03/19/2014 03:15 PM House LABOR & COMMERCE
| Audio | Topic |
|---|---|
| Start | |
| HCR15 | |
| HB370 | |
| HB152 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HCR 15 | TELECONFERENCED | |
| *+ | HB 370 | TELECONFERENCED | |
| += | HB 152 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE LABOR AND COMMERCE STANDING COMMITTEE
March 19, 2014
3:23 p.m.
MEMBERS PRESENT
Representative Kurt Olson, Chair
Representative Lora Reinbold, Vice Chair
Representative Mike Chenault
Representative Bob Herron
Representative Charisse Millett
Representative Dan Saddler
Representative Andy Josephson
MEMBERS ABSENT
Representative Craig Johnson
COMMITTEE CALENDAR
HOUSE CONCURRENT RESOLUTION NO. 15
Relating to the continuation of the Task Force on Unmanned
Aircraft Systems.
- MOVED CSHCR 15(L&C) OUT OF COMMITTEE
HOUSE BILL NO. 370
"An Act relating to employer drug testing; requiring the Alaska
Workers' Compensation Board to adopt regulations relating to the
prescription of controlled substances to employees; and limiting
the prescription of controlled substances to employees."
- HEARD & HELD
HOUSE BILL NO. 152
"An Act requiring certain employers who terminate participation
in the defined benefit retirement plan or the defined
contribution retirement plan of the Public Employees' Retirement
System to make contributions related to past service liability
and pay termination costs; repealing a requirement that
employers who terminate participation in the defined
contribution retirement plan or the defined benefit retirement
plan of the Public Employees' Retirement System pay for a
termination cost study; and providing for an effective date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HCR 15
SHORT TITLE: TASK FORCE ON UNMANNED AIRCRAFT SYSTEMS
SPONSOR(s): REPRESENTATIVE(s) HUGHES
01/21/14 (H) READ THE FIRST TIME - REFERRALS
01/21/14 (H) L&C
02/21/14 (H) L&C AT 3:15 PM BARNES 124
02/21/14 (H) Heard & Held
02/21/14 (H) MINUTE(L&C)
03/05/14 (H) L&C AT 3:15 PM BARNES 124
03/05/14 (H) -- MEETING CANCELED --
03/10/14 (H) L&C AT 3:15 PM BARNES 124
03/10/14 (H) Scheduled But Not Heard
03/19/14 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 370
SHORT TITLE: AWCB CONTROLLED SUBSTANCE PRESCRIPTIONS
SPONSOR(s): LABOR & COMMERCE
03/03/14 (H) READ THE FIRST TIME - REFERRALS
03/03/14 (H) L&C, JUD
03/19/14 (H) L&C AT 3:15 PM BARNES 124
BILL: HB 152
SHORT TITLE: PERS TERMINATION COSTS
SPONSOR(s): THOMPSON
03/04/13 (H) READ THE FIRST TIME - REFERRALS
03/04/13 (H) L&C, FIN
04/05/13 (H) L&C AT 3:15 PM BARNES 124
04/05/13 (H) Heard & Held
04/05/13 (H) MINUTE(L&C)
03/05/14 (H) L&C AT 3:15 PM BARNES 124
03/05/14 (H) -- MEETING CANCELED --
03/10/14 (H) L&C AT 3:15 PM BARNES 124
03/10/14 (H) Heard & Held
03/10/14 (H) MINUTE(L&C)
03/19/14 (H) L&C AT 3:15 PM BARNES 124
WITNESS REGISTER
REPRESENTATIVE SHELLEY HUGHES
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified as prime sponsor of HCR 15.
KONRAD JACKSON, Staff
Representative Kurt Olson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Explained Amendment 1 to HCR 15 on behalf
of the sponsor, House Labor & Commerce Committee, Representative
Kurt Olson, Chair.
JANE DALE, Legislative Affairs
Alaska Air Carriers Association (AACA)
Willow, Alaska
POSITION STATEMENT: Testified during the discussion of HCR 15.
ANNA LATHAM, Staff
Representative Kurt Olson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified on HB 370 on behalf of the
sponsor, the House Labor & Commerce Committee, Representative
Kurt Olson, Chair.
