Legislature(2023 - 2024)DAVIS 106
04/04/2024 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
| HB187 | |
| Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
| HB366 | |
| Confirmation Hearing(s)|| State Medical Board|| Board of Veterinary Examiners|| State Physical Therapy & Occupational Therapy Board|| Board of Marital & Family Therapy | |
| SB91 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | SB 91 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 187 | TELECONFERENCED | |
| + | HB 366 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 4, 2024
3:11 p.m.
MEMBERS PRESENT
Representative Mike Prax, Chair
Representative Justin Ruffridge, Vice Chair
Representative CJ McCormick
Representative Jesse Sumner
Representative Zack Fields
Representative Genevieve Mina
MEMBERS ABSENT
Representative Dan Saddler
COMMITTEE CALENDAR
CONFIRMATION HEARING(S)
State Medical Board
David Barnes - Wasilla
- CONFIRMATION(S) ADVANCED
Board of Veterinary Examiners
Denise Albert - Denali National Park
- CONFIRMATION(S) ADVANCED
State Physical Therapy & Occupational Therapy Board
Rebecca Dean - Fairbanks
- CONFIRMATION(S) ADVANCED
Board of Marital & Family Therapy
Kayla Green - Eagle River
- CONFIRMATION(S) ADVANCED
HOUSE BILL NO. 187
"An Act relating to utilization review entities; exempting
certain health care providers from making preauthorization
requests for certain services; and providing for an effective
date."
- MOVED HB 187 OUT OF COMMITTEE
HOUSE BILL NO. 366
"An Act relating to residential psychiatric treatment centers;
and providing for an effective date."
- MOVED HB 366 OUT OF COMMITTEE
CS FOR SENATE BILL NO. 91(FIN)
"An Act relating to telehealth; relating to multidisciplinary
care teams; and relating to the practice of medicine."
- MOVED CSSB 91(FIN) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 187
SHORT TITLE: PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS
SPONSOR(s): REPRESENTATIVE(s) SUMNER
05/03/23 (H) READ THE FIRST TIME - REFERRALS
05/03/23 (H) HSS, L&C
02/15/24 (H) HSS AT 3:00 PM DAVIS 106
02/15/24 (H) Heard & Held
02/15/24 (H) MINUTE(HSS)
03/14/24 (H) HSS AT 3:00 PM DAVIS 106
03/14/24 (H) Heard & Held
03/14/24 (H) MINUTE(HSS)
03/21/24 (H) HSS AT 3:00 PM DAVIS 106
03/21/24 (H) <Bill Hearing Canceled>
03/26/24 (H) HSS AT 3:00 PM DAVIS 106
03/26/24 (H) Heard & Held
03/26/24 (H) MINUTE(HSS)
04/04/24 (H) HSS AT 3:00 PM DAVIS 106
BILL: HB 366
SHORT TITLE: MINORS & RESIDENT PSYCH TREATMENT CENTERS
SPONSOR(s): REPRESENTATIVE(s) DIBERT
02/20/24 (H) READ THE FIRST TIME - REFERRALS
02/20/24 (H) HSS, L&C
04/04/24 (H) HSS AT 3:00 PM DAVIS 106
BILL: SB 91
SHORT TITLE: TELEHEALTH: MULTIDISCIPLINARY CARE TEAM
SPONSOR(s): SENATOR(s) CLAMAN
03/06/23 (S) READ THE FIRST TIME - REFERRALS
03/06/23 (S) HSS, FIN
03/21/23 (S) HSS AT 3:30 PM BUTROVICH 205
03/21/23 (S) Heard & Held
03/21/23 (S) MINUTE(HSS)
04/11/23 (S) HSS AT 3:30 PM BUTROVICH 205
04/11/23 (S) Heard & Held
04/11/23 (S) MINUTE(HSS)
04/13/23 (S) HSS AT 3:30 PM BUTROVICH 205
04/13/23 (S) Moved CSSB 91(HSS) Out of Committee
04/13/23 (S) MINUTE(HSS)
04/14/23 (S) HSS RPT CS 1DNP 4NR SAME TITLE
04/14/23 (S) NR: WILSON, TOBIN, KAUFMAN, DUNBAR
04/14/23 (S) DNP: GIESSEL
02/14/24 (S) FIN AT 9:30 AM SENATE FINANCE 532
02/14/24 (S) Heard & Held
02/14/24 (S) MINUTE(FIN)
02/29/24 (S) FIN AT 1:30 PM SENATE FINANCE 532
02/29/24 (S) Moved CSSB 91(FIN) Out of Committee
02/29/24 (S) MINUTE(FIN)
03/01/24 (S) FIN RPT CS 2DP 2NR SAME TITLE
03/01/24 (S) DP: OLSON, BISHOP
03/01/24 (S) NR: WILSON, MERRICK
03/22/24 (S) TRANSMITTED TO (H)
03/22/24 (S) VERSION: CSSB 91(FIN)
03/25/24 (H) READ THE FIRST TIME - REFERRALS
03/25/24 (H) HSS, FIN
04/04/24 (H) HSS AT 3:00 PM DAVIS 106
WITNESS REGISTER
DAVID BARNES, DO, Appointee
State Medical Board
Wasilla, Alaska
POSITION STATEMENT: Testified as appointee to the State Medical
Board.
