02/26/2009 03:00 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB26 | |
| HB2 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | HB 2 | TELECONFERENCED | |
| *+ | HB 26 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 26, 2009
3:11 p.m.
MEMBERS PRESENT
Representative Bob Herron, Co-Chair
Representative Wes Keller, Co-Chair
Representative John Coghill
Representative Bob Lynn
Representative Paul Seaton
Representative Sharon Cissna
Representative Lindsey Holmes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 26
"An Act repealing the repeal of preventative and restorative
adult dental services reimbursement under Medicaid; providing
for an effective date by repealing the effective date of sec. 3,
ch. 52, SLA 2006; and providing for an effective date."
- HEARD AND HELD
HOUSE BILL NO. 2
"An Act relating to the issuance of a certificate of birth
resulting in a stillbirth."
- HEARD AND HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 26
SHORT TITLE: MEDICAID FOR ADULT DENTAL SERVICES
SPONSOR(s): REPRESENTATIVE(s) HAWKER
01/20/09 (H) PREFILE RELEASED 1/9/09
01/20/09 (H) READ THE FIRST TIME - REFERRALS
01/20/09 (H) HSS, FIN
02/26/09 (H) HSS AT 3:00 PM CAPITOL 106
BILL: HB 2
SHORT TITLE: BIRTH CERTIFICATE FOR STILLBIRTH
SPONSOR(s): REPRESENTATIVE(s) GATTO
01/20/09 (H) PREFILE RELEASED 1/9/09
01/20/09 (H) READ THE FIRST TIME - REFERRALS
01/20/09 (H) HSS, JUD
02/26/09 (H) HSS AT 3:00 PM CAPITOL 106
WITNESS REGISTER
REPRESENTATIVE MIKE HAWKER
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as the sponsor of HB 26.
REGAN MATTINGLY
Alaska Primary Care Association (APCA)
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 26.
DON ROBERTS
Kodiak, Alaska
POSITION STATEMENT: Testified in support of HB 26.
DELISA CULPEPPER, COO
Alaska Mental Health Trust Authority (AMHTA);
Co-Chair
Alaska Dental Action Coalition
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 26.
ELAINE RATH
Alaska Brain Injury Network
Ketchikan, Alaska
POSITION STATEMENT: Testified in support of HB 26.
JON SHERWOOD, Medicaid Special Projects
Office of the Commissioner
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 26, Version E.
BRAD WHISTLER, Health Program Manager
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 26, Version E.
MARIE DARLIN, Coordinator
American Association for Retired People (AARP) Capital City Task
Force
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 26.
SANDRA WILSON, Staff
to Representative Gatto
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented HB 2 on behalf of the sponsor,
Representative Gatto, and responded to questions.
RHONDA CRAWFORD
Soldotna, Alaska
POSITION STATEMENT: Testified in support of HB 2.
MICHELLE HOYT
Palmer, Alaska
POSITION STATEMENT: Testified in support of HB 2.
DR. JOANNE CACCIATORE, CEO
M.I.S.S. Foundation
Peoria, Arizona
POSITION STATEMENT: Testified in support of HB 2.
DEBBIE JOSLIN, President
Eagle Forum Alaska
Delta Junction, Alaska
POSITION STATEMENT: Testified in support of HB 2.
MAYME OHNEMUS
Cooper Landing, Alaska
POSITION STATEMENT: Testified in support of HB 2.
PHILLIP MITCHELL, Chief
Vital Statistics
Division of Public Health
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Testified in support of HB 2, Version R.
ACTION NARRATIVE
3:11:20 PM
CO-CHAIR WES KELLER called the House Health and Social Services
Standing Committee meeting to order at 3:11 p.m.
Representatives Keller, Herron, Lynn, and Cissna were present at
the call to order. Representatives Coghill, Seaton, and Holmes
arrived as the meeting was in progress.