LORI WING-HEIER, Acting Director
Division of Insurance (DOI)
Department of Commerce, Community & Economic Development (DCCED)
Anchorage, Alaska
POSITION STATEMENT: Testified and answered questions during the
discussion of HB 370.
MICHAEL MONAGLE, Director
Central Office; Division of Workers' Compensation
Department of Labor & Workforce Development (DLWD)
Juneau, Alaska
POSITION STATEMENT: Answered questions regarding HB 370.
SIDNEY SEE
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 370.
JANE PIERSON, Staff
Representative Steve Thompson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 152.
MICHAEL BARNHILL, Deputy Commissioner
Department of Administration (DOA)
Juneau, Alaska
POSITION STATEMENT: Testified regarding HB 152.
KATHY LEA, Deputy Director
Central Office; Retirement and Benefits
Department of Administration (DOA)
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 152
KATHIE WASSERMAN, Executive Director
Alaska Municipal League (AML)
Juneau, Alaska
POSITION STATEMENT: Testified during the discussion of HB 152
ACTION NARRATIVE
3:23:42 PM
CHAIR KURT OLSON called the House Labor and Commerce Standing
Committee meeting to order at 3:23 p.m. Representatives Herron,
Josephson, Reinbold, and Saddler and Olson were present at the
call to order. Representatives Millett and Chenault arrived as
the meeting was in progress.
HCR 15-TASK FORCE ON UNMANNED AIRCRAFT SYSTEMS
3:23:56 PM
CHAIR OLSON announced that the first order of business would be
HOUSE CONCURRENT RESOLUTION NO. 15, Relating to the continuation
of the Task Force on Unmanned Aircraft Systems.
3:24:56 PM
REPRESENTATIVE SHELLEY HUGHES, Alaska State Legislature, stated
that the resolution will allow the Task Force on Unmanned
Aircraft Systems to continue. The task force was formed last
year and primarily addressed privacy and law enforcement use.
She described the technology as emerging technology and
anticipated other issues will surface and HCR 15 would allow the
task force to continue to operate. The task force's approach
has been to address problems as they arise. She said resolution
also will change the membership.
3:26:34 PM
REPRESENTATIVE REINBOLD made a motion to adopt Amendment 1,
labeled 28-LS1190\U.2, Strasbaugh, 3/4/14.
Page 1, line 1:
Delete "the continuation of"
Page 2, following line 22:
Insert a new paragraph to read:
"(2) the commissioner of commerce,
community, and economic development or the
commissioner's designee;"
Renumber the following paragraph accordingly.
Page 2, line 23:
Delete "one"
Insert "three"
Delete "member"
Insert "members"
Page 2, line 24, following "representatives":
Insert ", two of whom shall be participants in
the unmanned aircraft system industry who have
experience operating unmanned aircraft systems"
Page 3, line 13, following "systems":
Insert "to encourage development of the private
sector unmanned aircraft system industry"
CHAIR OLSON objected for the purpose of discussion.
3:26:51 PM
KONRAD JACKSON, Staff, Representative Kurt Olson, Alaska State
Legislature, stated that that Amendment 1 was developed in
conjunction with the sponsor and other members. He explained
the idea is to make the Task Force on Unmanned Aircraft more
commerce friendly. Amendment 1 adds the commissioner of DCCED
or the commissioner's designee to the task force. It would also
add two additional public members to encourage public
participation. He referred to lines 18-19 of Amendment 1, which
require two public members who have experience piloting unmanned
aircraft. He also referred to lines 22-23 of Amendment 1, which
encourages the task force to develop the private sector unmanned
aircraft system industry in the state.
CHAIR OLSON removed his objection. There being no further
objection, Amendment 1 was adopted.
3:28:41 PM
JANE DALE, Legislative Affairs, Alaska Air Carriers Association
(AACA), stated that ACCA has supported the work the Task Force
on Unmanned Aircraft has done to clarify privacy issues and to
further the integration of the unmanned aircraft systems (UAS)
into the system. As they become part of the aviation culture
and further commerce in Alaska, the AACA supports the extension
of the UAS task force to 2017. The ACCA also supports adding a
seat for the ACCA's membership on the task force since its
membership currently encounters the craft in national airspace.