DENISE ALBERT, DVM, Appointee
Board of Veterinary Examiners
Denali National Park, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Veterinary Examiners.
REBECCA DEAN, Appointee
State Physical Therapy & Occupational Therapy Board
Fairbanks, Alaska
POSITION STATEMENT: Testified as appointee to the State
Physical Therapy & Occupational Therapy Board.
KAYLA GREEN, Appointee
Board of Marital & Family Therapy
Eagle River, Alaska
POSITION STATEMENT: Testified as appointee to the Board of
Marital & Family Therapy.
SENATOR MATT CLAMAN
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented SB 91.
CLAIRE LUBKE, Staff
Senator Matt Claman
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented the sectional analysis for SB 91
on behalf of Senator Claman, prime sponsor.
GAIL BRATEN, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave invited testimony in support of SB 91.
TIM JENNINGS, representing self
Anchorage, Alaska
POSITION STATEMENT: Gave invited testimony in support of SB 91.
BROOKE LAVENDER, ALS Care Services Manager
Anchorage, Alaska
POSITION STATEMENT: Gave invited testimony in support of SB 91.
HOSANNA HEARTSONG, representing self
Soldotna, Alaska
POSITION STATEMENT: Testified in support of SB 91.
EMILY NENON, Director
Alaska Government Relations
American Cancer Society Cancer Action Network
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 91.
ACTION NARRATIVE
3:11:42 PM
VICE CHAIR RUFFRIDGE called the House Health and Social Services
Standing Committee meeting to order at 3:11 p.m.
Representatives McCormick, Fields, Mina, and Ruffridge were
present at the call to order. Representatives Sumner and Prax
arrived as the meeting was in progress.
^CONFIRMATION HEARING(S)
^State Medical Board
^Board of Veterinary Examiners
^State Physical Therapy & Occupational Therapy Board
^Board of Marital & Family Therapy
CONFIRMATION HEARING(S)
State Medical Board
Board of Veterinary Examiners
State Physical Therapy & Occupational Therapy Board
Board of Marital & Family Therapy
3:12:25 PM
VICE CHAIR RUFFRIDGE announced that the first order of business
would be confirmation hearings on the governor's appointees to
various boards and commissions.
3:13:14 PM
DAVID BARNES, DO, Appointee, State Medical Board, gave his
personal, educational, and employment background [resume
included in committee packet], and he expressed interest in
participating in the regulation of the medical practice in
Alaska, focusing on protection of both healthcare providers and
the public. He talked about the unique nature of Alaska with
its rural areas.
3:15:52 PM
REPRESENTATIVE MINA asked Dr. Barnes to describe the biggest
issues facing physicians.
DR. BARNES highlighted the issue of insurance being a barrier to
care, listing difficulties such as obtaining prior
authorizations, previously accepted procedures being refused,
and the insurance industry regulating what physicians can do.
In response to a follow-up question, he indicated that the
biggest issue addressed by the board is the regulation of
physicians, with multiple cases per week.
HB 187-PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS
[Although not announced, the next order of business, initiated
by a motion by Representative Sumner, was HOUSE BILL NO. 187,
"An Act relating to utilization review entities; exempting
certain health care providers from making preauthorization
requests for certain services; and providing for an effective
date."]
3:20:17 PM
REPRESENTATIVE SUMNER moved to report HB 187 out of committee
with individual recommendations and the accompanying fiscal
notes, and to authorize Legislative Legal Services to make
technical and conforming changes. There being no objection, HB
187 was reported out of the House Health and Social Services
Standing Committee.
3:21:25 PM
The committee took an at-ease from 3:21 p.m. to 3:26 p.m.
