Legislature(2013 - 2014)CAPITOL 106

04/08/2014 03:00 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 169 IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS TELECONFERENCED
Moved HCS CSSB 169(HSS) Out of Committee
+= HB 90 TESTING NEWBORNS FOR VITAMIN D TELECONFERENCED
Moved CSHB 90(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 8, 2014                                                                                          
                           3:03 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Pete Higgins, Chair                                                                                              
Representative Wes Keller, Vice Chair                                                                                           
Representative Lance Pruitt                                                                                                     
Representative Lora Reinbold                                                                                                    
Representative Paul Seaton                                                                                                      
Representative Geran Tarr                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Benjamin Nageak                                                                                                  
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
COMMITTEE SUBSTITUTE FOR SENATE BILL NO. 169(FIN)                                                                               
"An  Act establishing  in  the Department  of  Health and  Social                                                               
Services a  statewide immunization program and  the State Vaccine                                                               
Assessment  Council;  creating   a  vaccine  assessment  account;                                                               
requiring  a  vaccine  assessment from  assessable  entities  and                                                               
other program participants  for statewide immunization purchases;                                                               
repealing  the temporary  child and  adult immunization  program;                                                               
and providing for an effective date."                                                                                           
                                                                                                                                
     - MOVED HCS CSSB 169(HSS) OUT OF COMMITTEE                                                                                 
                                                                                                                                
HOUSE BILL NO. 90                                                                                                               
"An Act  establishing a  temporary program  in the  Department of                                                               
Health  and Social  Services for  testing  newborns for  baseline                                                               
vitamin D levels."                                                                                                              
                                                                                                                                
     - MOVED CSHB 90(HSS) OUT OF COMMITTEE                                                                                      
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 169                                                                                                                  
SHORT TITLE: IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS                                                                          
SPONSOR(s): SENATOR(s) GIESSEL                                                                                                  
                                                                                                                                
02/10/14       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/10/14       (S)       HSS                                                                                                    
02/21/14       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/21/14       (S)       Heard & Held                                                                                           
02/21/14       (S)       MINUTE(HSS)                                                                                            
02/24/14       (S)       HSS RPT CS  4DP   NEW TITLE                                                                            
02/24/14       (S)       DP: STEDMAN, MICCICHE, MEYER, ELLIS                                                                    
02/24/14       (S)       FIN REFERRAL ADDED AFTER HSS                                                                           
02/24/14       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/24/14       (S)       Moved CSSB 169(HSS) Out of Committee                                                                   
02/24/14       (S)       MINUTE(HSS)                                                                                            
03/03/14       (S)       FIN AT 5:00 PM SENATE FINANCE 532                                                                      
03/03/14       (S)       Scheduled But Not Heard                                                                                
03/05/14       (S)       FIN AT 5:00 PM SENATE FINANCE 532                                                                      
03/05/14       (S)       Moved CSSB 169(FIN) Out of Committee                                                                   
03/05/14       (S)       MINUTE(FIN)                                                                                            
03/07/14       (S)       FIN RPT CS  5DP   NEW TITLE                                                                            
03/07/14       (S)       DP: MEYER, KELLY, BISHOP, DUNLEAVY,                                                                    
                         OLSON                                                                                                  
03/21/14       (S)       TRANSMITTED TO (H)                                                                                     
03/21/14       (S)       VERSION: CSSB 169(FIN)                                                                                 
03/24/14       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/24/14       (H)       HSS, FIN                                                                                               
03/25/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/25/14       (H)       Heard & Held                                                                                           
03/25/14       (H)       MINUTE(HSS)                                                                                            
03/27/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/27/14       (H)       Heard & Held                                                                                           
03/27/14       (H)       MINUTE(HSS)                                                                                            
04/03/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
04/03/14       (H)       Heard & Held                                                                                           
04/03/14       (H)       MINUTE(HSS)                                                                                            
04/08/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB  90                                                                                                                  
SHORT TITLE: TESTING NEWBORNS FOR VITAMIN D                                                                                     
SPONSOR(s): REPRESENTATIVE(s) SEATON                                                                                            
                                                                                                                                