The U.S. Department of the Interior (DOI) recently received
Federal Aviation Administration's (FAAs) approval for unmanned
air system use that streamlines past procedures for operation.
She related that University of Alaska (UA) is operating UAS
under the auspices of research and this past year launched the
first commercial endeavor. These successes come with concerns,
conflicts, and potential issues from traditional air carriers
operations so air carriers would appreciate participating in the
task force to research and make recommendations to resolve
issues. She thanked members for the opportunity to testify.
3:30:34 PM
CHAIR OLSON, after first determining no one else wished to
testify, closed public testimony on HCR 15.
REPRESENTATIVE HERRON jested that he hoped by the end of task
force at least one legislator will know how to operate the UAS.
3:31:24 PM
REPRESENTATIVE REINBOLD moved to report HCR 15, as amended, out
of committee with individual recommendations and the
accompanying fiscal note. There being no objection, the CSHCR
15 (L&C) was reported from the House Labor and Commerce Standing
Committee.
3:31:55 PM
The committee took an at-ease from 3:31 p.m. to 3:34 p.m.
HB 370-AWCB CONTROLLED SUBSTANCE PRESCRIPTIONS
3:34:33 PM
CHAIR OLSON announced that the next order of business would be
HOUSE BILL NO. 370, "An Act relating to employer drug testing;
requiring the Alaska Workers' Compensation Board to adopt
regulations relating to the prescription of controlled
substances to employees; and limiting the prescription of
controlled substances to employees."
3:34:40 PM
ANNA LATHAM, Staff, Representative Kurt Olson, Alaska State
Legislature, stated that HB 370 requires Alaska Workers'
Compensation Board (AWCB) to adopt regulations relating to
limiting controlled substances to employees. Section 1 would
authorize employers to drug test injured workers for controlled
substances prescribed to the employee listed in schedule IA
under AS 11.70.140 if the employee has been prescribed a
controlled substance for more than 90 days as the result of a
workers' compensation claim.
MS. LATHAM related that Section 2 requires the Workers'
Compensation Board to adopt regulations relating to the
prescription of controlled substances to implement Section 3.
Section 3 would limit a physician's prescription of a controlled
substance listed in schedule IA under AS 11.71.140, or a
controlled opium substance in schedule IIIA under 11.71.160, or
schedule VA under AS 11.71.180. She stated that HB 370 will
discourage the use of long-term opioids by restricting the
prescription to a 30-day supply. In addition, the bill would
allow employers to drug test employees who have been prescribed
schedule 1A controlled substances for more than 90 days,
primarily to see if the prescription is being diverted.
Statistics show that one in four prescriptions are used by
someone who has not been prescribed the medication. These
prescriptions are paid for by the employer, directly or through
insurance premiums.
MS. LATHAM stated that the drugs referred to in HB 370 are
synthetic versions of opium derived drugs. Under AS 11,
controlled substances are classified into six categories, with
schedule IA having the highest degree of danger to the public
and Schedule VI having the lowest degree of danger. For
example, morphine is classified as a schedule IA drug, marijuana
is classified as a schedule VI drug, and schedule IIIA and VA
drugs are considered opioid derivatives that vary in strength,
including drugs such as codeine. The use of higher dosage can
lead to addiction, increased disability, work loss, and even
death. She referred to statistics in members' packets on
workers' compensation claims.
3:37:51 PM
MS. LATHAM stated that last year, approximately 200 deaths due
to opioid abuse were a result of workers' compensation claims.
Not only is prescription drug abuse a public health and safety
issue, prescriptions are also a "cost driver" for workers'
compensation premiums. Alaska has the highest workers'
compensation insurance premiums in the nation. In 2011,
prescription drugs comprised almost 20 percent of medical costs
for workers' compensation claims in Alaska. Prescriptions were
covered by workers' compensation in 90 percent of the cases of
workers who missed a week or more of work. Sixty to 80 percent
of workers' compensation injured workers received opioids as
part of their prescribed medicines. Alaska, along with many
other states, has been working to address the overuse and misuse
of opioids, and many states have also implemented reforms. Some
states have restricted physician dispensing practices,
implementing pain management guidelines and restricting the
dosages and length of time that opioids can be prescribed.