^CONFIRMATION HEARING(S)
^State Medical Board
^Board of Veterinary Examiners
^State Physical Therapy & Occupational Therapy Board
^Board of Marital & Family Therapy
CONFIRMATION HEARING(S)
State Medical Board
Board of Veterinary Examiners
State Physical Therapy & Occupational Therapy Board
Board of Marital & Family Therapy
3:26:53 PM
VICE CHAIR RUFFRIDGE announced that the next order of business
would be a return to the confirmation hearings on the governor's
appointees to various boards and commissions.
VICE CHAIR RUFFRIDGE opened public testimony on the confirmation
hearing for Dr. Barnes. After ascertaining there was on one who
wished to testify, he closed public testimony.
HB 366-MINORS & RESIDENT PSYCH TREATMENT CENTERS
3:27:57 PM
VICE CHAIR RUFFRIDGE announced the next order of business would
be HOUSE BILL NO. 366, "An Act relating to residential
psychiatric treatment centers; and providing for an effective
date."
3:28:08 PM
REPRESENTATIVE SUMNER moved to report HB 366 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, HB 366 was reported out of the
House Health and Social Services Standing Committee.
3:28:44 PM
The committee took an at-ease from 3:28 p.m. to 3:30 p.m.
^CONFIRMATION HEARING(S)
^State Medical Board
^Board of Veterinary Examiners
^State Physical Therapy & Occupational Therapy Board
^Board of Marital & Family Therapy
CONFIRMATION HEARING(S)
State Medical Board
Board of Veterinary Examiners
State Physical Therapy & Occupational Therapy Board
Board of Marital & Family Therapy
3:30:33 PM
VICE CHAIR RUFFRIDGE announced that the next order of business
would be the completion of the confirmation hearings on the
governor's appointees to various boards and commissions.
3:30:48 PM
DENISE ALBERT, DVM, Appointee, Board of Veterinary Examiners,
gave her personal, educational, and employment background
[resume included in committee packet], including her vast
experience working with sled dogs. She said she has learned
about regulatory medicine as an active member of the board.
3:33:39 PM
REPRESENTATIVE MINA asked Dr. Albert to describe the big issues
that the board has been addressing.
DR. ALBERT mentioned eight years of board work to correct the
prescription drug monitoring program laws, which had been
created without input from the veterinary medical profession and
had been problematic. She also talked about the arrival of
telehealth since 2020 and ensuring a standard quality of care by
addressing antiquated regulations on the books. She discussed
the makeup of the board and its work to ensure the eligibility
of applicants for licensure.
3:37:36 PM
VICE CHAIR RUFFRIDGE opened public testimony on the appointment
of Dr. Albert. After ascertaining there was no one who wished
to testify, he closed public testimony.
3:38:22 PM
REBECCA DEAN, Appointee, State Physical Therapy & Occupational
Therapy Board, gave her personal, educational, and employment
background, including her work in the area of licensing. She
said she brings regulatory board competency and health care
delivery expertise to the board. She talked about the balance
between board and consumer and having a strong sense of
professionalism and ability to collaborate.
3:43:50 PM
REPRESENTATIVE MINA asked Ms. Dean to discuss the major issues
the board faces.
MS. DEAN, in response, outlined the board's strategic
initiatives, including the support of the physical therapy
compact and related bills. She talked about safety and
protection of patients, as well as flexibility for interstate
licensing. She said clinicians need to understand business and
leadership in clinical roles in order to expand access to care
in Alaska. She said the board is revising continuing education
requirements and is committed to continue its focus on national
best practice systems to bring to Alaska. She mentioned
recruitment and retention; a fair and standardized disciplinary
metric; requirements for licensing that streamline the process;
and the clarification of statutory and regulatory guidelines
aimed at improving communication pathways and access to full
information for licensees.
3:48:36 PM
VICE CHAIR RUFFRIDGE opened public testimony on the confirmation
for Ms. Dean. After ascertaining there was no one who wished to
testify, he closed public testimony.
3:49:15 PM
KAYLA GREEN, Appointee, Board of Marital & Family Therapy,
shared her personal background, education, and employment
history [resume included in committee packet] and pointed to
goals of the board in helping people get licensed and take part
in continued education. She mentioned telehealth efforts and
legislation. She said her education and understanding of health
care is an asset on the board.
REPRESENTATIVE MINA asked Ms. Green to talk about key issues
related to the board and therapists.
