Legislature(2015 - 2016)CAPITOL 106

04/05/2016 03:00 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Recessed to 4/6/16 at 3:30 pm --
*+ HB 345 INSURANCE COVERAGE FOR CONTRACEPTIVES TELECONFERENCED
Heard & Held
-- Public Testimony --
+= HB 334 CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE TELECONFERENCED
Heard & Held
+= HB 315 ELECTRONIC VISIT VERIFICATION: MEDICAID TELECONFERENCED
Moved CSHB 315(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                         April 5, 2016                                                                                          
                           3:05 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Paul Seaton, Chair                                                                                               
Representative Liz Vazquez, Vice Chair                                                                                          
Representative Neal Foster                                                                                                      
Representative David Talerico                                                                                                   
Representative Geran Tarr                                                                                                       
Representative Adam Wool                                                                                                        
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Louise Stutes                                                                                                    
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 345                                                                                                              
"An  Act relating  to insurance  coverage for  contraceptives and                                                               
related  services; relating  to medical  assistance coverage  for                                                               
contraceptives  and  related  services;   and  providing  for  an                                                               
effective date."                                                                                                                
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 334                                                                                                              
"An Act relating to visitation and child custody."                                                                              
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 315                                                                                                              
"An Act relating to an electronic visit verification system for                                                                 
providers of certain medical assistance services."                                                                              
                                                                                                                                
     - MOVED CSHB 315(HSS) OUT OF COMMITTEE                                                                                     
                                                                                                                                
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 345                                                                                                                  
SHORT TITLE: INSURANCE COVERAGE FOR CONTRACEPTIVES                                                                              
SPONSOR(s): REPRESENTATIVE(s) CLAMAN                                                                                            
                                                                                                                                
02/24/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/24/16       (H)       HSS, FIN                                                                                               
04/05/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 334                                                                                                                  
SHORT TITLE: CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE                                                                            
SPONSOR(s): REPRESENTATIVE(s) MUNOZ                                                                                             
                                                                                                                                
02/22/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/22/16       (H)       HSS, JUD                                                                                               
03/22/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/22/16       (H)       Heard & Held                                                                                           
03/22/16       (H)       MINUTE(HSS)                                                                                            
03/24/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/24/16       (H)       <Bill Hearing Rescheduled to 3/29/16>                                                                  
03/29/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/29/16       (H)       Heard & Held                                                                                           
03/29/16       (H)       MINUTE(HSS)                                                                                            
04/05/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
BILL: HB 315                                                                                                                  
SHORT TITLE: ELECTRONIC VISIT VERIFICATION: MEDICAID                                                                            
SPONSOR(s): REPRESENTATIVE(s) VAZQUEZ                                                                                           
                                                                                                                                
02/17/16       (H)       READ THE FIRST TIME - REFERRALS                                                                        
02/17/16       (H)       HSS                                                                                                    
03/22/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/22/16       (H)       Heard & Held                                                                                           
03/22/16       (H)       MINUTE(HSS)                                                                                            
03/24/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
03/24/16       (H)       Heard & Held                                                                                           
03/24/16       (H)       MINUTE(HSS)                                                                                            
04/05/16       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
MEGAN CAVANAUGH, Staff                                                                                                          
Representative Matt Claman                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented the changes to HB 345, on behalf                                                               
of Representative Claman, prime sponsor.                                                                                        
                                                                                                                                
REPRESENTATIVE MATT CLAMAN                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Introduced HB 345, as prime sponsor.                                                                     
                                                                                                                                
DIANA GREENE FOSTER, Researcher                                                                                                 
University of California, San Francisco                                                                                         
San Francisco, California                                                                                                       
POSITION STATEMENT:  Testified during discussion of HB 345.                                                                   
                                                                                                                                
KENNI PSENAK LINDEN                                                                                                             
Palmer, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
ROBIN SMITH                                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
CATRIONA REYNOLDS, Clinic Manager                                                                                               
Kachemak Bay Family Planning Clinic                                                                                             
Homer, Alaska                                                                                                                   
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
STEVEN SAMUELSON                                                                                                                
Petersburg, Alaska                                                                                                              
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
ELIZABETH FIGUS                                                                                                                 
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
CHRISTINE NIEMI                                                                                                                 
The League of Women Voters - Alaska                                                                                             
Douglas, Alaska                                                                                                                 
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
ALYSON CURREY                                                                                                                   
Planned Parenthood of the Great Northwest                                                                                       
and the Hawaiian Islands                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
SAMANTHA SAVAGE                                                                                                                 
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
CAITLIN HEDBERG                                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support of HB 345.                                                                          
                                                                                                                                
MAXINE DOOGAN                                                                                                                   
Community United for Safety and Protection                                                                                      
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT:  Testified in support for HB 345.                                                                         
                                                                                                                                
MARGARET BRODIE, Director                                                                                                       
Division of Health Care Services                                                                                                
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
345.                                                                                                                            
                                                                                                                                
CRYSTAL KOENEMAN, Staff                                                                                                         
Representative Cathy Munoz                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions on HB 334, on behalf of                                                               
the Representative Munoz, prime sponsor.                                                                                        
                                                                                                                                
KEELEY OLSON, Executive Director                                                                                                
Standing Together Against Rape (STAR)                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Testified during discussion of HB 334.                                                                   
                                                                                                                                
CHRISTINE PATE, Legal Program Director                                                                                          
Alaska Network on Domestic Violence & Sexual Assault (ANDVSA)                                                                   
Sitka, Alaska                                                                                                                   
POSITION STATEMENT:  Testified against proposed HB 334.                                                                       
                                                                                                                                
LINDA BRUCE, Attorney                                                                                                           
Legislative Legal Services                                                                                                      
Legislative Affairs Agency                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
334.                                                                                                                            
                                                                                                                                
NANCY MEADE, General Counsel                                                                                                    
Administrative Staff                                                                                                            
Office of the Administrative Director                                                                                           
Alaska Court System                                                                                                             
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Answered questions during discussion of HB                                                               
334.                                                                                                                            
                                                                                                                                
TANEEKA HANSEN, Staff                                                                                                           
Representative Paul Seaton                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION  STATEMENT:   Testified  and  answered questions  during                                                             
discussion of HB 315.                                                                                                           
                                                                                                                                
DEB ETHERIDGE, Deputy Director                                                                                                  
Central Office                                                                                                                  
Division of Senior and Disabilities Services                                                                                    
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions  during the discussion of                                                             
HB 315.                                                                                                                         
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:05:07 PM                                                                                                                    
                                                                                                                                
CHAIR PAUL  SEATON called  the House  Health and  Social Services                                                             
Standing   Committee    meeting   to    order   at    3:05   p.m.                                                               
Representatives Seaton,  Foster, Wool, and Talerico  were present                                                               
at the call  to order.  Representatives Vazquez  and Tarr arrived                                                               
as the meeting was in progress.                                                                                                 
                                                                                                                                
          HB 345-INSURANCE COVERAGE FOR CONTRACEPTIVES                                                                      
                                                                                                                                
3:05:49 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced that the  first order of business would be                                                               
HOUSE BILL  NO. 345, "An  Act relating to insurance  coverage for                                                               
contraceptives   and  related   services;  relating   to  medical                                                               
assistance coverage for contraceptives  and related services; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
3:06:28 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TALERICO moved  to adopt  the proposed  committee                                                               
substitute  (CS)  for  HB   345,  labeled  29-LS1503\H,  Wallace,                                                               
3/22/16, as the working document.                                                                                               
                                                                                                                                
CHAIR SEATON objected for discussion.                                                                                           
                                                                                                                                
3:07:24 PM                                                                                                                    
                                                                                                                                
MEGAN CAVANAUGH, Staff, Representative  Matt Claman, Alaska State                                                               
Legislature,  shared  the  changes   to  the  proposed  committee                                                               
substitute, Version  H.  She  relayed that Version H  removes the                                                               
provisions  that applied  to  over-the-counter contraceptives  in                                                               
the original bill on page 1, lines 11 - 12; page 2, lines 16 -                                                                  
17; and page 3, lines 18 - 19.                                                                                                  
                                                                                                                                
3:08:15 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MATT  CLAMAN, Alaska  State Legislature,  as prime                                                               
sponsor  of  HB  345,  paraphrased  from  the  sponsor  statement                                                               
[included in  members' packets], which read  as follows [original                                                               
punctuation provided]:                                                                                                          
                                                                                                                                
