Legislature(2017 - 2018)CAPITOL 106

02/08/2018 03:00 PM HEALTH & SOCIAL SERVICES

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Audio Topic
03:04:18 PM Start
03:04:50 PM HB296
03:57:56 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ HB 296 YOUTH MARIJUANA PREVENTION PROGRAMS/FUND TELECONFERENCED
Heard & Held
-- Testimony <Invitation Only> --
+= HB 313 RECOVERY OF PAYMENT BY INSURANCE PROVIDER TELECONFERENCED
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                     
                        February 8, 2018                                                                                        
                           3:04 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Representative Ivy Spohnholz, Chair                                                                                             
Representative Bryce Edgmon, Vice Chair                                                                                         
Representative Sam Kito                                                                                                         
Representative Geran Tarr                                                                                                       
Representative David Eastman                                                                                                    
Representative Jennifer Johnston                                                                                                
Representative Colleen Sullivan-Leonard                                                                                         
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Representative Matt Claman (alternate)                                                                                          
Representative Dan Saddler (alternate)                                                                                          
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
HOUSE BILL NO. 296                                                                                                              
"An  Act  creating  the Alaska  marijuana  use  prevention  youth                                                               
services  grant  program;  creating   the  Alaska  marijuana  use                                                               
prevention,  education,  and  treatment  fund;  relating  to  the                                                               
duties  of  the  Alaska  Children's  Trust  Board;  creating  the                                                               
marijuana use  education and treatment  program; and  relating to                                                               
the duties of the Department of Health and Social Services."                                                                    
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
HOUSE BILL NO. 313                                                                                                              
"An Act relating to payments to providers and covered persons                                                                   
and recovery of payments by health care insurers."                                                                              
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB 296                                                                                                                  
SHORT TITLE: YOUTH MARIJUANA PREVENTION PROGRAMS/FUND                                                                           
SPONSOR(s): REPRESENTATIVE(s) CLAMAN                                                                                            
                                                                                                                                
01/19/18       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/18       (H)       HSS, FIN                                                                                               
02/08/18       (H)       HSS AT 3:00 PM CAPITOL 106                                                                             
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
REPRESENTATIVE MATT CLAMAN                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 296 as the sponsor of the                                                                   
bill.                                                                                                                           
                                                                                                                                
SARA PERMAN, Staff                                                                                                              
Representative Matt Claman                                                                                                      
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Presented HB 296 on behalf of the bill                                                                   
sponsor, Representative Claman.                                                                                                 
                                                                                                                                
THOMAS AZZARELLA, Director                                                                                                      
Alaska Afterschool Network                                                                                                      
Alaska Children's Trust                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented a PowerPoint, "Afterschool                                                                     
Programs," during discussion of HB 296.                                                                                         
                                                                                                                                
JAY BUTLER, MD, Chief Medical Officer/ DPH Director                                                                             
Central Office                                                                                                                  
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented a PowerPoint and answered                                                                      
questions during discussion of HB 296.                                                                                          
                                                                                                                                
JILL LEWIS, Deputy Director - Juneau                                                                                            
Central Office                                                                                                                  
Division of Public Health                                                                                                       
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Answered questions during the discussion of                                                              
HB 296.                                                                                                                         
                                                                                                                                
TREVOR STORRS, Executive Director                                                                                               
Alaska Children's Trust                                                                                                         
Anchorage, Alaska                                                                                                               
POSITION STATEMENT:  Presented a PowerPoint, "Afterschool                                                                     
Programs," during discussion of HB 296.                                                                                         
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
3:04:18 PM                                                                                                                    
                                                                                                                                
CHAIR IVY SPOHNHOLZ  called the House Health  and Social Services                                                             
Standing   Committee    meeting   to    order   at    3:04   p.m.                                                               
Representatives Spohnholz,  Kito, Sullivan-Leonard,  and Johnston                                                               
were  present at  the call  to order.   Representatives  Eastman,                                                               
Tarr, and Edgmon arrived as the meeting was in progress.                                                                        
                                                                                                                                
        HB 296-YOUTH MARIJUANA PREVENTION PROGRAMS/FUND                                                                     
                                                                                                                                
3:04:50 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced  that the only order  of business would                                                               
be HOUSE BILL NO. 296, "An  Act creating the Alaska marijuana use                                                               
prevention  youth services  grant  program;  creating the  Alaska                                                               
marijuana   use  prevention,   education,  and   treatment  fund;                                                               
relating  to the  duties of  the Alaska  Children's Trust  Board;                                                               
creating the  marijuana use education and  treatment program; and                                                               
relating to  the duties  of the Department  of Health  and Social                                                               
Services."                                                                                                                      
                                                                                                                                