Additionally, there has been an increase in the use of random
drug testing in workers' compensation claimants who use long-
term narcotics.
3:39:19 PM
MS. LATHAM shared statistics in members' packets from the
Lockton report [August 2012]. In a 2011 report, based on a
sample of 939,000 screenings, 71 percent of workers'
compensation claimants on chronic opioid therapy are not taking
their pain medication as prescribed due to misuse or abuse; 38
percent of patients were found to have no detectible level of
prescribed medication in their system; 29 percent had
nonprescribed medication; 27 percent had drug levels that were
higher than expected; and 11 percent had illicit drugs in their
system. These 2011 statistics were based on a sample of 939,000
screenings, she said. She emphasized that the statistics
reiterate the need for opioid prescriptions and allowing
employer drug testing in workers' compensation claims.
3:40:36 PM
CHAIR OLSON reported on other bills the committee has been
working on including one that will address physician dispensing
of opioids, including one for possible introduction next year to
address best practices for pain management that will tie in with
this issue and a fee schedule bill. He reported that many
jurisdictions are working on bills similar to HB 370, which is
having a significant impact on workers' compensation. He said
if patients are not taking their medication they may not be in
pain and may have found a new job. He said the intention of
this bill is not to step between the doctor and the patient, but
to support the belief that doctors should see their patient more
often before providing automatic refills on drugs such as
Oxycontin.
3:42:32 PM
REPRESENTATIVE JOSEPHSON asked whether the goal is to look for
criminal misconduct.
MS. LATHAM answered no; however, the main intent of the bill is
to lower costs for workers' compensation premiums. Thus, one
way to cut costs is to restrict insurance from paying for opioid
prescriptions that patients have not been taking.
3:43:11 PM
REPRESENTATIVE JOSEPHSON understood that patients may take too
many or too few pills. He asked whether she could identify the
stronger goal.
MS. LATHAM answered that the sponsor is particularly concerned
with prescriptions that are not being taken by patients. The
reason she mentioned the widespread abuse due to widespread
prescription drug abuse and that topic could render some
familiarity for members. The intent of the legislature is to
monitor workers' compensation patients taking opioids and ensure
that employers do not pay for prescriptions being paid for under
workers' compensation if the patients are not taking the drugs.
CHAIR OLSON commented that urinalysis (UA) has been used in a
number of occupations for a variety of reasons. In this
instance, if the urinalysis test comes back "clean" and the
patient is still collecting prescriptions, it is automatically
assumed the injured worker is ready to go back to work or they
have a new profession and the drugs are being diverted to
someone who is not the patient.
3:44:34 PM
REPRESENTATIVE JOSEPHSON reported that four major U.S. Supreme
Court cases and at least one major Alaska Supreme Court Case
have been issued [regarding drug testing]. These are considered
searches under the fourth amendment [of the U.S. Constitution].
That doesn't mean that the testing can't sometimes be done, but
there is a "special needs" test required. He asked whether
anyone has vetted this bill with the legislative legal counsel
on whether the "special needs" test has been met.
MS. LATHAM answered no; however, the statute that this bill
falls under is within employer policies so it would allow
employers to recognize that drug testing will be part of the
condition for employment.
3:45:42 PM
REPRESENTATIVE JOSEPHSON related a scenario in which the
patient/workers' compensation claimant simply didn't want to
develop a habit and made the decision not to take the
prescription. He asked whether it can be inferred that the
patients must be "dealing the drugs."
MS. LATHAM answered absolutely not. She indicated that if the
patients are restricted to a 30-day supply and the employees
chose not to take the drugs, there wouldn't be any reason for
the employees to obtain more than a 30-day.
CHAIR OLSON added that the doctor can renew the prescription,
but the bill requires some oversight and not allow the patient
to have over three months of prescription drugs.