     Unintended  pregnancies have  significant and  negative                                                                    
     consequences for individual  women, their families, and                                                                    
     society  as a  whole. Research  links births  resulting                                                                    
     from unintended or closely  spaced pregnancy to adverse                                                                    
     maternal  and child  health outcomes  and other  social                                                                    
     and   economic   challenges.   With   Alaska's   fiscal                                                                    
     challenges, we should look for  ways to reduce costs in                                                                    
     the  shortterm  and  long-term.  House  Bill  345  will                                                                    
     reduce costs associated  with unintended pregnancies by                                                                    
     making  oral contraceptives  more  easily available  to                                                                    
     Alaskan women.                                                                                                             
                                                                                                                                
     In  2010,  48%  of   all  pregnancies  in  Alaska  were                                                                    
     unintended. Alaska's unintended  pregnancy rate in 2010                                                                    
     was 54 per 1,000 women  aged 15-44. Of those unintended                                                                    
     pregnancies, 60%  resulted in  births, 26%  resulted in                                                                    
     abortions, and the  remainder resulted in miscarriages.                                                                    
     Most   unintended  pregnancies   are  associated   with                                                                    
     significant public  costs. In 2010, 64.3%  of unplanned                                                                    
     births   in  Alaska   were  publically   funded,  which                                                                    
     resulted in a $42.9 million cost to the state.                                                                             
                                                                                                                                
     House Bill 345 seeks to  reduce the costs of unintended                                                                    
     pregnancies by  making oral contraceptives  more easily                                                                    
     available  to Alaskan  women.  A  research study  shows                                                                    
     that  women who  were  dispensed a  12-month supply  of                                                                    
     oral  contraceptives were  30% less  likely to  have an                                                                    
     unintended pregnancy  than women  who received a  1- or                                                                    
     3-month prescription.  The study concluded  that health                                                                    
     insurance  programs  and  public  health  programs  may                                                                    
     avert  costly  unintended   pregnancies  by  increasing                                                                    
     dispensing limits  on oral  contraceptives to  a 1-year                                                                    
     supply.                                                                                                                    
                                                                                                                                
     HB  345   requires  health  care   insurers,  including                                                                    
     Medicaid services,  to cover 12 months  of prescriptive                                                                    
     oral  contraceptives at  a  time.  Alaskan women  often                                                                    
     face  challenges while  trying  to access  prescription                                                                    
     contraceptives. Women living in  rural Alaska have less                                                                    
     access  to  healthcare   services  and  therefore  less                                                                    
     reliable   access   to   prescriptive   contraceptives.                                                                    
     Fisherwomen working on  a boat for two  or three months                                                                    
     at  a time  need longer  supplies of  prescription oral                                                                    
     contraceptives. This  bill looks to reduce  health care                                                                    
     costs  in Alaska  by preventing  unintended pregnancies                                                                    
     and providing  Alaskan women  greater access  to family                                                                    
     planning options.                                                                                                          
                                                                                                                                
3:09:19 PM                                                                                                                    
                                                                                                                                
MS.  CAVANAUGH clarified  that  the  recently distributed  fiscal                                                               
note  reflected  the  original   version  and  not  the  proposed                                                               
committee   substitute,  Version   H.      She  explained   that,                                                               
additionally, a fiscal note was  written for the Senate companion                                                               
bill, SB 156,  and reflected a $1.3 million cost  savings for the                                                               
state.                                                                                                                          
                                                                                                                                
CHAIR SEATON  pointed out  that the  fiscal note  for SB  156 was                                                               
located in the committee packets.                                                                                               
                                                                                                                                
MS.  CAVANAUGH  reported that  the  proposed  bill mandated  that                                                               
health  care   insurers  provide  coverage  for   a  prescriptive                                                               
contraceptive  up  to  12  months  at  one  time.    She  defined                                                               
prescriptive   contraceptives   as  self-administered,   hormonal                                                               
contraceptives, namely  oral contraceptives  that do  not require                                                               
insertion  or   other  types  of  administration   by  a  medical                                                               
professional.   She said this was  explained in Section 1  of the                                                               
proposed bill, which  contained a religious exemption  as well as                                                               
a  definition for  health care  insurer, which  included a  self-                                                               
insured employer, such  as the State of Alaska.   She moved on to                                                               
explain  that  Section  2  of  the  proposed  bill  directed  the                                                               
Department of  Health and Social  Services to cover the  12 month                                                               
supply of prescription contraceptives  for eligible recipients of                                                               
medical assistance.   Section 3 of the proposed  bill allowed for                                                               
the 12  month supply  of prescription  contraceptives to  be made                                                               
available to Medicaid  recipients, and Section 4  of the proposed                                                               
bill related to the effective date.                                                                                             
                                                                                                                                
MS. CAVANAUGH  stated that  a major  premise behind  the proposed                                                               
bill was that  offering women greater access  and availability to                                                               
contraceptives  reduced unintended  pregnancies.   This reduction                                                               
in  unintended  pregnancies had  a  direct  cost savings  to  the                                                               
state, which  was reflected  in the  provided fiscal  note, which                                                               
was drafted  to the  Senate version.   She directed  attention to                                                               
the study  [included in members'  packets], which  reported that,                                                               
in 2010,  48 percent of  pregnancies, about 8,000  pregnancies in                                                               
Alaska,  were unintended.   She  pointed out  that the  study had                                                               
used the  Centers for Disease  Control and  Prevention definition                                                               
of  an unintended  pregnancy  to mean  either  "mistimed, or  the                                                               
woman did not  want to become pregnant at that  time."  She added                                                               
that  the study  estimated that  3,000,  or 64.3  percent of  the                                                               
unplanned  pregnancies  in  2010,  were  publicly  funded.    She                                                               
reported that Alaska had spent  almost $113 million on unintended                                                               
pregnancies, that  70.8 percent was federally  funded, while 42.9                                                               
percent was  funded by the state.   She relayed that  these costs                                                               
also  had impacts  on programs  down the  line, including  foster                                                               
care, and on the child's overall  well-being.  She shared that an                                                               
additional study  [included in members' packets]  reviewed 84,000                                                               
women  in  California  provided  with  varying  amounts  of  oral                                                               
contraceptives, and that those researchers  observed a 30 percent                                                               
reduction in the odds of  pregnancy when given a year-long supply                                                               
of  oral  contraceptives.    Also reported  in  this  study,  the                                                               
California  family planning  program paid  $99 more  annually for                                                               
women who  received three cycles  of oral contraceptives  and $44                                                               
more  annually  for   women  who  received  one   cycle  of  oral                                                               
contraceptives than  it did for  women who received  the 12-month                                                               
supply all at once.  She  shared that the additional costs were a                                                               
result of pregnancy tests and  associated visits.  She noted that                                                               
the proposed  bill did not  change who was eligible  for coverage                                                               
or what kind  of prescriptions were being covered,  the bill only                                                               
allowed   that  women   who  currently   received  coverage   for                                                               
prescription  contraceptives could  receive the  prescription for                                                               
12 months  at one time,  if they choose.   She shared  that there                                                               
had been  concerns expressed from the  Small Business Association                                                               
for whether the  bill would apply to self-insured  entities.  She                                                               
stated that the sponsor would continue  to work with the group to                                                               
address  these  concerns.   She  pointed  out that  an  important                                                               
inclusion  to the  proposed  bill  was for  the  definition of  a                                                               
health care insurer  to include a self-insured  entity, which did                                                               
help  to  address  some  of  the concerns.    She  declared  that                                                               
proposed HB 345  would offer "huge advantages  for Alaskan women,                                                               
from eliminating the inconvenience  of refilling the prescription                                                               
every one  or three months  at a time  to the real  inability for                                                               
some  Alaskan  women to  make  it  to  the clinic,  hospital,  or                                                               
pharmacy to  refill that  prescription at all."   She  listed the                                                               
difficulties that many women faced in refilling prescriptions.                                                                  
                                                                                                                                
3:14:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  pointed out  that the  fiscal note  showed a                                                               
$1.3 million savings annually.                                                                                                  
                                                                                                                                
3:15:11 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON opened public testimony on HB 345.                                                                                 
                                                                                                                                