3:05:55 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MATT  CLAMAN, Alaska State  Legislature, presented                                                               
proposed HB  296, as  the sponsor  of the  bill.   He paraphrased                                                               
from the Sponsor Statement [Included  in members' packets], which                                                               
read:                                                                                                                           
                                                                                                                                
     In 2014,  Alaskans legalized the use  and possession of                                                                    
     marijuana  in  the state.  Ballot  measure  2 gave  the                                                                    
     state the  ability to tax and  regulate the production,                                                                    
     sale,  and  use  of  marijuana.   In  2015  the  Alaska                                                                    
     Legislature  decided to  implement a  $50/ounce tax  on                                                                    
     marijuana sales. Since the measure  went into effect in                                                                    
     early  2015  the  state  has  collected  more  than  $6                                                                    
     million dollars in tax revenue.                                                                                            
                                                                                                                                
     HB  296 creates  the Alaska  marijuana use  prevention,                                                                    
     education, and  treatment fund. Under  current statute,                                                                    
     fifty  percent  of  the   tax  revenue  generated  from                                                                    
     marijuana sales  is designated to go  to the recidivism                                                                    
     reduction  fund established  within  the general  fund.                                                                    
     The  remaining fifty  percent  goes  directly into  the                                                                    
     general fund.                                                                                                              
                                                                                                                                
     Under  HB 296,  the  remaining fifty  percent would  be                                                                    
     allocated  into  the  new fund.  Under  HB  296,  fifty                                                                    
     percent  of  the  new  fund may  be  allocated  to  the                                                                    
     Department of  Health and Social Services  (DHSS) for a                                                                    
     comprehensive  marijuana  use education  and  treatment                                                                    
     program, and the remainder of  the funds will go to the                                                                    
     newly  established  Alaska   marijuana  use  prevention                                                                    
     youth services  grant program which is  administered by                                                                    
     the Alaska Children's Trust Board.                                                                                         
                                                                                                                                
     The  program   implemented  by   DHSS  will   focus  on                                                                    
     statewide  misuse  prevention   and  education  on  the                                                                    
     effects of marijuana and the  Alaska marijuana laws. It                                                                    
     also funds  substance abuse screening and  treatment as                                                                    
     well as  monitoring public perception.  Separately, the                                                                    
     Alaska  Children's  Trust  Board  will  administer  the                                                                    
     Alaska  marijuana use  prevention youth  services grant                                                                    
     program,  giving  grants  to  non-profit  out-of-school                                                                    
     programs  that provide  youth marijuana  use prevention                                                                    
     and reduction curriculums.                                                                                                 
                                                                                                                                
     It is  the intent that the  Legislature treat marijuana                                                                    
     much   like  alcohol   and   tobacco   and  invest   in                                                                    
     prevention,  education,   and  treatment   services  in                                                                    
     youths  and  adults   to  reduce  long-term  associated                                                                    
     costs.  House Bill  296 creates  statewide programs  as                                                                    
     well as the funding structure to do so.                                                                                    
                                                                                                                                
3:07:12 PM                                                                                                                    
                                                                                                                                
SARA PERMAN, Staff, Representative Matt Claman, Alaska State                                                                    
Legislature, paraphrased from the Sectional Analysis [Included                                                                  
in members' packets], which read:                                                                                               
                                                                                                                                
     Section 1                                                                                                                
     Adds new sections to AS 17.38:                                                                                             
     Creates  the  Alaska  marijuana  use  prevention  youth                                                                    
     services  grant  program  and  designates  that  it  is                                                                    
     administered  by  the  Alaska  Children's  Trust  (ACT)                                                                    
     Board.  The  program  provides funds  and  training  to                                                                    
     statewide  and community-based  programs that  focus on                                                                    
     reducing the  number of youth trying  marijuana for the                                                                    
     first time, and the  number of youth consistently using                                                                    
     marijuana  as   well  as   reducing  youth   access  to                                                                    
     marijuana  and   exposure  to  impaired   driving.  The                                                                    
     programs selected  by the Board must  be either 501c(3)                                                                    
     or federally  recognized tribes,  a municipal  or state                                                                    
     government, or a school. The  ACT Board is charged with                                                                    
     adopting  regulations to  carry out  the grant  program                                                                    
     including   application   requirements  and   reporting                                                                    
     criteria.                                                                                                                  
                                                                                                                                