01/30/13       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/30/13       (H)       HSS, FIN                                                                                               
02/21/13       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
02/21/13       (H)       Heard & Held                                                                                           
02/21/13       (H)       MINUTE(HSS)                                                                                            
02/06/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
02/06/14       (H)       Heard & Held                                                                                           
02/06/14       (H)       MINUTE(HSS)                                                                                            
04/08/14       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
TOM STUDLER, Staff                                                                                                              
Representative Pete Higgins                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented the  committee substitute (CS) for                                                             
SB 169.                                                                                                                         
                                                                                                                                
SENATOR CATHY GIESSEL                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified as the sponsor of SB 169.                                                                      
                                                                                                                                
STEPHANIE WRIGHTSMAN-BIRCH, Chief                                                                                               
Women, Children & Family Health                                                                                                 
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 90.                                                                    
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:03:07 PM                                                                                                                    
                                                                                                                                
CHAIR PETE  HIGGINS called the  House Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    3:03   p.m.                                                               
Representatives  Higgins, Keller,  Seaton,  Reinbold, and  Pruitt                                                               
were present at  the call to order.   Representative Tarr arrived                                                               
as the meeting was in progress.                                                                                                 
                                                                                                                                
        SB 169-IMMUNIZATION PROGRAM; VACCINE ASSESSMENTS                                                                    
                                                                                                                                
3:04:10 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS  announced that the  first order of  business would                                                               
be CS FOR  SENATE BILL NO. 169(FIN), "An Act  establishing in the                                                               
Department   of   Health   and  Social   Services   a   statewide                                                               
immunization program  and the  State Vaccine  Assessment Council;                                                               
creating  a  vaccine  assessment  account;  requiring  a  vaccine                                                               
assessment   from   assessable   entities   and   other   program                                                               
participants for statewide  immunization purchases; repealing the                                                               
temporary  child and  adult immunization  program; and  providing                                                               
for an effective date."                                                                                                         
                                                                                                                                
3:04:23 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER   moved  to  adopt  the   House  committee                                                               
substitute  (HCS) for  CSSB  169,  labeled 28-LS1219\D,  Mischel,                                                               
4/7/14.  There being no objection, it was so ordered.                                                                           
                                                                                                                                
3:04:46 PM                                                                                                                    
                                                                                                                                
TOM  STUDLER, Staff,  Representative Pete  Higgins, Alaska  State                                                               
Legislature,  paraphrased from  the  Sectional  Analysis for  the                                                               
house committee substitute  for CSSB 169, Version  D [Included in                                                               
members' packets], which read:                                                                                                  
                                                                                                                                
     Section 1. Establishes a Statewide Immunization                                                                          
     Program with a State Vaccine Assessment Council; sets                                                                      
     requirements for vaccine assessments, reporting and                                                                        
     penalties for assessable entities and other program                                                                        
     participants; and creates a vaccine assessment                                                                             
     account.                                                                                                                   
     Section 2. Definitions.                                                                                                  
     Section 3. Amends Title 21 (Insurance) to require                                                                        
     assessable entities to provide information and pay                                                                         
     assessments.                                                                                                               
     Section 4. Adds the vaccine assessment account to the                                                                    
     list of program receipts authorized in the budget.                                                                         
     Section 5. Repeals this act on January 1, 2021.                                                                          
     Section 6. Repeals Ch. 24 SLA 2012.                                                                                      
     Section 7. Redirects the unobligated funds from Ch. 24                                                                   
      SLA 2012 to be deposited into the vaccine assessment                                                                      
     account.                                                                                                                   
     Section 8. Makes the effective date January 1, 2015.                                                                     
                                                                                                                                
CHAIR HIGGINS asked for clarification  that the January 1 date, a                                                               
calendar  year, was  for accounting  purposes for  the assessable                                                               
entities.                                                                                                                       
                                                                                                                                
MR. STUDLER  explained that the  effective date would  allow this                                                               
to  coincide with  the assessable  entities and  providers fiscal                                                               
year.   It  would  also  allow Department  of  Health and  Social                                                               
Services the opportunity  to use the existing funds  in the House                                                               
Bill 301 account before this effective date.                                                                                    
                                                                                                                                
3:07:38 PM                                                                                                                    
                                                                                                                                
MR. STUDLER paraphrased from the Explanation of changes for the                                                                 
House CS for CS SB 169\D [Included in members' packets], which                                                                  
read:                                                                                                                           
                                                                                                                                