3:15:24 PM                                                                                                                    
                                                                                                                                
DIANA GREENE  FOSTER, Researcher,  University of  California, San                                                               
Francisco, explained  that she  was working  on research  for the                                                               
State of California  to evaluate and analyze the  impact of year-                                                               
long  supplies for  oral  contraceptives.   She  shared that  her                                                               
research indicated that  the benefits included a  cost savings of                                                               
almost $100  annually per person.   She reported that  there were                                                               
fewer clinic visits and fewer  pregnancy tests.  She relayed that                                                               
a second  study linked family  planning dispensing to  claims for                                                               
pregnancies,  births,  and abortions.    The  findings were  that                                                               
women who  received a one  year supply  were less likely  to have                                                               
either  a birth  or  an abortion  in the  subsequent  year.   She                                                               
stated  that  oral contraceptives  were  the  most commonly  used                                                               
reversible  method of  contraception  in the  United States,  and                                                               
that most  unintended pregnancies and most  abortions occurred to                                                               
women  using contraceptives  inconsistently.   She reported  that                                                               
one  in five  women in  abortion clinics  reported that  they had                                                               
unprotected  sex because  they ran  out  of birth  control.   She                                                               
allowed  that this  change  would offer  a  higher potential  for                                                               
women to avert unintended pregnancies.                                                                                          
                                                                                                                                
3:17:50 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  noted that a  synopsis of her research  is included                                                               
in members' packets.                                                                                                            
                                                                                                                                
3:18:27 PM                                                                                                                    
                                                                                                                                
KENNI PSENAK  LINDEN shared that,  as a college student,  she had                                                               
been  diagnosed   with  Stage   4  endometriosis  and   had  been                                                               
prescribed  hormonal  birth  control  to  allow  for  the  future                                                               
possibility to have children.   She reported on the difficulty of                                                               
maintaining  consistent use  of  birth control  while being  only                                                               
allowed a  one-month prescription, and  stated that having  a 12-                                                               
month supply  readily available  "would have  been a  huge relief                                                               
and  would have  given  me much  needed peace  of  mind about  my                                                               
health  and  my  ability  to  choose what  was  best  for  me  in                                                               
consultation with my  doctor."  She asked that  the proposed bill                                                               
address access to  birth control by dependents.   She relayed the                                                               
health  difficulties  of  endometriosis,   and  shared  that  the                                                               
prescriptions for hormonal birth  control allowed her to continue                                                               
with and  graduate from  college.  She  declared support  for the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
3:20:23 PM                                                                                                                    
                                                                                                                                
ROBIN SMITH  stated that this was  a good bill, and  there was no                                                               
reason not to  pass it as it offered cost  savings.  She declared                                                               
that  this  was  a  preventative   care  bill,  as  it  prevented                                                               
unintended  and unwanted  births and  abortions.   She listed  10                                                               
reasons why a  doctor might prescribe birth  control pills, other                                                               
than  to  prevent  pregnancy:   protection  against  ovarian  and                                                               
endometrial  cancer; prevention  of  ovarian  cysts; prevent  and                                                               
treat endometriosis;  prevent anemia; avoid  migraines associated                                                               
with menstrual  periods; treat PMS;  treat acne, and  excess hair                                                               
growth; and  balance hormone deficiency.   She declared  that, as                                                               
it  was beneficial  for women  to  have access  to birth  control                                                               
pills, there were not any  negatives associated with the proposed                                                               
bill.                                                                                                                           
                                                                                                                                
3:23:58 PM                                                                                                                    
                                                                                                                                
CATRIONA REYNOLDS,  Clinic Manager, Kachemak Bay  Family Planning                                                               
Clinic, pointed out  that she had sent in two  pages of facts and                                                               
data.  She stated that  consistent access to birth control should                                                               
not  be  dependent on  an  insurance  carrier.   She  listed  the                                                               
benefits  for supplying  12 months  of birth  control protection,                                                               
which included consistent use.                                                                                                  
                                                                                                                                
3:26:32 PM                                                                                                                    
                                                                                                                                
STEVEN SAMUELSON stated his support  of the proposed bill, noting                                                               
that people should  not be hindered by legislation  in pursuit of                                                               
health, especially when discussed with  a doctor.  He pointed out                                                               
that  many women  were  working in  the field  and  did not  have                                                               
immediate access  to refills.   He declared "people like  sex, so                                                               
why not have them be prepared."   He reiterated his support of HB                                                               
345.                                                                                                                            
                                                                                                                                
3:28:48 PM                                                                                                                    
                                                                                                                                
ELIZABETH FIGUS  reported that during  the summer  fishing season                                                               
she  did not  have time  to visit  a doctor.   She  allowed that,                                                               
although  some medical  issues were  unavoidable, it  was "silly"                                                               
and   "unnecessary"   not   to  pre-approve   a   birth   control                                                               
prescription.   She declared  that the  proposed bill  would save                                                               
money and  time for  individual women, and  would save  the costs                                                               
for   unplanned  pregnancies.      She  pointed   out  that,   as                                                               
contraception was already legal, it was only necessary to make                                                                  
the system be more fiscally efficient.  She stated her support                                                                  
for proposed HB 345.                                                                                                            
                                                                                                                                
3:30:53 PM                                                                                                                    
                                                                                                                                
CHRISTINE NIEMI, The League of Women Voters - Alaska,                                                                           
paraphrased from a prepared statement [included in members'                                                                     
packets], which read as follows [original punctuation provided]:                                                                
                                                                                                                                
     The League of Women  Voters of Alaska strongly supports                                                                    
     HB  345  (companion  to  SB 156),  a  bill  related  to                                                                    
     insurance   coverage  for   contraceptives  and   other                                                                    
     services   that   reduce   the   risk   of   unintended                                                                    
     pregnancies.  At  the  national level,  the  League  of                                                                    
     Women  Voters of  the  United  States supports  primary                                                                    
     care  for   all,  care  that  includes   "prenatal  and                                                                    
     reproductive  health." When  women have  the consistent                                                                    
     ability  to  plan  their  pregnancies,  their  families                                                                    
     benefit    through   greater    financial   well-being,                                                                    
     healthier   living   conditions,  healthier   children,                                                                    
     greater  opportunities,  and  a  myriad  of  additional                                                                    
     benefits.  While  improving  the quality  of  life  for                                                                    
     families, the  ability to avoid  unintended pregnancies                                                                    
     also reduces  costs for state and  federal governments.                                                                    
     In  2010 according  to  the  Guttmacher Institute,  the                                                                    
     State  of Alaska  spent nearly  $43  million on  health                                                                    
     costs  related  to  unintended  pregnancies  while  the                                                                    
     federal  government added  another  $71  million for  a                                                                    
     total  cost of  $114 million.  Guttmacher reports  that                                                                    
     48%  of   all  pregnancies  in  Alaska   in  2010  were                                                                    
     unplanned  and 64%  of  Alaska's unplanned  pregnancies                                                                    
     were  publicly  funded,  representing the  $43  million                                                                    
     cost.  In addition,  the  cost  benefits of  supporting                                                                    
     women in  their efforts to plan  their pregnancies goes                                                                    
     far beyond  the cost of  the pregnancy itself.  A woman                                                                    
     who is  able to plan  a pregnancy can  better guarantee                                                                    
     that  her   health  is  at   optimum  level   prior  to                                                                    
     pregnancy, reducing  the risk of a  difficult pregnancy                                                                    
     and  trauma to  the  child. Such  planning reduces  the                                                                    
     possibility  of  increased   health  problems  for  the                                                                    
     child, problems  which can follow  the child  for years                                                                    
     and require  increased health  and education  costs for                                                                    
     the  State. A  planned  pregnancy  increases a  woman's                                                                    
     ability to  manage her  role as  income provider  for a                                                                    
     family and  allows that family the  best opportunity to                                                                    
     remain   as   financially  independent   as   possible.                                                                    
     Supporting  affordable contraceptives  prescribed on  a                                                                    
     12-month basis  will undoubtedly  reduce the  number of                                                                    
     unintended  pregnancies in  Alaska, thereby  increasing                                                                    
     family  wellbeing and  reducing State  costs. 2  HB 345                                                                    
     can assist  women and families  to plan  pregnancies so                                                                    
     they  are  ready  for the  added  responsibility  of  a                                                                    
     child. In  addition, costs to the  State for unintended                                                                    
     pregnancies  can be  reduced.  This is  a win-win  bill                                                                    
     that   deserves   consideration  by   the   Legislature                                                                    
     especially  as it  struggles  with  the budget  crisis.                                                                    
     Thank you for your consideration.                                                                                          
                                                                                                                                