     17.38.410                                                                                                                
     Creates   the   Alaska    marijuana   use   prevention,                                                                    
     education, and treatment fund. The  fund is part of the                                                                    
     general account  and may be  added to  by appropriation                                                                    
     or donation.  The legislature  appropriates the  50% of                                                                    
     the marijuana  sales tax revenue  that is not  used for                                                                    
     recidivism reduction fund toward  the fund. Up to fifty                                                                    
     percent  (50%)  of  the  fund  may  go  to  the  Alaska                                                                    
     marijuana  use  prevention,  education,  and  treatment                                                                    
     program administered  by the  ACT Board while  an equal                                                                    
     amount may  go toward  the marijuana use  education and                                                                    
     treatment  program administered  by  the Department  of                                                                    
     Health and Social Services.                                                                                                
                                                                                                                                
     Section 2                                                                                                                
     Amends AS 37.14.230(a)                                                                                                     
     Updates the  responsibilities of the  Alaska Children's                                                                    
     Trust  Board  to  include  the  administration  of  the                                                                    
     Alaska  marijuana use  prevention youth  services grant                                                                    
     program.                                                                                                                   
                                                                                                                                
     Section 3                                                                                                                
     Amends AS 43.61.010(c):                                                                                                    
     Designates that  the 50 percent of  the marijuana sales                                                                    
     tax revenue that  is not being used  for the recidivism                                                                    
     reduction  fund  may  be  appropriated  to  the  Alaska                                                                    
     marijuana  use  prevention,  education,  and  treatment                                                                    
     fund.                                                                                                                      
                                                                                                                                
     Section 4                                                                                                                
     Amends 43.61.010(d):                                                                                                       
     Updates  language to  distinguish recidivism  reduction                                                                    
     fund in place of 'fund'.                                                                                                   
                                                                                                                                
     Section 5                                                                                                                
     Amends AS 44.29.020(a):                                                                                                    
     Updates  the  responsibilities  of  the  Department  of                                                                    
     Health  and   Social  Services  (DHSS)to   include  the                                                                    
     administration   of  a   comprehensive  marijuana   use                                                                    
     education and  treatment program  which must  include a                                                                    
     misuse   prevention  component,   a  public   education                                                                    
     campaign,   surveys   of  Alaskan   populations   about                                                                    
     attitudes  and   perceptions  towards   marijuana  use,                                                                    
     monitoring   of  public   health   status  related   to                                                                    
     marijuana  usages,  and  a substance  abuse  screening,                                                                    
     intervention  and treatment  component.  To the  extent                                                                    
     possible, the Department  should administer the program                                                                    
     by grant or contract.                                                                                                      
                                                                                                                                
3:10:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  pointed to the opioid  crisis as                                                               
the highest priority  regarding drug use in Alaska  and asked why                                                               
the collected sales tax was not being directed toward this.                                                                     
                                                                                                                                
REPRESENTATIVE  CLAMAN,  in  response, shared  that  alcohol  and                                                               
alcohol  abuse was  also an  issue in  the communities,  and that                                                               
this  proposed  bill  was  an  effort  to  educate  people  about                                                               
marijuana so there would not be the same abuse issues.                                                                          
                                                                                                                                
REPRESENTATIVE  SULLIVAN-LEONARD asked  if any  of the  marijuana                                                               
tax dollars were being directed toward the opioid crisis.                                                                       
                                                                                                                                
REPRESENTATIVE CLAMAN suggested that  this be directed toward the                                                               
recidivism reduction fund,  as it received 50 percent  of the tax                                                               
per earlier legislation.  He offered  his hope that some of these                                                               
funds were being directed to address the opioid issues.                                                                         
                                                                                                                                
3:12:04 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ shared  that there was a proposed bill  for a tax                                                               
on opioids, which could be used for treatment.                                                                                  
                                                                                                                                
3:12:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO offered his  understanding that the marijuana                                                               
initiative  and subsequent  legislation  had  identified that  50                                                               
percent of  the funds be  directed toward treatment  programs and                                                               
anti-recidivism programs.  He pointed  out that directing another                                                               
50 percent of this tax  elsewhere would eliminate any revenue for                                                               
the  general fund  and would  not offer  any help  to the  fiscal                                                               
situation.                                                                                                                      
                                                                                                                                
REPRESENTATIVE CLAMAN stated  that, as the proposed  bill did not                                                               
create  a dedicated  fund,  any distribution  of  funds would  be                                                               
determined by the legislature.                                                                                                  
                                                                                                                                