HB 26-MEDICAID FOR ADULT DENTAL SERVICES
3:11:37 PM
CO-CHAIR KELLER announced that the first order of business would
be HOUSE BILL NO. 26, "An Act repealing the repeal of
preventative and restorative adult dental services reimbursement
under Medicaid; providing for an effective date by repealing the
effective date of sec. 3, ch. 52, SLA 2006; and providing for an
effective date."
3:12:04 PM
REPRESENTATIVE MIKE HAWKER, Alaska State Legislature, in
response to Co-Chair Keller, said that there was a reason for
not originally amending the bill as the committee had, but that
Version E was the will of the committee.
3:12:21 PM
CO-CHAIR HERRON moved to adopt the proposed committee substitute
(CS) for HB 26, Version 26-LS0142\E, Mischel, 2/20/09, as the
working document. There being no objection, Version E was
adopted.
3:12:49 PM
REPRESENTATIVE HAWKER explained that, until two years ago, adult
dental service had only been allowed through Medicaid if there
were both acute pain and infection. He noted that the 2007 bill
for preventive care had included a two year sunset clause, in
order to monitor and review the fiscal impact. He opined that
the program had gone quite well and that the growth had been
reasonable. He reported that the health community supported
making HB 26 permanent. He noted that Version E was adding
another five year limitation. He explained that this created a
challenge for the development of a provider base. He reported
that dentists made more money working with regular insurance
clients, rather than Medicaid, and that they were reluctant to
work with a program of limited duration.
3:15:39 PM
REPRESENTATIVE SEATON asked Representative Hawker for his
preference to a limited or unlimited duration for HB 26.
REPRESENTATIVE HAWKER offered his belief that there was adequate
basis for it to become permanent.
3:16:44 PM
CO-CHAIR KELLER reported that he had included a sunset clause in
HB 26 for the purpose of discussion. He added that HB 26 would
next be referred to the House Finance Committee, which was
chaired by Representative Hawker.
REPRESENTATIVE HAWKER said that the House Finance Committee
would take into consideration the wishes of the House Health and
Social Services Standing Committee.
3:17:47 PM
REPRESENTATIVE CISSNA asked Representative Hawker to clarify
that the reason for the original sunset clause was economic, but
that the program had shown to be a good preventive dental health
policy.
REPRESENTATIVE HAWKER agreed, but said that there had been many
unknowns, including cost and utilization. He opined that 2
years had been adequate time for review.
REPRESENTATIVE CISSNA asked if the state could monitor this
program, and still review it without a sunset clause.
3:19:58 PM
REPRESENTATIVE HAWKER explained that HB 26 merely extended the
existing program, including the benefit parameters.
3:20:43 PM
REPRESENTATIVE SEATON asked if there was any significance to the
title change between HB 26 and Version E.
CO-CHAIR KELLER said that the intent was only to include a
sunset clause.
3:22:15 PM
CO-CHAIR HERRON questioned whether the House Finance Committee
should dictate health and social services policy to the House
Health and Social Services Standing Committee. He offered his
belief that it was the fiduciary responsibility of the House
Finance Committee to ensure that the state operated effectively.
REPRESENTATIVE HAWKER, in response to Co-Chair Herron, explained
that the committee process operated on good faith and trust. He
allowed that each committee chairman had to decide "what is the
right thing to do." He said that the House Finance Committee
would not dictate human service policy, but that, as a sponsor
of HB 26, he would attempt to influence human service policy
with the best arguments. He observed that his research
indicated that a permanent repeal of the sunset clause would
facilitate the implementation of the program, with providers
more willing to participate.
3:25:19 PM
CO-CHAIR HERRON asked if Version E would change the fiscal note.
REPRESENTATIVE HAWKER opined that the fiscal note would only
change at the sunset.
3:26:11 PM
CO-CHAIR HERRON asked if Representative Hawker preferred Version
E or HB 26.
REPRESENTATIVE HAWKER said that he preferred the permanent
implementation of HB 26.
3:27:20 PM
REPRESENTATIVE COGHILL asked to clarify that Version E had been
adopted. He opined that once a Medicaid program had been
included, it would never be retracted. He expressed his support
for HB 26.