3:32:36 PM                                                                                                                    
                                                                                                                                
ALYSON CURREY, Planned Parenthood of  the Great Northwest and the                                                               
Hawaiian Islands, stated support for  insurance coverage for a 12                                                               
month  supply of  birth control  when supplied  by a  health care                                                               
provider.   She  added that  1 in  4 women  said they  had missed                                                               
pills  because of  not  being able  to  get them  in  time.   She                                                               
reported that a one year  supply dramatically improved consistent                                                               
use,   lowered  unintended   pregnancies,   and  hence,   reduced                                                               
abortions.                                                                                                                      
                                                                                                                                
3:34:10 PM                                                                                                                    
                                                                                                                                
SAMANTHA  SAVAGE   stated  her  support   for  HB  345   and  she                                                               
paraphrased  from  a  prepared statement  [included  in  members'                                                               
packets], which read as follows [original punctuation provided]:                                                                
                                                                                                                                
     I am writing today to  encourage you to support SB 156.                                                                    
     For many many women  oral contraception is their method                                                                    
     of  choice   for  various  personal   medical  reasons.                                                                    
     Alaskan women  face more barriers trying  to access all                                                                    
     medications due to  geographic and occupational reasons                                                                    
     (women who  live and  work in  rural communities  or on                                                                    
     fishing  vessels for  example).  Speaking  from my  own                                                                    
     life as  someone who left  the Mat-Su Valley  to attend                                                                    
     school  in Fairbanks,  trying  to  get my  prescription                                                                    
     refilled was an incredible burden  as I could only have                                                                    
     it  refilled on  a  month by  month  basis. Having  the                                                                    
     ability to have  12 months of birth  control covered by                                                                    
     an insurance  plan and  Medicaid at  one time  saves in                                                                    
     costs related  to doctors visits  to the  women seeking                                                                    
     medication, and  it saves  money related  to unintended                                                                    
     pregnancy. I urge your support  of this bill that would                                                                    
     have a  positive impact  on the  lives of  many Alaskan                                                                    
     women.                                                                                                                     
                                                                                                                                
3:35:36 PM                                                                                                                    
                                                                                                                                
CAITLIN HEDBERG urged  support of the proposed bill.   She shared                                                               
that she  is a  professional woman, and  that she  often traveled                                                               
for work.   She noted  that it was  a burden having  to re-supply                                                               
birth control,  reporting that missing  a pill or starting  a new                                                               
cycle because  of an interruption  to access wreaks havoc  on the                                                               
human body.   She had experienced an unintended  pregnancy due to                                                               
a lack  of access for  birth control.   She pointed out  that her                                                               
insurance would  only allow a  one month supply  at a time.   She                                                               
concluded  that the  proposed bill  was the  fiscally responsible                                                               
choice for the state and for the women of the state.                                                                            
                                                                                                                                
3:38:49 PM                                                                                                                    
                                                                                                                                
MAXINE  DOOGAN,  Community  United  for  Safety  and  Protection,                                                               
reported that she  represented current and former  sex workers in                                                               
Alaska, sex trafficking victims, and  their allies.  She declared                                                               
support for HB 345 as it expanded access to health care.                                                                        
                                                                                                                                
3:39:33 PM                                                                                                                    
                                                                                                                                
CHAIR   SEATON  closed   public   testimony  on   HB  345   after                                                               
ascertaining no one further wished to testify.                                                                                  
                                                                                                                                
3:39:41 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE WOOL  stated that  he supported the  proposed bill                                                               
as it "totally  makes sense."  He asked if  this was an insurance                                                               
bill, and whether it had been  previously possible for a 12 month                                                               
prescription for birth control pills.                                                                                           
                                                                                                                                
MS. CAVANAUGH  replied that  currently women could  not get  a 12                                                               
month  supply of  oral  contraceptives  at one  time,  as it  was                                                               
usually limited to one or three month supplies.                                                                                 
                                                                                                                                
REPRESENTATIVE  WOOL mused  that the  current state  of insurance                                                               
regulations  would not  cover the  payments for  more than  three                                                               
months.                                                                                                                         
                                                                                                                                
3:41:32 PM                                                                                                                    
                                                                                                                                
MARGARET BRODIE, Director, Director's  Office, Division of Health                                                               
Care  Services,   Department  of  Health  and   Social  Services,                                                               
explained that  a Medicaid prescription  was on  a month-by-month                                                               
basis, with those  individuals under 18 years of age  able to get                                                               
a 3  month prescription.  In  response to Chair Seaton,  she said                                                               
that the proposed bill would change  the situation for a 12 month                                                               
prescription, but that  it would be necessary to  ensure that the                                                               
individual  was eligible  for  all  12 months,  and  if not,  the                                                               
department  would have  to reimburse  the federal  government for                                                               
its  share  of  the  prescription that  the  individual  was  not                                                               
eligible.                                                                                                                       
                                                                                                                                
MS. BRODIE,  in response  to Chair  Seaton, replied  that private                                                               
insurance, dependent on  the plan, was for either a  one month or                                                               
a three month prescription.                                                                                                     
                                                                                                                                
REPRESENTATIVE WOOL directed attention  to the benefit savings in                                                               
the analysis of  the fiscal note, and asked  about the difference                                                               
between  the 9  percent failure  rate and  the 7  percent failure                                                               
rate,  resulting in  120 unintended  pregnancies.   He questioned                                                               
whether  all  of  the  unintended  pregnancies  had  resulted  in                                                               
childbirth.                                                                                                                     
                                                                                                                                
MS.  BRODIE  expressed her  agreement  that  the 120  pregnancies                                                               
would not  all result in live  birth, and she offered  her belief                                                               
that this had been taken into consideration in the calculations.                                                                
                                                                                                                                
3:45:14 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON said that HB 345 would be held over.                                                                               
                                                                                                                                
3:45:45 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  declared that  this problem with  access had                                                               
been long standing.  She pointed  out that young families had not                                                               
testified,  noting  that  they  were  very  challenged  with  the                                                               
demands of parenthood and working.   She opined that the proposed                                                               
bill would be very beneficial to young families.                                                                                
                                                                                                                                
3:46:58 PM                                                                                                                    
                                                                                                                                
CHAIR  SEATON removed  his objection  to  the proposed  committee                                                               
substitute.   There  being no  further objection,  Version H  was                                                               
adopted as the working draft.                                                                                                   
                                                                                                                                
[HB 345 was held over.]                                                                                                         
                                                                                                                                
3:47:25 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
         HB 334-CHILD CUSTODY;DOM. VIOLENCE;CHILD ABUSE                                                                     
                                                                                                                                
3:47:47 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced  that the next order of  business would be                                                               
HOUSE  BILL NO.  334, "An  Act relating  to visitation  and child                                                               
custody."                                                                                                                       
                                                                                                                                
3:48:30 PM                                                                                                                    
                                                                                                                                
CRYSTAL  KOENEMAN,  Staff,  Representative  Cathy  Munoz,  Alaska                                                               
State  Legislature,  on  behalf of  Representative  Munoz,  prime                                                               
sponsor of  HB 334, reported  that the  committee recommendations                                                               
had been  taken into consideration  and that she would  provide a                                                               
proposed committee substitute (CS) for review and approval.                                                                     
                                                                                                                                
3:49:31 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
3:50:18 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  brought the committee  back to order.   He reopened                                                               
public  testimony  on HB  334,  [which  had  been closed  at  the                                                               
previous bill hearing on 3/29/16].                                                                                              
                                                                                                                                