REPRESENTATIVE  KITO  suggested  that passage  of  this  proposed                                                               
legislation  would create  an expectation  that  all the  funding                                                               
would be directed  toward treatment or recidivism  reduction.  He                                                               
allowed that this  could cause complaints that the  money was not                                                               
being directed  as determined  by the legislature.   He  asked if                                                               
there  was  any discussion  for  identifying  a lower  amount  of                                                               
funding, and then ramping up programs.                                                                                          
                                                                                                                                
REPRESENTATIVE  CLAMAN   replied  that   they  had   spoken  with                                                               
Department of  Health and Social  Services and a variety  of non-                                                               
profit   organizations   interested   in   addressing   marijuana                                                               
education and prevention  of its abuse.  He  acknowledged that it                                                               
would create the expectation of a legislative priority.                                                                         
                                                                                                                                
3:15:22 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOHNSTON asked  if  there was  any current  state                                                               
funding for after school programs.                                                                                              
                                                                                                                                
3:16:14 PM                                                                                                                    
                                                                                                                                
THOMAS  AZZARELLA, Director,  Alaska Afterschool  Network, Alaska                                                               
Children's Trust,  explained that, currently, the  funds going to                                                               
after school programs were federal  pass-through dollars from the                                                               
21st Century  Community Learning  Center programs.   He explained                                                               
that those  federal dollars were  administered by each  state for                                                               
targeted  intervention  at low-income,  under-achieving  schools.                                                               
He said that there was no  specific line item or fund for funding                                                               
after  school programs  in Alaska.   He  reported that  there had                                                               
been appropriations  made to support physical  infrastructure for                                                               
facilities.                                                                                                                     
                                                                                                                                
3:17:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  asked about the origination  of the language                                                               
for the  proposed program, whether  it was created in  Alaska, or                                                               
used by  another state.  He  asked how it would  be verified that                                                               
this would  result in  a reduction  for the  use of  marijuana by                                                               
youth.                                                                                                                          
                                                                                                                                
MS.  PERMAN   asked  whether  he   was  referencing   the  Alaska                                                               
Children's Trust or the Department  of Health and Social Services                                                               
section.                                                                                                                        
                                                                                                                                
REPRESENTATIVE KITO directed attention to  page 4, line 29 of the                                                               
proposed bill, which  listed the components of  the Department of                                                               
Health  and  Social  Services  program.     He  asked  about  the                                                               
components of the  Alaska Children's Trust program.   He declared                                                               
that, as he desired to know  that the funding would be effective,                                                               
he  wanted to  know whether  the language  of the  bill had  been                                                               
adopted  from another  state and  whether that  program had  been                                                               
effective.                                                                                                                      
                                                                                                                                
MS. PERMAN reported  that a work group had come  together in 2014                                                               
and established a set of initiatives  on which to focus, and then                                                               
had reviewed  similar programs  in California,  Oregon, Colorado,                                                               
Washington, Maine, Massachusetts, and Nevada.                                                                                   
                                                                                                                                
3:19:20 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE CLAMAN  clarified that  the proposed bill  did not                                                               
use specific language from other states.                                                                                        
                                                                                                                                
3:20:00 PM                                                                                                                    
                                                                                                                                
JAY  BUTLER, MD,  Chief Medical  Officer/  DPH Director,  Central                                                               
Office,  Division  of Public  Health,  Department  of Health  and                                                               
Social  Services, presented  a PowerPoint  titled "Marijuana  Use                                                               
Prevention,  Education,  and Treatment  Fund."    He suggested  a                                                               
high-level overview with five components.   He offered his belief                                                               
that  the vision  aligned with  the 3  Cs: community  engagement,                                                               
communication,  and  collaboration.     He  added  a   4th  C,  a                                                               
comprehensive approach.   He stated  that although the  focus was                                                               
for marijuana,  it was with  an awareness for the  broader issues                                                               
related  to  substance  misuse  and  addiction  in  Alaska.    He                                                               
referenced  slide  3,  which  depicted   the  allocation  of  the                                                               
funding,  and slide  4,  which listed  the  overarching goals  of                                                               
Community-based   marijuana   misuse    and   prevention;   youth                                                               
prevention; behavioral  health treatment;  and public  health and                                                               
safety.   He declared that the  role of the Department  of Health                                                               
and Social  Services would  be as  the statewide  coordinator for                                                               
these measures.   He moved on to slide 5,  and discussed the five                                                               
aspects  of   the  program,  which  included:     community-based                                                               
marijuana misuse  prevention, with  a focus on  youth prevention;                                                               
assessment of  knowledge and  awareness of the  laws, as  well as                                                               
use  of  marijuana products,  noting  that  it was  necessary  to                                                               
understand  the  concentration  as well  as  edibles,  beverages,                                                               
topicals, and  vaping solutions; monitoring of  population health                                                               
impact  related  to  marijuana use  and  legalization;  marijuana                                                               
education;  and substance  abuse  screening, brief  intervention,                                                               
referral,  and   treatment.    He   stated  that  this   was  the                                                               
comprehensive aspect.   He added  that cannabis use  disorder was                                                               
thought to develop in about 10  percent of those who use cannabis                                                               
products and was similar to the  rate of alcoholism with a higher                                                               
rate among those who initiate use during adolescence and teens.                                                                 
                                                                                                                                