REPRESENTATIVE HAWKER, in response to Representative Coghill,
pointed out that out of control but well intended programs had
been disciplined.
REPRESENTATIVE COGHILL, in response to Representative Hawker,
noted that the legislature had been reluctant to change Medicaid
services, other than to increase them. He supported the
preventative aspect of HB 26, and its positive economic impact.
REPRESENTATIVE CISSNA, in response to Representative Coghill,
noted that the most expensive medevacs from the Aleutians were
dental related. She reported that HB 26 had preventative
aspects that were not usually included with Medicaid.
3:33:29 PM
REPRESENTATIVE HOLMES opined that the sunset clause was not
necessary for HB 26, as the Medicaid expenses would be routinely
reviewed.
3:35:17 PM
[Co-Chair Keller opened public testimony.]
3:35:23 PM
REGAN MATTINGLY, Alaska Primary Care Association (APCA),
explained that the Alaska Primary Care Association represented
26 health care organizations. He said that APCA supported HB
26, as oral health care was critical, and that dental services
reduced the future likelihood of more expensive and acute dental
problems.
3:36:14 PM
DON ROBERTS said that dental care was necessary.
3:38:16 PM
DELISA CULPEPPER, COO, Alaska Mental Health Trust Authority
(AMHTA); Co-Chair, Alaska Dental Action Coalition, said that
AMHTA supported a repeal of the sunset clause, and offered her
belief that it would be reviewed as a part of the annual
Medicaid budget authorizations.
3:40:30 PM
ELAINE RATH, Alaska Brain Injury Network, said that the
preventive dental services were utilized by seniors.
3:41:45 PM
JON SHERWOOD, Medicaid Special Projects, Office of the
Commissioner, Department of Health and Social Services (DHSS),
said that the administration supported the 5 year sunset clause,
as there was not yet conclusive data to the cost effectiveness.
3:43:27 PM
BRAD WHISTLER, Health Program Manager, Department of Health and
Social Services (DHSS), reported that good oral health was a
quality of life issue, and that it could affect employment and
food choices. He said that coverage of preventative and routine
restorative dental services had precluded more expensive
replacement costs. He explained that a dental program for
adults, along with children, was necessary for a comprehensive
preventative dental program. He said that DHSS supported
passage of some version of HB 26.
3:47:21 PM
REPRESENTATIVE SEATON asked for a comparison to the amount of
dental facilities expansion and participation both with and
without the 5 year sunset clause in HB 26.
MR. WHISTLER explained that the 2 year sunset clause did not
show a commitment, but that re-authorization of the program,
even with a 5 year sunset clause, reflected a much greater
assurance. He reported that private dentists were concerned
with participation in Medicaid because of reimbursement issues
and increases in federal audits.
3:49:19 PM
REPRESENTATIVE SEATON asked about the result should the program
exceed its allocated funding.
MR. WHISTLER said that it would result in emergency regulations
to lower the annual recipient limit for the succeeding fiscal
year.
3:51:11 PM
REPRESENTATIVE SEATON asked if maintaining a fiscal note and a
sunset clause determined this dental program to be a separate
Medicaid program.
MR. SHERWOOD, in response to Representative Seaton, explained
that the budgeting for this as part of the Medicaid
appropriation was separate from the sunset clause.
3:52:52 PM
MR. SHERWOOD, in response to Co-Chair Keller, said that seniors
were eligible for Medicaid at 65, though some individuals with
disabilities or low income were eligible earlier. He said that
Medicare did not include dental service.
3:54:01 PM
REPRESENTATIVE SEATON asked if the dental therapists in rural
Alaska were included in this program.
MR. WHISTLER replied that dental therapists were included in the
tribal dental care program.
3:55:30 PM
MARIE DARLIN, Coordinator, American Association for Retired
People (AARP) Capital City Task Force, said that AARP had
already written a letter in support and that the continuation of
the program was important.