3:50:56 PM                                                                                                                    
                                                                                                                                
KEELEY OLSON, Executive Director,  Standing Together Against Rape                                                               
(STAR), shared  her background working against  domestic violence                                                               
and sexual  assault since 1989.   She testified in  opposition to                                                               
the  proposed  bill,   as  it  did  not   provide  the  necessary                                                               
protections  for  the  victims  of domestic  violence  and  their                                                               
children.    She offered  her  belief  that the  requirement  for                                                               
criminal conviction was  too high a standard to be  placed on the                                                               
victims of  domestic violence  when they  were seeking  civil and                                                               
legal  protections.     She  suggested   that  the   rebuttal  of                                                               
presumption was  a very effective  tool to protect the  safety of                                                               
victims  and  children,  and  that   much  of  the  testimony  by                                                               
attorneys were complaints  that this created havoc  in the family                                                               
law  courts.   She  stated  that domestic  violence  was a  messy                                                               
business, and  was one of  most underreported crimes  in America.                                                               
She said  that there  would not  be an  increase of  criminal law                                                               
convictions  with   this,  and  that  the   requirement  for  the                                                               
conviction would  not offer any  protection to the victims.   She                                                               
declared that  it was  necessary to be  cautious and  to properly                                                               
vet the  claimed experts of family  law, as opposed to  those who                                                               
have worked in the field  and understand the dynamics of domestic                                                               
abuse.    She said  that  for  courts to  take  on  the issue  of                                                               
custody, it  needed to  be prepared  to hear  "some of  the messy                                                               
business that  goes on  behind closed doors  that is  the typical                                                               
situation of domestic  abuse."  She stated her  opposition to the                                                               
proposed bill.                                                                                                                  
                                                                                                                                
3:56:13 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  relayed that  the proposed CS  had been  revised to                                                               
change  the  standard from  conviction  to  clear and  convincing                                                               
evidence  that  there  was  a   history  of  performing  domestic                                                               
violence.                                                                                                                       
                                                                                                                                
3:56:56 PM                                                                                                                    
                                                                                                                                
CHRISTINE  PATE,  Legal  Program   Director,  Alaska  Network  on                                                               
Domestic Violence  & Sexual  Assault (ANDVSA),  stated opposition                                                               
to  the  proposed bill.    She  relayed  that the  legal  program                                                               
provided civil  legal assistance, primarily in  family law cases,                                                               
to victims  of domestic violence  and sexual assault, as  well as                                                               
legal  advice  and counsel  to  advocates  in the  ANDVSA  member                                                               
programs.    She  shared  her  background in  family  law.    She                                                               
expressed her understanding of how  the custody statutes affected                                                               
victims, both  before and since  the enactment of  the rebuttable                                                               
presumption  law.    She  expressed concern  for  the  effect  on                                                               
children  of this  proposed  legislation.   She  stated that  the                                                               
rebuttable  presumption  law  was   enacted  to  protect  Alaskan                                                               
children  from  the  harmful  effects  of  exposure  to  domestic                                                               
violence.   She  expressed agreement  with the  sponsor statement                                                               
that fathers  were a critical  part of a child's  life; although,                                                               
she  declared, it  was most  important for  a child  to have  two                                                               
healthy  parents.   She stated  that  Alaska consistently  ranked                                                               
near  the  top  nationally  for   domestic  violence  and  sexual                                                               
assault.   She  pointed  out that  the  emotional, physical,  and                                                               
mental health  of children  in homes  with domestic  violence was                                                               
detrimentally  affected.    She  explained  that  the  rebuttable                                                               
presumption  against awarding  a  parent custody  was enacted  to                                                               
ensure that the  court made consideration of  domestic violence a                                                               
top priority in  the decisions for custody of  children, as prior                                                               
to this,  domestic violence  was only one  of nine  best interest                                                               
factors that  could be considered  by the court in  these custody                                                               
decisions.  She said that  domestic violence was such an enormous                                                               
issue in Alaska  that it needed to  be more than one  of the nine                                                               
best  interest factors,  declaring that  the proposed  bill would                                                               
return Alaska  to these  considerations unless  there had  been a                                                               
criminal  conviction  for  domestic  violence.   She  shared  her                                                               
concerns for the proposed committee  substitute regarding a clear                                                               
and convincing  evidence standard.   She offered her  belief that                                                               
domestic violence  was very  hard to prove  in court,  as victims                                                               
often did not want to come  forward because of fear or shame, and                                                               
often there  was not  extraneous evidence.   She stated  that the                                                               
clear and convincing standard made  domestic violence even harder                                                               
to prove  in a custody  case, and  she expressed support  for the                                                               
removal of  the criminal  conviction standard.   She  opined that                                                               
this standard was  an enormous burden to  overcome, especially in                                                               
Rural  Alaska.    She  stated  that  there  was  nothing  in  the                                                               
legislative  history  of  the  rebuttable  presumption  law  that                                                               
indicated  its  purpose was  to  require  a criminal  history  of                                                               
domestic  violence, as  the  current law  required  a history  of                                                               
perpetrating   domestic  violence   to   invoke  the   rebuttable                                                               
presumption.    She  reported  that  rebuttable  presumption  was                                                               
defined as one  act which caused serious physical  injury, a very                                                               
high standard,  or more than  one act of domestic  violence found                                                               
by a  preponderance of  the evidence,  51 percent  or more.   She                                                               
declared that the  history of domestic violence  was well defined                                                               
in  the statute.    She  stated that  an  accusation of  domestic                                                               
violence  was  not enough  to  invoke  the presumption  and  lose                                                               
custody of  the children,  as there  had to be  a finding  by the                                                               
trial court  that it was  more likely  than not, the  civil legal                                                               
standard, that one incident of  serious physical injury or two or                                                               
more  incidences occurred.   She  pointed out  that this  finding                                                               
could not  happen in  an ex parte  protection order  hearing, but                                                               
could only occur after a  long term domestic violence hearing, or                                                               
in  a custody  case where  both  parties had  the opportunity  to                                                               
fully present  evidence and  testify about  the incidences.   She                                                               
emphasized that courts are hesitant  to make findings of domestic                                                               
violence  in  long term  protection  order  cases because  of  an                                                               
understanding to  the significance of  the findings in  a custody                                                               
case.  She  declared that supervised visitation was  free in most                                                               
areas of Alaska.                                                                                                                
                                                                                                                                
CHAIR SEATON pointed out that the  proposed bill would next go to                                                               
the House Judiciary Standing Committee.                                                                                         
                                                                                                                                
4:04:00 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  closed public  testimony on  HB 334  after pointing                                                               
out that  the above two  testifiers had  been cut off  during the                                                               
previous hearing on HB 334 due to technical difficulties.                                                                       
                                                                                                                                
4:04:32 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR   reflected  that  her  struggle   with  the                                                               
proposed bill was  that the testimony had been  in such contrast.                                                               
She pointed  out that the  testimony regarding  supervised visits                                                               
had ranged  from not being available,  to very costly at  $75 per                                                               
hour, to being free in most communities.                                                                                        
                                                                                                                                
4:05:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TALERICO moved  to adopt  the proposed  committee                                                               
substitute (CS)  for HB 334, Version  29-LS1409\N, Bruce, 4/5/16,                                                               
as the  working draft.  There  being no objection, Version  N was                                                               
before the committee.                                                                                                           
                                                                                                                                
4:06:38 PM                                                                                                                    
                                                                                                                                
MS.  KOENEMAN stated  that the  proposed bill  was a  complicated                                                               
issue, and  that the  sponsor was  trying to  find a  more middle                                                               
ground  for the  best interest  of  the children.   She  directed                                                               
attention  to  the  original  intent   language  adopted  by  the                                                               
legislature in 1981, which essentially  stated that it was in the                                                               
best   interest   for   parents   to   share   the   rights   and                                                               
responsibilities  of  child  bearing.     While  actual  physical                                                               
custody may not be practical or  appropriate in all cases, it was                                                               
the  intent  of  the  legislature   that  both  parents  had  the                                                               
opportunity to guide and nurture the  child and to meet the needs                                                               
of the children on an  equal footing beyond the considerations of                                                               
support or actual  custody.  She declared that  the proposed bill                                                               
was seeking to ensure that the needs of the child were met.                                                                     
                                                                                                                                
CHAIR SEATON,  in response to Representative  Talerico, asked Ms.                                                               
Koeneman to explain  the changes made for  the proposed committee                                                               
substitute, Version N.                                                                                                          
                                                                                                                                