     Section 1. Adds Article 1A Statewide Immunization                                                                          
     Program to AS 18.09.                                                                                                       
                                                                                                                                
     Sec. 18.09.200(a). Establishes a statewide                                                                                 
     immunization program in the Department for the purpose                                                                     
     of monitoring, purchasing, and distributing vaccines                                                                       
     to providers.                                                                                                              
                                                                                                                                
     Sec. 18.09.200(b). The Department of Health and Social                                                                     
     Services shall maintain a list of recommended vaccines                                                                     
     for inclusion in the program; establish the 1st year's                                                                     
     assessment & thereafter make annual assessments based                                                                      
     on commission determinations; notify insurers and                                                                          
     other program participants of the assessment amount;                                                                       
     devise a method for crediting overpayments; coordinate                                                                     
     the bulk purchase of vaccine; set procedures for                                                                           
     distributing vaccines; and review appeals for errors.                                                                      
                                                                                                                                
     Sec. 18.09.210. Establishes the State Vaccine                                                                              
     Assessment Council within HSS for the purpose of                                                                           
     determining the assessment amount. The council has 8                                                                       
     members appointed by the Commissioner: the state's                                                                         
     Chief Medical Officer (chair); Director of Division                                                                        
     Insurance; 3 health care insurers, one of whom must be                                                                     
     a plan administrator; 2 health care providers, one of                                                                      
     which must be a pediatrician; and 1 representing a                                                                         
     tribal or public health insurance plan who serve                                                                           
     without compensation or reimbursement of expenses.                                                                         
     Terms are 3 years with a 2- term limit. HSS will                                                                           
     provide staff and other assistance to the council. The                                                                     
     commission establishes and implements a plan of                                                                            
     operation, submits an annual financial report to HSS                                                                       
     each July 1st, and monitors compliance with the                                                                            
     program.                                                                                                                   
                                                                                                                                
     Sec. 18.09.210(b)(1) the department's chief medical                                                                        
     officer for public health or the chief medical                                                                             
     officer's designee, who shall serve as the chair;                                                                          
                                                                                                                                
     Sec. 18.09.210(f)(2). Requires an annual financial                                                                         
     report to the commissioner and legislature.                                                                                
                                                                                                                                
      Sec. 18.09.220(a) Establishes the vaccine assessment                                                                      
     and reporting requirements after being phased into the                                                                     
     program by the commissioner.                                                                                               
                                                                                                                                
     Sec.18.09.220(e). An assessable entity may opt out of                                                                      
     the program during the three year phase-in period.                                                                         
                                                                                                                                
     Sec. 18.09.225(a). Allows health care providers to opt                                                                     
     into the program to purchase vaccine.                                                                                      
                                                                                                                                
     Sec. 18.09.225(b) a health care provider who did not                                                                       
     opt into the program may not be denied a claim from an                                                                     
     assessable entity.                                                                                                         
                                                                                                                                
     Sec. 18.09.225(c) a health care provider cannot bill a                                                                     
     payer or resell a vaccine distributed under the                                                                            
     program.                                                                                                                   
                                                                                                                                
     Sec. 18.09.230. Creates a special account in the                                                                           
     general fund for the purpose of purchasing vaccines.                                                                       
     The legislature may appropriate program receipts from                                                                      
     vaccine assessments, money from other sources, and                                                                         
     interest earned. Appropriations do not lapse.                                                                              
                                                                                                                                
     Sec. 18.09.240. Allows the commissioner to determine a                                                                     
     monetary penalty for noncompliance.                                                                                        
                                                                                                                                
     Section 2. 18.09.990. Defines the terms assessable                                                                       
     entity, commissioner (Health & Social Services),                                                                         
     council, covered individual, other program                                                                               
     participant, program, provider, recommended vaccine,                                                                     
     and vaccine.                                                                                                             
                                                                                                                              
     Section 3. Requires assessable entities to provide                                                                       
     information to the department under (AS 21.09.242)                                                                       
                                                                                                                              
     Section 4. Adds the vaccine assessment account to the                                                                    
     list of special accounts for program receipts in (AS                                                                     
     37.05.146(c)                                                                                                             
                                                                                                                              
     Section 5. repeals this act on January 1, 2021                                                                           
                                                                                                                              
     Section6. Repeals Ch. 24, SLA 2012 (HB310), a                                                                            
     temporary statewide immunization program.                                                                                
                                                                                                                              
