the  members of the task  force.  He                                                               
declared  that its  mission was  to make  recommendations to  the                                                               
Alaska  State   Legislature  for   development  of   a  statewide                                                               
comprehensive plan  to support early  diagnosis and  treatment of                                                               
autism, for  evaluation of  the fiscal  impact of  its proposals,                                                               
and  for analysis  of the  effect of  the Patient  Protection and                                                               
Affordable Care  Act on the  recommendations and policies  of the                                                               
task force.   He reported that  proposed HB 147 would  extend the                                                               
available time for  the task force to January 15,  2015, the last                                                               
day  of the  28th  Legislature.   He  asked  for the  committee's                                                               
support in passage of the proposed bill.                                                                                        
                                                                                                                                
9:10:10 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON  asked whether  the parameters of  the task                                                               
force were  solely for  reviewing insurance  coverage, or  was it                                                               
also for reviewing effective treatment intervention.                                                                            
                                                                                                                                
REPRESENTATIVE  SADDLER, in  response  to Representative  Seaton,                                                               
said that  the task force would  review both issues, as  it had a                                                               
somewhat  broad mandate  for recommendation  of  ways to  improve                                                               
early  diagnosis  and  treatment,  and ways  to  implement  these                                                               
recommendations through legislation.                                                                                            
                                                                                                                                
9:10:48 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SEATON   asked    to   clarify   that   emerging                                                               
recommendations of prevention and treatment  of autism were to be                                                               
incorporated into  existing programs,  or if  the task  force was                                                               
solely to review current insurance coverage.                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER offered his belief  that the intent was to                                                               
focus on effecting current insurance  policies by including state                                                               
of the art  autism treatment into these policies.   He noted that                                                               
the  task  force was  not  designed  to  "push the  frontiers  of                                                               
treatment  programs,"   but  to  implement  what   was  currently                                                               
available.                                                                                                                      
                                                                                                                                
9:11:55 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE REINBOLD directed attention to  page 1, line 9, of                                                               
the proposed bill, and asked for the intent of the legislation.                                                                 
                                                                                                                                
REPRESENTATIVE SADDLER expressed his  agreement that it was broad                                                               
and comprehensive  coverage.  He  opined that the focus  would be                                                               
to  integrate the  state  of  the art  treatment  of autism  with                                                               
current insurance policies  and coverage.  He  commented that the                                                               
coverage in  Alaska was a  patchwork of insurance  providers, and                                                               
was  very complicated.   He  shared that  an effort  of the  task                                                               
force would be to "try and  meld those systems with the treatment                                                               
options available for autism."                                                                                                  
                                                                                                                                
REPRESENTATIVE  REINBOLD  asked  how  many  patients  this  would                                                               
affect, and she inquired about any fiscal note.                                                                                 
                                                                                                                                
REPRESENTATIVE  SADDLER replied  that  the majority  of the  task                                                               
force work would be via  teleconference, hence there would not be                                                               
a fiscal note.  In  response, he reported that research indicated                                                               
that  1  in 88  children  in  Alaska  were affected  with  autism                                                               
spectrum  disorder,  and  that this  was  a  "rather  significant                                                               
public health problem."                                                                                                         
                                                                                                                                
REPRESENTATIVE  REINBOLD asked  for  a total  number of  affected                                                               
individuals.                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  replied that he  was unsure of  the exact                                                               
numbers.                                                                                                                        
                                                                                                                                
9:14:55 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER stated his support  for HB 147.  He offered                                                               
some  clarification as  he had  been involved  with the  original                                                               
bill.   He  stated  that the  proposed bill  was  to explore  the                                                               
options for extending treatment  opportunities equally across the                                                               
state,  as   opposed  to  simply  directing   it  toward  private                                                               
insurance.     He  relayed  that   there  were   still  questions                                                               
outstanding, as there was a  desire for the coverage for autistic                                                               
children.   He pointed  out the  range of  diagnostic estimations                                                               
for autism  spectrum disorder,  and what it  covered.   He stated                                                               
that  autism was  included in  autism spectrum  disorder, and  he                                                               
expressed  his   desire  for   more  information   regarding  the                                                               
diagnostic definition  from the  task force.   He stated  that he                                                               
was  also concerned  for the  level of  Medicaid expansion  which                                                               
would result from this proposed bill.                                                                                           
                                                                                                                                