4:08:43 PM                                                                                                                    
                                                                                                                                
MS. KOENEMAN directed  attention to Section 1,  which removed the                                                               
rebuttable  presumption   language  in  AS  25.24.150(g).     She                                                               
reported that Section  2 added language for  clear and convincing                                                               
evidence  to   establish  a  history  of   perpetrating  domestic                                                               
violence, as well as the language  for the conviction of a crime,                                                               
for the judge to use in  determination of visitation rights.  She                                                               
moved on  to Section 3  which removed the  rebuttable presumption                                                               
language.   She explained  the changes to  Section 4  which dealt                                                               
with the  delegation of visitation  rights to a family  member by                                                               
deployed  parents.     She  relayed   that  Section  5   was  the                                                               
modification of  a custody or  visitation order that  removed the                                                               
rebuttable presumption.   She pointed out that  Section 6 removed                                                               
the  rebuttable presumption  language for  military families  for                                                               
the  delegation of  visitation rights  to a  family member.   She                                                               
reported  that Section  7  referenced  AS 25.24.150(c)(6),  which                                                               
removed  the  current  language  and changed  it  to  "clear  and                                                               
convincing evidence."  She reported  that Section 8 contained all                                                               
new language, which brought all  the custody arrangements back to                                                               
AS 25.20.061  if there was  any clear and convincing  evidence of                                                               
domestic violence, and that language was  set out in Section 2 of                                                               
the proposed  bill.  She noted  that the court could  order these                                                               
pieces  referenced  in  Section  2.   She  pointed  out  that  AS                                                               
25.24.150(m)  added a  time  frame around  the  acts of  domestic                                                               
violence.  She shared that AS  25.24.150(n) was in regard to both                                                               
parents committing  domestic violence,  and the award  of custody                                                               
to the  parent least likely  to perpetrate domestic  violence, or                                                               
to a suitable third party as ordered  by the court.  She moved on                                                               
to  the  changes for  Section  9  which repealed  the  rebuttable                                                               
presumption  language  as well  as  the  language regarding  both                                                               
parents  committing a  domestic  violence crime.   She  concluded                                                               
with  Section 10  which  stated  that this  act  only applied  to                                                               
visitation or  custody orders  issued on  or after  the effective                                                               
date of the proposed bill.                                                                                                      
                                                                                                                                
CHAIR SEATON directed attention to page  5, line 14, and asked if                                                               
this language  was applicable if this  was a child of  either one                                                               
of the parents.                                                                                                                 
                                                                                                                                
MS.  KOENEMAN  replied  that  the intent  was  to  include  step-                                                               
children or foster children.                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL suggested  that it  could read  "a child  of                                                               
either of the two parents."                                                                                                     
                                                                                                                                
CHAIR SEATON opined that it would be a child within the family.                                                                 
                                                                                                                                
4:16:46 PM                                                                                                                    
                                                                                                                                
LINDA BRUCE,  Attorney, Legislative Legal and  Research Services,                                                               
Legislative  Affairs Agency,  in response  to Chair  Seaton, said                                                               
that the language  currently exists under AS  25.20.061, and that                                                               
it could  be altered  to apply to  a child of  either of  the two                                                               
parents.                                                                                                                        
                                                                                                                                
CHAIR SEATON  asked if  this would cover  foster children  in the                                                               
home.                                                                                                                           
                                                                                                                                
MS.  BRUCE offered  her belief  that the  alteration would  cover                                                               
this,  although  she would  review  this  further and  provide  a                                                               
written response.                                                                                                               
                                                                                                                                
4:17:52 PM                                                                                                                    
                                                                                                                                
NANCY  MEADE, General  Counsel, Administrative  Staff, Office  of                                                               
the Administrative  Director, Alaska Court System,  said that she                                                               
would defer  to the Legislative  Legal and Research  Services for                                                               
the wording.   She stated  that definitions of  domestic violence                                                               
and household member already exist.                                                                                             
                                                                                                                                
4:18:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ  offered  her  belief that  there  was  a                                                               
definition of child  in the adoption chapter, AS  25.23.240.  She                                                               
relayed that  her problem was  that it was very  restrictive, and                                                               
she pointed  out that if  the child  was not biological,  and had                                                               
yet to  be adopted, they would  not be technically covered.   She                                                               
suggested the use of "household member" or similar.                                                                             
                                                                                                                                
CHAIR  SEATON  asked  if  this  could be  resolved  so  to  cover                                                               
domestic violence within the household.                                                                                         
                                                                                                                                
MS. BRUCE said that she would.                                                                                                  
                                                                                                                                
4:19:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  asked about  a circumstance with  two adults                                                               
and  a  blended  family  of  biological  children  from  previous                                                               
relationships,  although the  adults  were  not legally  married.                                                               
She  asked about  a time  frame for  legal custody  or visitation                                                               
rights by each parent.                                                                                                          
                                                                                                                                
MS. MEADE  replied that  there were  grandparent rights  and that                                                               
she would research  the rights for a person with  a long standing                                                               
relationship with the child.                                                                                                    
                                                                                                                                
4:20:53 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON suggested  a letter outlining the  questions be sent                                                               
to the next committee of referral.                                                                                              
                                                                                                                                
REPRESENTATIVE  TARR asked  that  the  circumstances around  non-                                                               
married couples be addressed.                                                                                                   
                                                                                                                                
CHAIR  SEATON reiterated  that a  letter  asking House  Judiciary                                                               
Standing Committee to address certain  issues could be sent along                                                               
with the proposed  bill.  He directed attention to  page 4, lines                                                               
11 - 14, and asked for an explanation.                                                                                          
                                                                                                                                
MS.  KOENEMAN expressed  her agreement  that the  language should                                                               
also  conform   to  "clear  and  convincing   evidence"  or  "has                                                               
committed a  crime" in order for  there to be consistency  in all                                                               
the areas.                                                                                                                      
                                                                                                                                
MS. MEADE replied  to an earlier question  by Representative Tarr                                                               
about supervised  visitation, and  its availability  in different                                                               
communities.   She explained  that she  had also  heard different                                                               
things.   She stated  that it  was most common  for the  judge to                                                               
seek that  the parties agree  on a  family friend or  relative to                                                               
supervise the  visitation, and  only if  there was  not agreement                                                               
would  there  be the  need  for  professional supervision.    She                                                               
opined  that  there was  no  longer  such  an entity  in  Juneau,                                                               
although this did vary by community.                                                                                            
                                                                                                                                
REPRESENTATIVE  TARR  asked  about participation  in  a  batterer                                                               
intervention program, offering her  belief that the only programs                                                               
available would  be prison  based, as  the funding  for community                                                               
based programs  was being  eliminated.  She  opined that  a judge                                                               
could  not order  this intervention  if there  was not  a program                                                               
within fifty miles.   She asked if this would  impact the ability                                                               
for these situations to be resolved favorably.                                                                                  
                                                                                                                                
MS.  MEADE,  in  response  to Representative  Tarr,  offered  her                                                               
belief that, in Section 9,  the presumption was eliminated, hence                                                               
there  would  not be  any  need  for the  batterers  intervention                                                               
program; however,  directing attention to  page 2, lines 8  - 12,                                                               
she relayed that  if there was a finding by  clear and convincing                                                               
evidence  of  domestic  violence  or  a  conviction  of  domestic                                                               
violence, the court  may order that the perpetrator go  to one of                                                               
these programs.   She noted that if a program  did not exist, she                                                               
would not expect that the judge would order this.                                                                               
                                                                                                                                
4:28:39 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON, noting that telehealth  programs had better results                                                               
as  they had  full attendance,  asked  if there  was a  batterers                                                               
program offered electronically.                                                                                                 
                                                                                                                                
MS.  KOENEMAN   relayed  that  there  were   batterer  prevention                                                               
programs available  on-line, although they  were new and  not yet                                                               
used in the state.                                                                                                              
                                                                                                                                
4:29:54 PM                                                                                                                    
                                                                                                                                
The committee took a brief at-ease.                                                                                             
                                                                                                                                
4:31:21 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced that HB 334 would be held over.                                                                          
                                                                                                                                
4:32:14 PM                                                                                                                    
                                                                                                                                
The committee took an at-ease from 4:32 p.m. to 4:37 p.m.                                                                       
                                                                                                                                
         HB 315-ELECTRONIC VISIT VERIFICATION: MEDICAID                                                                     
                                                                                                                                
4:37:41 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON announced that the  final order of business would be                                                               
HOUSE  BILL NO.  315, "An  Act  relating to  an electronic  visit                                                               
verification system  for providers of certain  medical assistance                                                               
services."                                                                                                                      
                                                                                                                                
4:38:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ moved  to  adopt  the proposed  committee                                                               
substitute (CS) for HB 315,  labeled 29-LS1287\N, Glover, 4/1/16,                                                               
as the working draft.                                                                                                           
                                                                                                                                
CHAIR SEATON objected for discussion.                                                                                           
                                                                                                                                