3:56:43 PM
CO-CHAIR KELLER asked if there was any more testimony, and
seeing none, public testimony was closed. He noted that Version
E would be kept in front of the committee, and a determination
to move the bill would be made at a later date.
CO-CHAIR HERRON said that he appreciated the sponsor's
discussion, and that Version E had been presented to encourage
the debate.
HB 2-BIRTH CERTIFICATE FOR STILLBIRTH
3:57:40 PM
CO-CHAIR KELLER announced that the next order of business would
be HOUSE BILL NO. 2, "An Act relating to the issuance of a
certificate of birth resulting in a stillbirth."
SANDRA WILSON, Staff to Representative Gatto, Alaska State
Legislature, explained that HB 2 allowed the issuance of a birth
certificate to the parents of a stillborn child.
3:58:26 PM
REPRESENTATIVE LYNN moved to adopt the proposed committee
substitute (CS) for HB 2, Version 26-LS0003\R, Mischel, 1/29/09,
as the working document.
3:58:39 PM
CO-CHAIR KELLER objected for the purpose of explanation.
3:58:47 PM
MS. WILSON explained that the difference between the original HB
2 and Version R was a removal for the duplication of records,
which was requested by the Division of Public Health, Vital
Statistics.
3:59:51 PM
CO-CHAIR KELLER removed his objection.
4:00:03 PM
MS. WILSON said that the purpose of HB 2 was to bring closure to
the parents of stillborn children. She said that currently, a
fetal death certificate was distributed. She reported that a
birth certificate would validate that a child was born and would
allow closure for the parents. She said that the birth
certificate was optional.
4:00:51 PM
CO-CHAIR KELLER opened the discussion to public testimony.
4:01:20 PM
RHONDA CRAWFORD shared her experience with the still birth of
her child. She said that having a birth certificate would mean
a lot to her family.
4:03:49 PM
MS. CRAWFORD, in response to Representative Lynn, said that it
had been five years.
4:04:10 PM
MICHELLE HOYT related her experience with the still birth of her
child. She said that HB 2 would bring closure for the families,
and would acknowledge that the child was born.
4:05:24 PM
DR. JOANNE CACCIATORE, CEO, M.I.S.S. Foundation, explained that
she represented 76 state chapters of the MISS Foundation, which
helped families whose children died. She informed that the
effect of still birth was devastating on families. She stated
her support for HB 2 and noted that 26 other states had similar
legislation.
4:07:40 PM
DEBBIE JOSLIN, President, Eagle Forum Alaska, shared her
experiences and encouraged support for HB 2.
4:09:55 PM
MAYME OHNEMUS said that she was the grandmother of a stillborn
child. She shared the history of her daughter in law's
pregnancy, and the devastation from the death of the baby. She
recounted the pain felt with a death certificate and that a
still birth certificate would have been much more respectful and
comforting.
4:13:40 PM
PHILLIP MITCHELL, Chief, Vital Statistics, Division of Public
Health, Department of Health and Social Services (DHSS),
explained that sub-section (f), HB 2, should be removed to
minimize any fiscal impact to the state. He explained that
Vital Statistics already had the information, and it only needed
the authority to issue the certificate. He noted that the
certificates needed to come to Juneau for the gold state seal to
be affixed.
4:15:14 PM
CO-CHAIR KELLER said that HB 2 would be held until the next
meeting.
4:15:48 PM
REPRESENTATIVE HOLMES shared that she had family friends who
still mourned.
4:16:18 PM
CO-CHAIR HERRON extended his sympathy to the testifiers.
4:17:11 PM
ADJOURNMENT
There being no further business before the committee, the
Department of Health and Social Services meeting was adjourned
at 4:17 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| DOC001.PDF |
HHSS 2/26/2009 3:00:00 PM |
|
| DOC002.PDF |
HHSS 2/26/2009 3:00:00 PM |
|
| HSS-HB2s.PDF |
HHSS 2/26/2009 3:00:00 PM |
HB 2 |
| HSS-HB2s2.PDF |
HHSS 2/26/2009 3:00:00 PM |
HB 2 |