     Section 7. Redirects the remaining HB310 funds to be                                                                     
     deposited to the vaccine account.                                                                                        
                                                                                                                              
     Section 8. Makes the act effective January 1, 2015.                                                                      
                                                                                                                                
3:09:17 PM                                                                                                                    
                                                                                                                                
CHAIR  HIGGINS referred  to an  earlier discussion  regarding the                                                               
window of opportunity for an assessable  entity to opt out of the                                                               
program, pointing out  that the opt out was  no longer voluntary,                                                               
but would  now be up  to the  discretion of the  commissioner for                                                               
determination of the time period.                                                                                               
                                                                                                                                
3:10:18 PM                                                                                                                    
                                                                                                                                
[Chair Higgins closed public testimony.]                                                                                        
                                                                                                                                
SENATOR CATHY  GIESSEL, Alaska State Legislature,  said that this                                                               
was a small but important step  in reducing the health care costs                                                               
for Alaskans, as  well as a step toward fulfillment  of the goals                                                               
of the Alaska Health Care Commission.                                                                                           
                                                                                                                                
3:11:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER moved  to report HCS CSSB  169, Version 28-                                                               
LS1219\D,  Mischel,  4/7/14,  out of  committee  with  individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection  HCS CSSB 169(HSS)  was moved from the  House Health                                                               
and Social Services Standing Committee.                                                                                         
                                                                                                                                
The committee took an at-ease from 3:12 p.m. to 3:16 p.m.                                                                       
                                                                                                                                
             HB  90-TESTING NEWBORNS FOR VITAMIN D                                                                          
                                                                                                                                
3:16:43 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS announced that the  next order of business would be                                                               
HOUSE BILL  NO. 90, "An  Act establishing a temporary  program in                                                               
the  Department  of  Health  and   Social  Services  for  testing                                                               
newborns  for baseline  vitamin  D  levels."   [In  front of  the                                                               
committee was the  proposed committee substitute (CS)  for HB 90,                                                               
labeled  28-LS0376\O, Mischel,  2/4/14,  adopted  as the  working                                                               
draft on February 6, 2014.]                                                                                                     
                                                                                                                                
REPRESENTATIVE  KELLER  moved  to adopt  the  proposed  committee                                                               
substitute  (CS)   for  HB  90,  labeled   28-LS0376\Y,  Mischel,                                                               
3/31/14, as the working draft.   There being no objection, it was                                                               
so ordered.                                                                                                                     
                                                                                                                                
REPRESENTATIVE SEATON, as the sponsor  of the bill, explained the                                                               
changes to Version  Y, reporting that these changes  were made in                                                               
response  to  suggestions  from   the  House  Health  and  Social                                                               
Services  Standing  Committee.     He  noted  that  the  original                                                               
proposal had  been for statewide  universal testing for  one year                                                               
with an opt out option, and  that the research did not direct any                                                               
immediate benefit for the newborns  or the mothers.  He explained                                                               
that Version Y  would make this a two year  pilot project for 500                                                               
volunteer  pregnant women.   He  was discussing  involvement with                                                               
various providers to become the  coordinating local entity and to                                                               
provide program  analysis and data for  the participants benefit.                                                               
He  reported  that this  would  become  a  project based  on  the                                                               
application  of medical  science  to collect  the information  on                                                               
pregnancies  in  Alaska  and  to  provide  medical  benefits  for                                                               
mothers and newborns.   He pointed out that a  similar project in                                                               
South  Carolina had  reduced the  pre-term births  to 7  percent,                                                               
which  would equate  to  a  reduction of  25  pre-term births  in                                                               
Alaska and a  savings of $1.3 million.  He  shared that the state                                                               
would  have a  maximum match  with  the partners  of 20  percent,                                                               
about  $100,000.   He referred  to the  Protect Our  Children Now                                                               
program  description and  cost  schedule.  [Included in  members'                                                               
packets]  He  stated that this would move  the population forward                                                               
in prevention  of unintended pregnancy  outcomes.  He  asked that                                                               
the committee move the bill forward.                                                                                            
                                                                                                                                