3:23:42 PM                                                                                                                    
                                                                                                                                
DR.  BUTLER  moved  on to  slide  6,  "Community-based  marijuana                                                               
misuse prevention," which focused  on mitigating risk factors and                                                               
promoting protective  factors.   He shared that  children engaged                                                               
with  caring adults  and those  who participated  in after-school                                                               
programs.   He  added  that  those who  were  engaged with  their                                                               
families were less  likely to initiate marijuana use  in the teen                                                               
years.   He added that  they wanted to enhance  existing programs                                                               
for public health  and education to address  substance misuse and                                                               
prevention.  He noted that  the Department of Education and Early                                                               
Development,  community-based  programs,   and  the  Division  of                                                               
Juvenile Justice would also be involved.                                                                                        
                                                                                                                                
3:25:02 PM                                                                                                                    
                                                                                                                                
DR. BUTLER  presented slide 7,  "Assessment and Monitoring."   He                                                               
directed  attention   to  the  questions:     Do  youth  perceive                                                               
marijuana as  a less  harmful substance  due to  legalization? Do                                                               
youth and adults see driving  under the influence of marijuana as                                                               
dangerous?  How  has  marijuana legalization  affected  Alaskan's                                                               
health and safety?   He shared that there had  been some one-time                                                               
funding from  the Alaska Mental  Health Trust Authority  to begin                                                               
some of  these assessments.   He expressed  his concern  for data                                                               
which  revealed  that 16  percent  of  teens who  used  marijuana                                                               
reported that they had operated a vehicle "while high."                                                                         
                                                                                                                                
3:26:05 PM                                                                                                                    
                                                                                                                                
DR. BUTLER  shared slide  8, "Marijuana education."     He stated                                                               
that this  included assessment  in the  community to  find "where                                                               
are  the  knowledge  gaps."    He  stressed  that  this  included                                                               
engagement with the health care community.                                                                                      
                                                                                                                                
3:27:00 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE SULLIVAN-LEONARD  asked about the use  of cannabis                                                               
for health  reasons, including  lupus, arthritis,  or neuropathy,                                                               
and whether this use was also being gauged.                                                                                     
                                                                                                                                
DR. BUTLER explained that about  10 percent of the respondents to                                                               
survey data stated that it was used for medicinal purposes.                                                                     
                                                                                                                                
3:27:54 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON  asked if those people  driving under the                                                               
influence of marijuana were driving very slowly.                                                                                
                                                                                                                                
DR. BUTLER  reflected that driving  very slowly was  a compromise                                                               
in judgement  and offered  that there was  great concern  for the                                                               
compensation mechanisms when alcohol  and marijuana were co-used.                                                               
He  pointed out  that driving  under the  influence of  marijuana                                                               
while also driving under the  influence of alcohol was "more than                                                               
an additive  effect in  terms of the  possible compromise  of the                                                               
ability  to  drive a  vehicle."    He  shared three  messages  of                                                               
concern  for  public  safety:     driving  under  the  influence;                                                               
underage  use  and  inadvertent   intoxication;  and  use  during                                                               
pregnancy,  although  it  was unclear  of  the  immediate  health                                                               
effects.                                                                                                                        
                                                                                                                                
3:29:44 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ  asked about  damage to  a developing  brain from                                                               
marijuana use.                                                                                                                  
                                                                                                                                
DR.  BUTLER replied  that the  developing  brain had  cannabinoid                                                               
receptors  as  the   brain  made  its  own   internal,  or  endo,                                                               
cannabinoids,  which appeared  to be  necessary for  normal brain                                                               
development.   He  declared  that it  was  unclear how  exogenous                                                               
cannabinoid  might influence  how the  receptors were  stimulated                                                               
and influenced brain development, especially early in life.                                                                     
                                                                                                                                
CHAIR  SPOHNHOLZ asked  about the  development of  the brains  in                                                               
teens who could be experimenting recreationally with marijuana.                                                                 
                                                                                                                                