MS. LATHAM offered her belief that approximately 15 states have
enacted something similar.
CHAIR OLSON also added that it has been "court-tested" in those
states.
3:46:54 PM
REPRESENTATIVE JOSEPHSON referred to a 2001 EPD decision, which
emphasizes the privacy clause. He asked whether this would
result in more workers' compensation litigation because
employers and their insurance companies said, "You're not truly
injured. You couldn't because you're not taking your meds.
Your pain must not be that great. Therefore, you're healed."
He wondered if there is any concern that this could create other
sorts of problems.
MS. LATHAM did not believe that HB 370 would lead to increased
litigation, but it most likely will stop extra prescriptions
from being written and not being taken by the patients.
CHAIR OLSON noted the departments could also testify.
3:48:02 PM
REPRESENTATIVE MILLETT related her recent experience with a
series of back problems, noting she was shocked at the amount of
a 90-day supply of opioids, including Valium and Xanax.
Obtaining a 90-day supply meant that she didn't need to see her
doctor during that period. Although she acknowledged that she
is not on a workers' compensation claim she also recognized a
distinct need to keep workers' compensation claims costs down.
She suggested limiting the aforementioned prescription drugs to
a 30-day supply, which should be sufficient for injured workers
in an ongoing workers' compensation claim.
REPRESENTATIVE MILLETT said she was astonished this [limit]
hasn't been previously put in place since one problem the police
encounters is the sale of illegal prescription drugs. One of
her prescriptions got stolen, noting insurance will not pay for
it unless the theft was reported to police. She reiterated her
surprise at the amount of opioids in a 90 day supply, noting
that some of drugs cost upwards of $2,000. She emphasized the
importance to have control over that process to have patients
see their doctors for continuation of care, with the outcome and
goal to have the workers' compensation claimant go back to work.
She appreciated HB 370, especially due to the understanding she
gained from her own experience with chronic back problem since
it helped illustrate the quantity of drugs. She emphasized that
this bill attempts to try to keep illegal drugs off the street
and ensure that workers' compensation claimants are using the
drugs in an efficient manner with the goal to get workers'
compensation claimants back to work, since medical costs is one
of the biggest expenditures for employers and the state.
3:52:03 PM
REPRESENTATIVE SADDLER asked for the level of accuracy of the
"UA" or drug tests.
MS. LATHAM offered to report back to the committee.
REPRESENTATIVE SADDLER anticipated some court challenges and
thought the accuracy would be important.
3:52:59 PM
REPRESENTATIVE CHENAULT said this has the makings of a good
bill. He offered his belief that some people will commit murder
to obtain a 90-day supply of drugs. He has observed illicit
drugs become a problem in his community. The legislature needs
to do what it can to ensure the drugs are legally used. He did
not object to "UA" use for some people. He questioned what
happens to full drug prescriptions if the workers' compensation
patients are not taking them. He recalled an instance in his
family, in which a family member had a prescription for
oxycontin that led to excess prescription drugs in the family
member's house. Certainly, there must be a way to control drugs
from getting into the open market, he said. Although [penalty
provisions] are not in the bill, he concluded that if the drugs
are being sold on the street that the sellers need to be held
accountable. In response to a question, he affirmed that
patients possessing a 90-day supply of drugs could be in danger.
3:55:49 PM
REPRESENTATIVE HERRON echoed that this is a good measure. He
found a normal range to be 30-day supply of drugs; however, he
asked if this limit is rigid and impractical for some.
MS. LATHAM answered that the contact with the physician is not
defined in the bill so prescriptions could be filled by an
office visit or by phone. She related his understanding that
mailing prescriptions to small communities is also possible.
3:57:05 PM
REPRESENTATIVE HERRON asked to have on the record that doctors
need to know if the pain medication is necessary, but abuses can
occur if patients are not taking their medication and are
selling the prescriptions. Again, just for the record he wanted
to ensure there are "smart ways" exist so patients don't have to
submit to a physical contact due to the size of the state and
the remoteness of some communities.
CHAIR OLSON welcomed any suggested language changes.