3:23:08 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS asked  for clarification that the end  goal for the                                                               
program was  for documentation proving  that Vitamin D  does what                                                               
Representative Seaton had presented, and to encourage its use.                                                                  
                                                                                                                                
REPRESENTATIVE SEATON  expressed his agreement,  reiterating that                                                               
this was a  voluntary demonstration project and  that, should the                                                               
results  support it,  the medical  community would  encourage the                                                               
use of Vitamin D.                                                                                                               
                                                                                                                                
CHAIR HIGGINS asked about the study in Australia.                                                                               
                                                                                                                                
REPRESENTATIVE  SEATON  clarified   that  the  proposed  program,                                                               
Protect Our  Children Now, was  based on a South  Carolina study.                                                               
He  opined  that  the  program could  lower  pre-term  births  in                                                               
Alaska.                                                                                                                         
                                                                                                                                
3:25:37 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SEATON,  in response  to Chair Higgins,  said that                                                               
the South Carolina  study had been conducted since  2004, and had                                                               
begun as a  research project.  He said that  the proposed program                                                               
for Alaska was an outgrowth of this project.                                                                                    
                                                                                                                                
CHAIR  HIGGINS reflected  on  a recent  seminar  he had  attended                                                               
which discussed  studies and  research.   He offered  an anecdote                                                               
claiming  that a  two year  study was  useless and  needed to  be                                                               
drawn out over a much longer  period, and that the performance of                                                               
the  studies often  made the  research useless.   He  pointed out                                                               
that the  proposed bill was for  a two-year study, yet  he opined                                                               
that  it was  necessary for  a longer  research project  to fully                                                               
understand the data.                                                                                                            
                                                                                                                                
REPRESENTATIVE SEATON  expressed his  agreement.  He  pointed out                                                               
that the  aforementioned had  been a  research study,  while this                                                               
was a  project based on that  research.  He noted  that pregnancy                                                               
outcomes were recognized in 9  months, and it would require about                                                               
500  pregnancies for  enough data  to review  the pre-term  birth                                                               
rate.   He  declared that  the proposed  bill was  for a  project                                                               
based on  scientific research, and  although it would  offer more                                                               
data, was not a research project.                                                                                               
                                                                                                                                
3:30:17 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  SEATON  pointed out  that  the  fiscal note  from                                                               
Department  of  Health  and  Social   Services  was  higher  than                                                               
permitted by the  proposed bill, and he relayed that  there was a                                                               
search for a different partner to  do this more economically.  He                                                               
mentioned partners  in other states  performing this  program for                                                               
much  less than  the attached  fiscal note  proposed.   He shared                                                               
that the proposed  bill would show a willingness by  the State of                                                               
Alaska  to  participate  in  the improvement  of  the  health  of                                                               
pregnant women and infants.  He  reiterated that this was a pilot                                                               
project,  implementing  earlier   research  findings  from  other                                                               
studies.                                                                                                                        
                                                                                                                                
3:31:19 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  referred to  other screenings, and  asked if                                                               
any  of them  would  be willing  to  incorporate questions  about                                                               
Vitamin D use.                                                                                                                  
                                                                                                                                
REPRESENTATIVE  SEATON replied  that this  would be  part of  the                                                               
nutritional  and screening  information compiled  from those  who                                                               
volunteered to be in the program.   He clarified that the project                                                               
was not designed  for a questionnaire, but would  focus on better                                                               
outcomes and healthier  mothers and newborns.   The proposed bill                                                               
would show  that the state would  be willing to participate  as a                                                               
minor partner.                                                                                                                  
                                                                                                                                
3:33:37 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS stated that public testimony was still open.                                                                      
                                                                                                                                