DR.  BUTLER  pointed out  that  the  teen  years  was a  time  of                                                               
plasticity for the brain, and  that the brain was "reeling itself                                                               
back in."   He explained  that exposure to substances  during the                                                               
teen years,  including marijuana, alcohol, tobacco,  opioids, and                                                               
other drugs, appeared to be  a particularly vulnerable period for                                                               
increasing the  risk for problems  in later years  with substance                                                               
use disorders and addictions.                                                                                                   
                                                                                                                                
3:31:44 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO asked  how  determination to  the amount  of                                                               
support for the programs was made.                                                                                              
                                                                                                                                
DR. BUTLER  replied that this  determination did not come  out of                                                               
the blue, as  marijuana had been legal in Alaska  for four years,                                                               
and  in retail  establishments for  two  years.   He pointed  out                                                               
that,  as it  had  been  recognized "early  on"  that there  were                                                               
potentials  for health  impacts,  there had  been  review of  the                                                               
infrastructure  in states  with  legal marijuana.   He  explained                                                               
that this review had  lead to the five areas of  focus as well as                                                               
the details  to the  fiscal note for  "how do we  get to  what we                                                               
think we  need to be able  to do this in  a way that is  going to                                                               
maximize the health benefit for Alaskans."                                                                                      
                                                                                                                                
3:33:12 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO, referencing the  fiscal note, asked what the                                                               
remainder of  the $2 million not  going into grants was  going to                                                               
support.                                                                                                                        
                                                                                                                                
DR. BUTLER explained  that this included one staff  person to run                                                               
the  program,  as well  as  the  development of  the  educational                                                               
materials in  conjunction with  existing staff  in the  Office of                                                               
Substance Misuse and  Addiction Prevention.  He  pointed out that                                                               
this  involved  visits  to  the  communities  and  meetings  with                                                               
people, noting that  the users believed the  retailers above most                                                               
others.                                                                                                                         
                                                                                                                                
REPRESENTATIVE  KITO  asked  for  further  clarification  of  the                                                               
fiscal note.                                                                                                                    
                                                                                                                                
3:35:44 PM                                                                                                                    
                                                                                                                                
JILL LEWIS,  Deputy Director -  Juneau, Central  Office, Division                                                               
of  Public  Health, Department  of  Health  and Social  Services,                                                               
explained that there were two  fiscal notes [Included in members'                                                               
packets], one  from the Division  of Public Health and  the other                                                               
from the Division  of Behavioral Health.  She  explained that the                                                               
Division of Behavioral Health would  be responsible for the fifth                                                               
element, the screening, then the  brief intervention and referral                                                               
to treatment  aspect.  She added  that the PCNs were  included in                                                               
that fiscal  note, as  well as two  persons already  employed who                                                               
would  use  5  percent  of  their time  for  development  of  the                                                               
materials in the first year and  then 10 percent of their time in                                                               
subsequent years.                                                                                                               
                                                                                                                                
3:36:50 PM                                                                                                                    
                                                                                                                                
DR. BUTLER  paraphrased from  the data on  slide 12,  "Adults can                                                               
help reduce  youth marijuana use,"  which he labeled as  the take                                                               
home message, which read:   "Supportive Teachers: Youth who agree                                                               
that teachers care and encourage  them are 52 percent less likely                                                               
to have used marijuana in the past month."                                                                                      
                                                                                                                                
DR. BUTLER  moved on to  slide 14,  and compared Alaska  with the                                                               
other  states,  Oregon,  Colorado,  Washington,  and  California,                                                               
which  had  legalized  marijuana,   even  though  Alaska  had  no                                                               
designated funding  to address  marijuana health  related issues.                                                               
He  stated that  it was  "very  unlikely that  we'll see  federal                                                               
funding for  this kind of  work," unlike the federal  grants, tax                                                               
revenues, and settlements for tobacco and opioid education.                                                                     
                                                                                                                                
3:39:15 PM                                                                                                                    
                                                                                                                                
DR. BUTLER summarized and declared  that everyone had an interest                                                               
in the health of Alaska youth.                                                                                                  
                                                                                                                                
CHAIR  SPOHNHOLZ  shared  that  the citizen  initiative  and  the                                                               
cultural norming of  marijuana had led to an  increased use among                                                               
young people.   She reflected  that, as the  health repercussions                                                               
over the long  term were pretty serious, this  was an opportunity                                                               
to address it.                                                                                                                  
                                                                                                                                
3:40:18 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  asked if there  was any  consideration given                                                               
to  contracting  with   existing  organizations  for  educational                                                               
outreach and training.                                                                                                          
                                                                                                                                