REPRESENTATIVE HERRON respected having a "rigid process," that
limits the amount of drugs prescribed, but at the same time he
recognized in a lot of ways it might be impractical.
3:58:50 PM
REPRESENTATIVE JOSEPHSON asked whether the sponsor has seen any
evidence that abuse of opioids is greater among workers'
compensation claimants than all the other segments of society.
MS. LATHAM answered she not seen specific statistics that have
shown abuse on workers' compensation claims are higher than the
widespread abuse. She said the trends tend to mirror each other
in terms of the national statistics and are similar to workers'
compensation in terms of abuse.
3:59:28 PM
REPRESENTATIVE JOSEPHSON asked whether a wise amendment would be
that this principle should apply to all Alaskans.
MS. LATHAM offered her belief that would be a tough sell, but
the bill will be brought back up for consideration.
4:00:10 PM
LORI WING-HEIER, Acting Director, Division of Insurance (DOI),
Department of Commerce, Community & Economic Development,
related that workers' compensation is a Department of Labor &
Workforce Development statute but the employers tend to fund
their obligation under the statute by purchasing insurance. The
DOI sets those rates. In terms of cost, the DOI's rates are
impacted by the cost of prescriptions through workers'
compensation claims. As members know, Alaska has the highest
workers' compensation rates in the nation. She provided a
ranking of the cost and number of claims, noting Alaska ranks 43
of 46 on medical claims and 39 of 46 for indemnity claims -
typically the longer term claims with a higher injury.
Historically, in reviewing claims for the past five years,
Alaska should expect to have 4,800 claims for every 100,000
workers. Of those 4,800 claims, 1,400 would represent long-term
claims and these are the claimants who will have long-term
prescriptions. The costs have steadily increased with the
average amount of $190 per claim in 2007 having risen to $265.
Most injured employees are receiving up to six prescriptions for
an injury, not including renewals. The top ten drugs being
prescribed are for pain medications with 25 percent being for
oxycontin. She characterized the statistics as being staggering
and employers are paying for these through the workers'
compensation costs. The division has been trying to work with
the DLWD to reduce costs to an affordable level. She hoped
members would consider HB 370 to help reduce workers'
compensation insurance rates and costs.
4:03:07 PM
REPRESENTATIVE JOSEPHSON remarked that when he hears that the
average injured worker has been prescribed six medications, that
the medical community is absolutely complicit in the problem.
He asked whether she agreed.
MS. WING-HEIER answered that she would not disagree with that
statement. The statistics prove that prescription drugs are
overprescribed and often for 90 days for convenience. She
offered her belief that overprescribing is an issue.
4:04:24 PM
REPRESENTATIVE MILLETT said Aetna insurance members are limited
to 90-day supply at a time before refills are authorized. She
said that Aetna insurance doesn't allow for prescriptions for a
longer timeframe.
MS. WING-HEIER said that limit refers to the personal employer-
sponsored health plan. She did not know of any limitation
within the statutes with respect to workers' compensation
prescriptions, but deferred to the DLWD to respond.
4:05:23 PM
REPRESENTATIVE MILLETT asked whether doctors can prescribe up to
a year under the workers' compensation plan.
MS. WING-HEIER said she was unsure. She said she has not heard
of up to a year timeframe, but has heard of prescriptions for
some large amounts.
4:05:59 PM
REPRESENTATIVE CHENAULT asked if the average was for six
different prescriptions.
MS. WING-HEIER answered that the average prescription is for six
different kinds of medications.
4:06:27 PM
REPRESENTATIVE CHENAULT remarked he has never been in the
workers' compensation system. He asked whether it is odd that a
doctor would not want to see a patient within 90 days to assess
if the patient is healing or getting worse. He offered his
belief that in his own community some doctors write too many
prescriptions. He asked whether any tracking occurs to compare
the average number of prescriptions to the number of
prescriptions doctors write for a specific drug.
MS. WING-HEIER answered she was not aware of any study.
Unfortunately, prescription drug abuse represents an epidemic
throughout the nation that has negatively impacted the state.
She said she hopes this bill will start to address this, in
particular, due to the costs.