3:33:55 PM                                                                                                                    
                                                                                                                                
STEPHANIE  WRIGHTSMAN-BIRCH,  Chief,  Women,  Children  &  Family                                                               
Health,  Division  of Public  Health,  Department  of Health  and                                                               
Social Services,  stated appreciation for the  changes to Version                                                               
Y,  especially as  it included  treatment and  public information                                                               
after the data  had been collected.  She  expressed concerns with                                                               
the  content of  the  bill  as it  pointed  toward conducting  an                                                               
experimentally  designed  research  study   which  would  be  the                                                               
responsibility  of  the  Division   of  Public  Health  to  carry                                                               
forward.   She  stated  that  this was  not  a  core function  of                                                               
Division of  Public Health.  She  acknowledged that participation                                                               
was  voluntary,  although  she   opined  that  all  research  was                                                               
voluntary.   She  stated  that  a longer  time  was necessary  to                                                               
collect the data.   She declared that DHSS was  very sensitive to                                                               
requiring Institutional Review Board  (IRB) approvals.  She noted                                                               
that  there  were rigorous  study  design  elements and  national                                                               
standards  that  needed  to  be  adhered.   She  noted  that  the                                                               
proposed   fiscal  note   included  state   personnel  time   for                                                               
administration, and even  if the intent was for  a contractor and                                                               
a grantee,  it was the  responsibility of the Division  of Public                                                               
Health to oversee  the study design and protocol,  and to conduct                                                               
a secondary  review of the  data.   She declared that  there were                                                               
costs  included  for this.    Once  the  data was  collected  and                                                               
analyzed,  it  had  to  be   compared  with  prior  research  and                                                               
recommendations.   She  declared a  challenge to  be the  lack of                                                               
acceptable standard  recommendations or guidelines for  Vitamin D                                                               
levels  on  newborns  or  pregnant women.    She  acknowledged  a                                                               
difference of  opinion between the  Vitamin D literature  and the                                                               
recommendations  for its  use by  organizations  to which  public                                                               
health officials were bound to follow.                                                                                          
                                                                                                                                
3:39:09 PM                                                                                                                    
                                                                                                                                
CHAIR HIGGINS closed public testimony and took a brief at-ease.                                                                 
                                                                                                                                
3:39:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER moved  to  report  the proposed  committee                                                               
substitute  (CS)   for  HB  90,  labeled   28-LS0376\Y,  Mischel,                                                               
3/31/14,  out of  committee with  individual recommendations  and                                                               
the  attached  fiscal notes.    There  being no  objection,  CSHB                                                               
90(HSS)  was moved  from  the House  Health  and Social  Services                                                               
Standing Committee.                                                                                                             
                                                                                                                                
3:39:58 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:42:11 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 3:42 p.m.                                                                                                          
                                                                                                                                

Document Name Date/Time Subjects
HB090 sponsor statement- 2014.pdf HHSS 4/8/2014 3:00:00 PM
HB 90
HB090 draft proposed CS Ver 28-LS0376Y.pdf HHSS 4/8/2014 3:00:00 PM
HB 90
HB090 changes-ver O to ver Y.pdf HHSS 4/8/2014 3:00:00 PM
HB 90
Alaska Vaccine Letter Medicaid FINAL 4-7-14.pdf HHSS 4/8/2014 3:00:00 PM
HB090 Support Document-study-Wagner-2013.pdf HHSS 2/6/2014 3:00:00 PM
HHSS 4/8/2014 3:00:00 PM
HB 90
HB090 Support Document-Protect our Children Now-booklet 2-3-14_grassroots.pdf HHSS 2/6/2014 3:00:00 PM
HHSS 4/8/2014 3:00:00 PM
HB 90
HCS for CSSB 169 ver T Section Analysis.pdf HHSS 4/3/2014 3:00:00 PM
HHSS 4/8/2014 3:00:00 PM
SB 169
HCS for CSSB 169 ver T Explanation of Changes.pdf HHSS 4/3/2014 3:00:00 PM
HHSS 4/8/2014 3:00:00 PM
SB 169
CS SB 169 Version T.pdf HHSS 4/3/2014 3:00:00 PM
HHSS 4/8/2014 3:00:00 PM
SB 169
SB169 WhoPaysFor VaccineInAK.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB 169 DCCED fiscal note.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB 169 DHSS fiscal note #2.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB 169 DHSS fiscal note.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB 169 DOA fiscal note.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB 169 Fund Transfers fiscal note.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
SB169 Sponsor Statement Immunization Program.pdf HHSS 4/8/2014 3:00:00 PM
SHSS 2/21/2014 1:30:00 PM
SB 169
House CSSB 169 Version D.pdf HHSS 4/8/2014 3:00:00 PM
SB 169
HCS for CSSB 169 ver D Section Analysis.pdf HHSS 4/8/2014 3:00:00 PM
SB 169
HCS for CSSB 169 ver D Explanation of Changes.pdf HHSS 4/8/2014 3:00:00 PM
SB 169