4:38:35 PM                                                                                                                    
                                                                                                                                
TANEEKA HANSEN,  Staff, Representative Paul Seaton,  Alaska State                                                               
Legislature,  explained that  the  proposed committee  substitute                                                               
would narrow  the approach for the  electronic visit verification                                                               
(EVV) system for the first  few years by directing the Department                                                               
of Health  and Social  Services to  establish pilot  projects for                                                               
these EVV systems.   She reported that Section 1  of the proposed                                                               
CS  was legislative  intent  language, stating  that  it was  the                                                               
intent of the legislature to  protect vulnerable Alaskans and the                                                               
integrity  of  the medical  assistance  program  by reducing  the                                                               
number  of  fraudulent claims  and  insuring  that services  were                                                               
provided to  medical recipients.   She relayed that it  would use                                                               
technology to  improve accountability for personal  care services                                                               
and  home  and  community  based services  delivered  to  medical                                                               
assistance recipients.                                                                                                          
                                                                                                                                
MS.  HANSEN   discussed  Section  2,  uncodified   law,  as  this                                                               
established  a  pilot  project and  directed  the  Department  of                                                               
Health and Social  Services to adopt standards  for an electronic                                                               
visit verification (EVV) system under  this project.  This system                                                               
would  be used  to verify  visits conducted  to provide  personal                                                               
care services in  the home or other setting  and visits conducted                                                               
to provide  home and  community based services.   She  noted that                                                               
this should  establish the providers eligible  to participate and                                                               
require  that the  EVV system  will document,  at a  minimum, the                                                               
name of the provider, or  their employee, the recipient, the date                                                               
and  time  the  contractor  begins   and  ends  the  delivery  of                                                               
services,  and the  location  of services.    She explained  that                                                               
subsection  (b) stated  that DHSS  would review  the EVV  systems                                                               
implemented  under  this  section   and  prepare  a  report  with                                                               
recommendations  for  statewide  application of  an  EVV  system,                                                               
which would  be due on or  before January 1, 2018,  and delivered                                                               
to the Alaska State Legislature.                                                                                                
                                                                                                                                
4:41:20 PM                                                                                                                    
                                                                                                                                
CHAIR  SEATON removed  his objection  to  the proposed  committee                                                               
substitute, Version N.  There  being no further objection, it was                                                               
adopted as the working draft.                                                                                                   
                                                                                                                                
REPRESENTATIVE WOOL  asked whether the  pilot program was  at the                                                               
discretion of the  department for hiring a vendor  or creating it                                                               
in-house.                                                                                                                       
                                                                                                                                
CHAIR SEATON explained  that this would be clarified in  a yet to                                                               
be introduced amendment.   He offered some  possibilities for the                                                               
pilot projects to ensure that  the department had the flexibility                                                               
"to get something  that will work and that people  are willing to                                                               
participate in."  In response  to Representative Wool, he pointed                                                               
out  that  there  was  a  fiscal  note  and  testimony  from  the                                                               
department.                                                                                                                     
                                                                                                                                
4:44:07 PM                                                                                                                    
                                                                                                                                
DEB  ETHERIDGE,  Deputy  Director, Central  Office,  Division  of                                                               
Senior  and  Disabilities  Services,  Department  of  Health  and                                                               
Social  Services, asked  for clarification  to which  fiscal note                                                               
was being referenced.                                                                                                           
                                                                                                                                
CHAIR SEATON clarified that the  fiscal note was for the original                                                               
bill and included information about the vendor.                                                                                 
                                                                                                                                
MS.  ETHERIDGE  said  that  she   could  speak  on  some  of  the                                                               
anticipated costs  associated with the  pilot project.   She said                                                               
that  she had  not calculated  the necessary  statistically valid                                                               
sample  for an  effective pilot  program, although  consultations                                                               
with industry  experts and  other states  had indicated  that the                                                               
transaction fee per transaction was  about $0.15, with each visit                                                               
consisting of  two transactions.   She noted that the  cost would                                                               
depend  on the  number of  services a  person received  each day.                                                               
She  suggested  that  a  pilot project  for  only  personal  care                                                               
services, and  not for home  and community based  services, would                                                               
have  fewer per  day transactions.   She  reported that  a person                                                               
could have personal care services  three times each day, although                                                               
this  could  change  if  there  were  home  and  community  based                                                               
services, as  well.  She  stated that  the draft fiscal  note had                                                               
anticipated costs for  two visits each day, five  days each week,                                                               
and 20 days each month.                                                                                                         
                                                                                                                                
CHAIR SEATON asked if this yielded an overall savings.                                                                          
                                                                                                                                
MS. ETHERIDGE  replied that  the savings  were associated  with a                                                               
1.5  percent  efficiency  found   in  administrative  claims  for                                                               
Medicaid.   She  explained that  there  would be  an actual  time                                                               
associated, and there would be a  savings as the time for service                                                               
would no longer be rounded.                                                                                                     
                                                                                                                                
4:48:31 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  pointed out  that the savings  in other  states had                                                               
accrued in the  first year, although, as  the providers adjusted,                                                               
those savings did not continue.                                                                                                 
                                                                                                                                
MS.  ETHERIDGE expressed  her agreement,  noting  that there  was                                                               
considerable savings  in small populations, which  did not always                                                               
continue when  moved into a  larger population.  She  stated that                                                               
the pilot program was a good way to ensure the savings.                                                                         
                                                                                                                                
CHAIR SEATON asked  that the pilot program be large  enough to be                                                               
statistically significant,  so there would  be a better  idea for                                                               
its savings on  a larger scale.   He asked if the  pilot would be                                                               
designed for different locations.                                                                                               
                                                                                                                                
MS.  ETHERIDGE replied  that  this would  be  necessary, as  some                                                               
associated expenditures  which were difficult to  anticipate were                                                               
with  connectivity,  and it  would  be  necessary  to pay  for  a                                                               
solution.   She  relayed that  it  would be  necessary to  target                                                               
different areas in  the state to ensure an  understanding for the                                                               
costs, and then to realize the savings.                                                                                         
                                                                                                                                
REPRESENTATIVE  WOOL  suggested  that  some savings  would  be  a                                                               
result  of reduction  in  fraud if  the  verification system  was                                                               
working.    He surmised  that  these  savings would  diminish  as                                                               
"people sort of start playing by the rules."                                                                                    
                                                                                                                                
MS.  ETHERIDGE  stated  that  the  expectation  was  for  ongoing                                                               
compliance and adherence when billing  for services using the EVV                                                               
system, and an overall reduction  and savings was anticipated for                                                               
each year.   She  referenced a  concern by  Representative Seaton                                                               
that  some   states  had  implemented  the   EVV  system  without                                                               
allocating enough  funds for a system  which provided recognition                                                               
of a service  provider in the home.  She  said that this required                                                               
extra funding,  noting that, without  it, the  verifications were                                                               
not as  valid.   She shared  that it was  necessary to  weigh the                                                               
cost of  the solution against  the cost of the  Medicaid program.                                                               
She  reported that  any additional  administrative  costs on  the                                                               
service from the Medicaid program  were captured in a cost report                                                               
and would be  reflected in the reimbursement.  She  said that all                                                               
of these  factors were considered when  implementing programs for                                                               
the state.                                                                                                                      
                                                                                                                                
REPRESENTATIVE  WOOL mused  that the  EVV system  would eliminate                                                               
fraud, and the  resultant criminal convictions for  fraud, as the                                                               
care and  the time  was accurately recorded.   He  suggested that                                                               
the costs should then stabilize.                                                                                                
                                                                                                                                
MS. ETHERIDGE clarified that most  authorized services were in 15                                                               
minute  units, and  it  was anticipated  that  more people  would                                                               
receive their authorized services.                                                                                              
                                                                                                                                
REPRESENTATIVE  VAZQUEZ  added  that  there was  also  a  quality                                                               
assurance component  with the  verification program,  noting that                                                               
Florida and Oklahoma had savings over the first few years.                                                                      
                                                                                                                                
4:55:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WOOL  observed that  the  system  appeared to  be                                                               
necessary,  and that  the  pilot program  could  determine if  it                                                               
would work and if there would be a savings.                                                                                     
                                                                                                                                
CHAIR  SEATON explained  that the  purpose  of the  pilot was  to                                                               
determine  if  the  data  could   be  fully  utilized  and  avoid                                                               
implementing a  big system  to cover the  entire state  and solve                                                               
all the problems at one time, which could then fail.                                                                            
                                                                                                                                