DR.  BUTLER  acknowledged  that  it  was open  for  all  ways  to                                                               
accomplish  this.    He  pointed  out that  most  of  the  public                                                               
outreach through the media was contracted.                                                                                      
                                                                                                                                
3:41:34 PM                                                                                                                    
                                                                                                                                
TREVOR  STORRS,  Executive  Director,  Alaska  Children's  Trust,                                                               
stated that everyone valued children  and agreed that they should                                                               
be safe  and healthy.  He  stated that it was  necessary to think                                                               
about  prevention.   He explained  that, as  Colorado was  in the                                                               
forefront  for marijuana  legalization,  much of  the lesson  had                                                               
come   from  them   for  establishment   of  an   entity  outside                                                               
government.   Colorado  had identified  the  importance of  being                                                               
nimble  when dealing  with youth  and prevention  work.   He said                                                               
that  having  "an  entity   outside  the  standard,  bureaucratic                                                               
system"  allowed for  this nimble  process.   He stated  that the                                                               
Alaska  Children's Trust  used this  model and  he referred  to a                                                               
report  on  after  school  programming   by  the  McDowell  Group                                                               
[Included in members' packets].   He declared that this issue did                                                               
not stop at marijuana, and  that protective factors addressed all                                                               
substance  uses, suicide,  graduation, and  other decisions.   He                                                               
reported  that,  even though  there  were  26,000 kids  in  after                                                               
school programming  getting these protective factors,  there were                                                               
almost  twice as  many  who  wanted but  could  not access  these                                                               
programs.    He pointed  out  that  with the  use  of  $2.5 -  $3                                                               
million, about 25 percent of  the projected revenues, the numbers                                                               
would  be lessened,  especially  in the  rural  communities.   He                                                               
emphasized that it was not  just the activity, but the connection                                                               
with  the  adult mentors  that  made  the  impact and  built  the                                                               
protective factors.                                                                                                             
                                                                                                                                
3:45:44 PM                                                                                                                    
                                                                                                                                
MR.  AZZARELLA explained  that the  "Alaska Afterschool  Network"                                                               
was a program  of the Alaska Children's Trust.   He reported that                                                               
the  afterschool network  was the  only  statewide coalition  and                                                               
organization  dedicated to  supporting and  strengthening out  of                                                               
school  time for  kids from  kindergarten through  twelfth grade.                                                               
He  reported that  there  were  more than  200  after school  and                                                               
summer programs throughout Alaska.   These programs included Boys                                                               
and Girls  Club, Campfire,  Twenty-first Century,  culture camps,                                                               
parks and  recreation, and Native  Dance groups.  He  stated that                                                               
Alaska  struggled  with  the  effects  of  the  opioid  epidemic,                                                               
confronted  alcohol   abuse,  and   now,  as  it   addressed  the                                                               
legalization  of marijuana,  it  was critical  to understand  the                                                               
role  of protective  factors for  prevention  of youth  substance                                                               
use.  He referenced the  McDowell Group report for the protective                                                               
factors that helped  youth avoid substance use and  abuse and the                                                               
role which  out of school  time played  in support.   He declared                                                               
that the afterschool programs helped  keep kids out of harm's way                                                               
and  safe during  those highest  risk  hours each  day when  both                                                               
parents were  at work.   He added  that the  afterschool programs                                                               
helped  protect  kids  from  risky   behavior,  both  online  and                                                               
offline,  as   the  programs  kept   kids  actively   engaged  in                                                               
recreation  opportunities, as  they learn  and build  life skills                                                               
which readied them  for the work force.  He  pointed out that the                                                               
afterschool programs  provided critical support time  for working                                                               
families.  He emphasized that  kids and teens needed safe places,                                                               
and that it was critical  for teenagers to have opportunities for                                                               
positive   engagement  outside   school.     He  reported   that,                                                               
currently,  more  than  45,000  kids   in  Alaska  did  not  have                                                               
afterschool   spots,  as   they   were   either  not   available,                                                               
waitlisted,  or  cost  prohibitive.     He  referenced  the  2017                                                               
statistic that  42 percent of  youth had used marijuana  at least                                                               
one  time, and  22 percent  had used  in the  last 30  days.   He                                                               
reiterated that  those risk hours  of 3 p.m.  to 6 p.m.  were the                                                               
peak  time for  juvenile crimes,  as well  as the  winter, spring                                                               
break,  and summer  vacation being  key times  for engagement  of                                                               
risk behaviors.                                                                                                                 
                                                                                                                                