MS. GREEN replied that the board is looking at ways to lower its
high fees, make continued education accessible, maintain
telehealth, and support license transferability.
3:54:18 PM
VICE CHAIR RUFFRIDGE opened public testimony on the confirmation
for Ms. Green. After ascertaining there was no one who wished
to testify, he close public testimony.
3:54:53 PM
VICE CHAIR RUFFRIDGE stated that the House Health and Social
Services Standing Committee has reviewed the qualifications of
the governor's appointees and recommends that the following
names be forwarded to a joint session for consideration: David
Barnes, State Medical Board; Denise Albert, Board of Veterinary
Examiners; Rebecca Dean, State Physical Therapy & Occupational
Therapy Board; and Kayla Green, Board of Marital & Family
Therapy. He said that signing the report regarding appointments
to boards and commissions in no way reflects an individual
member's approval or disapproval of the appointee, and the
nomination is merely forwarded to the full legislature for
confirmation or rejection.
3:55:26 PM
The committee took an at-ease from 3:55 p.m. to 3:56 p.m.
SB 91-TELEHEALTH: MULTIDISCIPLINARY CARE TEAM
3:56:54 PM
VICE CHAIR RUFFRIDGE announced that the final order of business
would be CS FOR SENATE BILL NO. 91(FIN), "An Act relating to
telehealth; relating to multidisciplinary care teams; and
relating to the practice of medicine."
3:57:24 PM
The committee took an at-ease from 3:57 p.m. to 3:58 p.m.
3:58:23 PM
SENATOR MATT CLAMAN, Alaska State Legislature, as prime sponsor,
presented CSSB 91(FIN). He informed the committee that the
incentive for the proposed legislation was a visit from a
constituent with amyotrophic lateral sclerosis (ALS), a
degenerative disease that leads to paralysis and death within
two to five years, but for which medical care can improve
quality of life. This constituent flew to Seattle and was told
she could continue her treatment with her physician via
telehealth but would have to fly to Seattle to meet in person
with the other seven members of her multidisciplinary team. She
travels four times a year to visit these caregivers, but in the
future, she will be unable to do so. Senator Claman encouraged
committee members to read the letter from Ms. Swanson [included
in the committee packet]. He explained there are 30 individuals
with ALS in Alaska and treatment for them is not available in
the state. As a practical matter, this type of specialized care
is available in large cities with major medical centers and a
higher volume of patients.
SENATOR CLAMAN noted that in 2022, the legislature passed House
Bill 265, which created a framework for telehealth. He
explained that CSSB 91(FIN) would amend the language of House
Bill 265 by adding members of out-of-state and multidisciplinary
care teams as an option of telehealth when an Alaskan is
suffering with a life-threatening condition and the
multidisciplinary care is not readily available in Alaska. The
proposed legislation would ensure that "all members of the
multidisciplinary care team are subject to Alaska's regulatory
authority" and would "align multidisciplinary care teams with
the current registration process of Alaska's telemedicine
business registry." The bill would expand telehealth options
"so that Alaskans with life-threatening conditions can receive
the specialized care they need while remaining in their local
support network whenever possible."
4:01:36 PM
CLAIRE LUBKE, Staff, Senator Matt Claman, Alaska State
Legislature, on behalf of Senator Claman, prime sponsor,
presented the sectional analysis for SB 91, which read as
follows [original punctuation provided]:
Senate Bill 91 Sectional Analysis Version S
Section 1
AS 08.02.130. Telehealth
Amends subsection (b) to expand who may provide health care
services through telehealth to include out of state members
of the physician's multidisciplinary care team when the
health care service provided by the multidisciplinary care
team is not reasonably available in Alaska and is "for on-
going treatment or follow-up care regarding a suspected or
diagnosed life-threatening condition," as stated in the new
subsection (C).
Section 2
AS 08.02.130. Telehealth
Amends the definition of "health care provider" in (j)(1)
by adding section (C) to include a member of a
multidisciplinary care team who is licensed in another
state.
Section 3
AS 08.02.130. Telehealth
Creates a definition for "member of a multidisciplinary
care team" in (5) of this section to mean "an audiologist,
speech-language pathologist, behavior analyst, professional
counselor, dietitian, nutritionist, naturopath, marital and
family therapist, podiatrist, osteopath, physician
assistant, nurse, pharmacist, physical therapist,
occupational therapist, psychologist or psychological
associate, advanced nurse practitioner, or a social worker
who is a member of a team that includes a physician
licensed in another state who meets the requirements of
(b)(1) of this section."