9:17:23 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SADDLER, in  response, explained  that Asperger's                                                               
Syndrome was  no longer  included in the  autism definition.   He                                                               
pointed  out that  autism spectrum  disorder ranged  from low  to                                                               
high  function.   He reported  that the  State of  Washington was                                                               
making  progress  for autism  coverage,  and  that the  State  of                                                               
Alaska was  also reviewing  its coverage.   He agreed  that there                                                               
was  a patchwork  of autism  coverage, noting  that Tricare  also                                                               
offered coverage.                                                                                                               
                                                                                                                                
9:18:44 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR shared  her support  for the  proposed bill.                                                               
She  discussed environmental  health research,  which underscored                                                               
the need to  learn a lot more about autism  spectrum disorder and                                                               
early interventions.  She welcomed  the upcoming reports from the                                                               
proposed task force.                                                                                                            
                                                                                                                                
9:19:23 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON asked  if the task force  meetings would be                                                               
available for listening.                                                                                                        
                                                                                                                                
REPRESENTATIVE SADDLER replied that  the task force would welcome                                                               
any input and suggestions.                                                                                                      
                                                                                                                                
9:20:41 AM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS commented  that  he had  been  learning about  the                                                               
Alaska Governor's Council on  Disabilities and Special Education.                                                               
He reported that these council members  were paid, and, as one of                                                               
its  jobs  was  for  the  same   work  as  this  task  force,  he                                                               
recommended that the groups work  together.  He pointed out that,                                                               
often,  the  various  groups  were  not  collaborative  with  the                                                               
information.                                                                                                                    
                                                                                                                                
9:22:04 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SADDLER  remarked that his  wife had been  on that                                                               
council for two terms, and he was very aware of the issues.                                                                     
                                                                                                                                
9:22:43 AM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS opened public testimony.                                                                                          
                                                                                                                                
9:22:52 AM                                                                                                                    
                                                                                                                                
PAUL VERHAGEN,  Staff, Representative Pete Higgins,  Alaska State                                                               
Legislature,  shared a  personal  anecdote about  the effects  of                                                               
autism on his  immediate family.  He explained  that his daughter                                                               
had four children who were  autistic.  He stated the difficulties                                                               
for finding any  support, and that the State  of [Oregon] offered                                                               
the most  assistance.   He reported  that the  state's assistance                                                               
brought  her a  base of  knowledge  for help  with the  children,                                                               
which she used to write a  children's book for teaching kids with                                                               
autism.  He expressed gratitude for  all the work and support for                                                               
autism.  He  reported that the children were now  thriving and at                                                               
grade level  in school.  He  declared that it was  more difficult                                                               
to discern that the kids had autism.                                                                                            
                                                                                                                                
9:27:03 AM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER  moved to  report HB  147 out  of committee                                                               
with individual recommendations and  the accompanying zero fiscal                                                               
notes.   There  being no  objection, HB  147 was  moved from  the                                                               
House Health and Social Services Standing Committee.                                                                            
                                                                                                                                
9:27:30 AM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 9:27 a.m. to 9:30 a.m.                                                                       
                                                                                                                                
9:30:26 AM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS brought the committee back to order.                                                                              
                                                                                                                                
9:31:32 AM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no further business before the committee, the House                                                                 
Health and Social Services Standing Committee meeting was                                                                       
adjourned at 9:31 a.m.                                                                                                          

Document Name Date/Time Subjects
HB184 Sponsor Statement (HB184 Sponsor Statement).pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB184 Ver N.pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB184 Sectional Analysis (HB184 Sectional Analysis).pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB184 Background Document (HB184 AK Metabolic Screening Program).pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB184 Background Document (HB184 Frequently Asked Questions).pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB184 Research - 13-345.pdf HHSS 4/6/2013 9:00:00 AM
HB 184
HB147 Sponsor Statement.pdf HHSS 4/6/2013 9:00:00 AM
HB 147
HB147 ver A.pdf HHSS 4/6/2013 9:00:00 AM
HB 147