4:58:13 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON  moved to  adopt proposed  Amendment 1,  labeled 29-                                                               
LS1287\N.5, Glover, 4/5/16, which read:                                                                                         
                                                                                                                                
     Page 2, following line 19:                                                                                                 
     Insert a new subsection to read:                                                                                           
          "(b) The Department of Health and Social Services                                                                     
     may consider a third-party vendor system for the pilot                                                                     
     project under this section."                                                                                               
                                                                                                                                
     Reletter the following subsection accordingly.                                                                             
                                                                                                                                
4:58:42 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE VAZQUEZ  objected for  the purpose  of discussion.                                                               
She  said  that  she  supported  the  proposed  amendment  as  it                                                               
provided   the   department    with   further   flexibility   for                                                               
implementing the program.                                                                                                       
                                                                                                                                
4:59:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ removed  her objection.   There  being no                                                               
further objection, Amendment 1 was adopted.                                                                                     
                                                                                                                                
4:59:29 PM                                                                                                                    
                                                                                                                                
CHAIR  SEATON moved  to adopt  proposed  Conceptual Amendment  1,                                                               
which read:                                                                                                                     
                                                                                                                                
     Page 2 line 7:  replace "and" with "or"                                                                                    
                                                                                                                                
There being no objection, Conceptual Amendment 1 was adopted.                                                                   
                                                                                                                                
5:01:02 PM                                                                                                                    
                                                                                                                                
CHAIR  SEATON moved  to adopt  proposed  Conceptual Amendment  2,                                                               
which read:                                                                                                                     
                                                                                                                                
       Page 2 line 23:  Delete "January" and replace with                                                                       
     "July"                                                                                                                     
                                                                                                                                
There being no objection, Conceptual Amendment 2 was adopted.                                                                   
                                                                                                                                
5:01:46 PM                                                                                                                    
                                                                                                                                
CHAIR SEATON moved to adopt Conceptual Amendment 3, which read:                                                                 
                                                                                                                                
     Page 2 lines 5, 8, 10:  Delete "standards" and replace                                                                     
     with "regulations"                                                                                                         
                                                                                                                                
CHAIR  SEATON  explained  that   the  purpose  of  this  proposed                                                               
amendment was to clarify for  the Department of Health and Social                                                               
Services that it  was not necessary for a  standards based pilot,                                                               
but  instead, as  they were  adopting regulations,  they had  the                                                               
freedom  to  adopt  a  pilot   with  a  vendor,  from  a  current                                                               
provider's system, or another design.                                                                                           
                                                                                                                                
5:02:35 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE TARR  objected for discussion.   She asked  if, as                                                               
it was  a pilot program,  this had been developed  with standards                                                               
language, instead of regulations,  because regulations would make                                                               
it necessary for the formal process of drafting regulations.                                                                    
                                                                                                                                
CHAIR SEATON asked  if the use of "regulations"  [in the proposed                                                               
conceptual amendment] would interfere  with the interpretation of                                                               
formal  regulations, or  could  "guidelines" replace  "standards"                                                               
and retain the meaning.                                                                                                         
                                                                                                                                
MS. ETHERIDGE,  in response, said  that Department of  Health and                                                               
Social Services would prefer to  have "guidelines" or "standards"                                                               
[in the  proposed conceptual amendment] for  flexibility in order                                                               
to implement  the pilot program  on a  timely basis and  then the                                                               
department  could  adopt  regulations   if  necessary  to  ensure                                                               
funding through the Medicaid program.                                                                                           
                                                                                                                                
CHAIR SEATON asked which would be better.                                                                                       
                                                                                                                                
REPRESENTATIVE   VAZQUEZ   interjected    that   the   usage   of                                                               
"regulations"  was for  a  formal process,  and  could be  overly                                                               
burdensome  for a  pilot project.   She  expressed her  agreement                                                               
with the  intent to avoid  confusion by not imposing  a standards                                                               
based.     She   suggested  that   "standards"  be   replaced  by                                                               
"guidelines" [in the proposed conceptual  amendment] to avoid any                                                               
confusion.                                                                                                                      
                                                                                                                                
MS. ETHERIDGE expressed her agreement.                                                                                          
                                                                                                                                
5:06:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ moved  to adopt  a friendly  amendment to                                                               
Conceptual Amendment 3, which read:                                                                                             
                                                                                                                                
      Page 2 lines 5, 8, 10 Delete "standards" and replace                                                                      
     with "guidelines"                                                                                                          
                                                                                                                                
[The committee treated the friendly amendment as adopted.]                                                                      
                                                                                                                                
REPRESENTATIVE  TARR  removed  her  objection.   There  being  no                                                               
further  objection,  Conceptual  Amendment  3,  as  amended,  was                                                               
adopted.                                                                                                                        
                                                                                                                                
5:07:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  TARR   pointed  out  that  there   needed  to  be                                                               
consideration for  the unique circumstances of  Alaska, that cost                                                               
effectiveness  and  quality  assurance be  considered,  and  that                                                               
expectations be realistic.   She reminded that,  as personal care                                                               
attendant  services were  only provided  for individuals  able to                                                               
live independently, a  no-show was often reported  by the client.                                                               
She declared her  support of the personal  care attendant program                                                               
to allow  people to stay  in their homes  and be closer  to their                                                               
families.                                                                                                                       
                                                                                                                                
5:11:50 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  VAZQUEZ moved  to  report CSHB  315, labeled  29-                                                               
LS1287\N,  Glover,  4/1/16, as  amended,  out  of committee  with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being no objection, CSHB  315(HSS) was moved from the House                                                               
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
CHAIR SEATON  said that new fiscal  notes for Version N  would be                                                               
forthcoming.                                                                                                                    
                                                                                                                                
5:12:40 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
recessed at 5:12 p.m., until 4/6/16, at 3:30.                                                                                   

Document Name Date/Time Subjects
HB 345 Supporting Document Guttmacher - general.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Supporting Document UCSF Study Newspaper Article.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Supporting Document Guttmacher Alaska Stats.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Sponsor Statement.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Supporting Document Unintended Pregnancies Study.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Supporting Document Cost Savings Study.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Supporting Document ADN Commentary.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345vA.PDF HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 vH.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 fiscal Note- DCCED-DOI-04.01.16.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Support- League of Women Voters.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 334 Opposition_SAFV_3.28.16.pdf HHSS 4/5/2016 3:00:00 PM
HB 334
HB 334 Letter of Concern_Rep Josephson.pdf HHSS 4/5/2016 3:00:00 PM
HB 334
HB 315 Proposed Cs Version N.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
hB 315Explanation of Changes from version A to W to E.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 Proposed Amendment E.2.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 345 Fiscal Note - DHSS-HCMS-3-16-16.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 315 Fiscal Note DRAFT-DHSS-SDSA -4-1-16 ver E.PDF HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 Fiscal Note DRAFT-DHSS-HCMS 4-1-16 ver E.PDF HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 Fiscal Notes DRAFT-DHSS-SDMS-4-1-16 ver E.PDF HHSS 4/5/2016 3:00:00 PM
HB 315
HB334-ACS-TRC-04-05-16.pdf HHSS 4/5/2016 3:00:00 PM
HB 334
HB 345 Background -SB 156 - Fiscal Note - DHSS 2.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
SB 156
HB 315 Support PCA April 5 Letter Support CSHB 315.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 Proposed Amendment to the CS_N.5.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 334 adopted CS version N.pdf HHSS 4/5/2016 3:00:00 PM
HB 334
HB 315 Opposition -remove HCBS- AADD.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 Letter of concern from the governors council.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB 315 CS HSS version P-HSS final.pdf HHSS 4/5/2016 3:00:00 PM
HB 315
HB334 opposition - Christine Pate.pdf HHSS 4/5/2016 3:00:00 PM
HB 334
HB 345 Support - Tanana Chiefs Conference.PDF HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Support Samantha Savage.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Testimony - Amend- Jamie Donley.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Support - Beth Leban.pdf HHSS 4/5/2016 3:00:00 PM
HB 345
HB 345 Opposition - Small business association.PDF HHSS 4/5/2016 3:00:00 PM
HB 345
HB 334 Proposed CS version P.pdf HHSS 4/5/2016 3:00:00 PM
HB 334