3:50:40 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   SULLIVAN-LEONARD  asked   about  the   breakdown                                                               
between medical use and recreational use of marijuana.                                                                          
                                                                                                                                
MR.  AZZARELLA opined  that this  was  referring to  recreational                                                               
use.     He   returned  attention   to  the   PowerPoint  titled,                                                               
Afterschool Programs, slide 3  "Afterschool Impact," and reported                                                               
that  afterschool   programs  helped  protect  kids   from  risky                                                               
behaviors, both  on and  offline, helped  avoid alcohol  and drug                                                               
use,  reduced juvenile  crime, and  helped  lower depression  and                                                               
anxiety.   He reported that  afterschool programs  were connected                                                               
to  youth  academic  gains, improved  attendance,  and  increased                                                               
graduation  rates.    He  declared that  these  programs  were  a                                                               
protective   factor,  as   young  people   engaged  in   positive                                                               
opportunities  out of  school.   He  stated  that these  programs                                                               
helped  develop  a  youth's  individual  protective  factor  with                                                               
improved school  performance, as well  as an increase  in impulse                                                               
control  skills,  decision  making,   and  social  and  emotional                                                               
learning skills.   He pointed  out that the  afterschool programs                                                               
helped  contribute  to  the  protective  factor  growth  for  the                                                               
individual student level, the family  level, the community level,                                                               
and  the school  level.   He  reported that  not all  afterschool                                                               
programs  were  built the  same,  as  it  was necessary  to  have                                                               
programming  that  specifically  focused on  reduction  of  youth                                                               
substance use.  He noted  that programs with clear specific goals                                                               
and objectives  were more likely  to achieve those outcomes.   He                                                               
concluded  that afterschool  programs  kept  kids safe,  inspired                                                               
learning, and helped support working families.                                                                                  
                                                                                                                                
3:53:16 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE   JOHNSTON  asked   if  there   were  any   recent                                                               
projections  for  the   number  of  children  to   be  served  by                                                               
afterschool programs.                                                                                                           
                                                                                                                                
MR.  STORRS replied  that  they  had not  come  up with  specific                                                               
numbers,  as  the  granting process  determined  the  ability  to                                                               
provide  service, especially  in  the more  expensive areas,  and                                                               
that  the  needs would  vary.    He  expressed his  concern  that                                                               
struggling programs would lose attendance.                                                                                      
                                                                                                                                
3:54:36 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE JOHNSTON asked if there  was any intent to partner                                                               
with afterschool programs  which had shown benefits  and could be                                                               
expanded to other regions.                                                                                                      
                                                                                                                                
MR. STORRS replied that this  was an advantage to the afterschool                                                               
network for  partnerships with local and  national programs. This                                                               
also helped with creation of the right program for a community.                                                                 
                                                                                                                                
REPRESENTATIVE  TARR asked  for additional  information regarding                                                               
program  participation to  improved school  outcomes.   She spoke                                                               
about the  economic realities  for participation  in some  of the                                                               
programs.                                                                                                                       
                                                                                                                                
3:57:23 PM                                                                                                                    
                                                                                                                                
CHAIR SPOHNHOLZ announced that HB 296 would be held over.                                                                       
                                                                                                                                
3:57:56 PM                                                                                                                    
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
There being no  further business before the  committee, the House                                                               
Health  and  Social  Services   Standing  Committee  meeting  was                                                               
adjourned at 3:57 p.m.                                                                                                          

Document Name Date/Time Subjects
HB296 Sponsor Statement 1.31.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Fiscal Note--DHSS-DBH 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Fiscal Note--DHSS-DPH 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Supplemental Document - ASD Increase Marijuana Suspension 1.31.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Supplemental Document - McDowell Group After School Programs Report 1.31.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Supplemental Document - TGYS Annual Report 1.31.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Supporting Document - DHSS Supporting Powerpoint 2.7.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 - Support Letter- Boys and Girls Club 2.7.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB296 Supporting Document - MJ Use in Alaska 2.7.18.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 296
HB313 - Additional Documents - AKLegResearch.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 313
HB313 Additional Documents - Connecticut - Legislative Research Article 2006 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 313
HB313 Additional Documents - State Refund Laws 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 313
HB313 Sponsor Statement - 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 313
HB313 Fiscal Note DCCED-IO 2.7.2018.pdf HHSS 2/8/2018 3:00:00 PM
HHSS 2/27/2018 3:00:00 PM
HB 313
HB296 Sectional Analysis 2.8.18.pdf HHSS 2/8/2018 3:00:00 PM
HB 296