Section 4
AS 08.02. Miscellaneous Provisions
Adds new sections AS 08.02.135: Grounds for imposition of
disciplinary sanctions of out of state multidisciplinary
care team members and AS 08.02.140: Disciplinary sanctions
for out of state multidisciplinary care team member.
Section 5
AS 44.33.381. Telemedicine business registry
Amends subsection (b) of this section by adding that the
department may "renew every two years the registration of a
business that meets all renewal requirements established by
regulation and pays a renewal fee every two years."
Section 6
AS 44.33.381. Telemedicine business registry
Adds new subsection (d) which includes the following fees
that the department shall charge businesses performing
telemedicine services in the state: (1) initial
registration fee, $100, adjusted for inflation in a manner
determined by the department; (2) renewal fee $100,
adjusted for inflation in a manner determined by the
department; and (3) fee to report changes in the business's
registration information, $50.
4:04:51 PM
VICE CHAIR RUFFRIDGE opened invited testimony on CSSB 91(FIN).
4:05:05 PM
GAIL BRATEN, representing self, gave invited testimony in
support of CSSB 91(FIN). She briefly described her background
and explained that health care for ALS patients is challenging.
In order for her and her husband to stay in Alaska at least part
of the time, they must be able to use telehealth. She described
the progress of the science for ALS. For her husband to have
the best outcomes, he needed to meet with a multidisciplinary
team of experts. With telehealth, he can meet with team members
who are specialized and bring the latest research in ALS to the
team. Through telehealth care team collaboration, her husband
can receive the best care. Alaska does not have specialized
multidisciplinary healthcare teams for ALS. She described the
Mayo Clinic team her husband met with in Minnesota who asked him
to return every 3 months. With telehealth, her husband could
meet with the Mayo multidisciplinary team without the stress and
expense of travel. She urged the committee to pass CSSB
91(FIN).
4:08:15 PM
TIM JENNINGS, representing self, gave invited testimony in
support of SB 91. He told the committee that he has ALS and
briefly explained the importance of being able to meet with an
interdisciplinary care team via telehealth. He urged the
committee to pass CSSB 91(FIN).
4:09:15 PM
REPRESENTATIVE FIELDS discussed one of his constituents who has
cancer and would benefit from telehealth medicine. He asked
whether the bill could be moved at that time.
4:09:50 PM
VICE CHAIR RUFFRIDGE pointed out that there was additional
testimony.
4:10:02 PM
BROOKE LAVENDER, ALS Care Services Manager, gave invited
testimony in support of CSSB 91(FIN). She described the
proposed legislation as a crucial element of care across Alaska.
Telehealth would particularly benefit those with ALS, multiple
sclerosis (MS), and cancer. She provided examples of patients
in Alaska who have great difficulty traveling to the Lower 48 to
receive appropriate care. Individuals with challenging health
conditions would greatly benefit from the multi-disciplinary
approach telehealth could provide. She urged the committee to
pass CSSB 91(FIN).
4:13:28 PM
VICE CHAIR RUFFRIDGE opened public testimony on SB 91.
4:13:45 PM
HOSANNA HEARTSONG, representing self, testified in support of SB
91. She has MS and shared her personal story. She urged the
committee to pass SB 91.
4:15:09 PM
EMILY NENON, Director, Alaska Government Relations, American
Cancer Society Cancer Action Network, testified in support of SB
91. She referred to the network she worked with who would
become part of a multidisciplinary approach to cancer care in
Alaska. She explained that most cancer patients can receive
appropriate care in Alaska. However, with complex cases, people
often go out of town to receive care. Multidisciplinary care is
the leading model for complex cancer cases, but without the
ability to travel or participate in telehealth, Alaska patients
lack access to this type of care. In addition, patients who
have to move or travel out of state to receive the level of care
they need are cut off from their support networks and home
health care teams. She urged the committee to pass SB 91.
4:18:31 PM
VICE CHAIR RUFFRIDGE, after ascertaining there was no one else
who wished to testify, closed public testimony on SB 91.
4:18:50 PM
REPRESENTATIVE MINA expressed her support for CSSB 91(FIN).
4:19:12 PM
REPRESENTATIVE SUMNER moved to report CSSB 91(FIN) out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSSB 91(FIN) was
reported out of the House Health and Social Services Standing
Committee.
VICE CHAIR RUFFRIDGE noted that Chair Prax had returned just
prior to adjournment.
4:20:13 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:20 p.m.