REPRESENTATIVE CHENAULT commented that if the state is concerned
about workers' compensation costs, but the first thing that
happens is an injured employee is given a 90-day prescription it
could be that "we are the problem."
MS. WING-HEIER offered her belief that it would be best
practices for the physicians to see their patients more often.
REPRESENTATIVE CHENAULT said he does not want to make
disparaging remarks about doctors, but it does seems odd. He
suggested that checking back with the patient seems important,
although he wondered if the initial prescriptions were for
prescriptions for a shorter timeframe.
4:09:30 PM
REPRESENTATIVE HERRON described his own experience at a heart
institute, noting he has been prescribed non-opioids for his
heart condition, typically for a ten-month timeframe. When it
comes to opioids, the patient sees the claimant's doctor. He
wondered whether the solution is to require mandatory visits,
with a maximum spacing of three months and for the doctors to
prescribe three 30-day prescriptions for tighter controls.
MS. WING-HEIER did not disagree that tighter controls would be
better to reduce rates. She wasn't sure if that is possible but
she thought it might reduce rates.
4:11:06 PM
REPRESENTATIVE MILLETT, with respect to Representative Herron's
question, asked whether the workers' compensation regulations
require patients to see their doctors every 30 days. She did
not understand why the workers' compensation division couldn't
require claimants to have more visits to track the injured
worker's progress, which could reduce workers' compensation
costs. She further wondered if after 30 days rest, whether
doctors could release their patients.
MS. WING-HEIER answered that workers' compensation has a third
party adjuster who works with the patient and doctor. She was
unsure of any requirements since the adjuster is directly
involved with the injured worker. She suggested that it is
possible in long-term injury workers' compensation cases that
the patient might not see the doctor every 30 days. She said
that this activity would be monitored by the adjuster.
4:13:11 PM
REPRESENTATIVE JOSEPHSON asked whether the division has any data
relative to costs associated by requiring more doctor office
visits. He offered his belief this requirement would drive
costs up. He recalled the motivation for a telemedicine bill
before the legislature was to decrease the number of office
visits and for patients to be able to quickly obtain
prescriptions in order to reduce medical costs. He asked
whether telemedicine approach will work or if increasing office
visits to better monitor injured people is the answer.
CHAIR OLSON answered that the goal is to get injured workers
back to work. He offered his belief that the cost savings will
occur once the injured worker is back to work and off drugs such
as oxycontin, which is a drug that was developed for end-of-life
terminal cancer patients that later became a painkiller. He
said that drugs like OxyContin are being overprescribed and
reiterated that the intent is to get the employee back to work,
which saves the state, the worker, and the employer money. He
cautioned that once injured workers are on opioids for a lengthy
period of time, workers typically don't go back to work.
4:15:00 PM
REPRESENTATIVE MILLETT remarked that the committee is not
advocating telemedicine for workers' compensation claims.
REPRESENTATIVE JOSEPHSON said he was unsure.
CHAIR OLSON agreed telemedicine is not being advocated.
4:15:27 PM
MICHAEL MONAGLE, Director, Central Office, Division of Workers'
Compensation, Department of Labor & Workforce Development
(DLWD), with respect to an injured workers needing to see the
doctor on a regular basis, answered that there is a provision in
law that an employer can require an injured worker to see the
doctor at least once every two weeks. He acknowledged that most
of the time claims are managed by a claims administrator;
however, a claims adjuster typically handles over 100 cases.
These adjusters tend to pay more attention to serious indemnity
claims than a medical only claim. He reiterated that an
employer can direct an injured worker to see the doctor semi-
monthly. In the event an injured worker has surgery and the
normal recovery time is six to eight weeks, it may not make
sense to see the doctor any earlier. In response to the
question regarding whether problems are more prevalent in
workers' compensation than in the general population, he
reported that a study by the Workers' Compensation Research
Institute indicates the average number of workers receiving
opioids for a time-loss claim is over 75 percent.
4:17:19 PM
MR. MONAGLE did not find it unreasonable for patients with
strains or breaks to have a need for pain prescriptions. He
pointed out that in workers' compensation cases, the problem is
that the longer the injured workers are on pain medications, the
longer they miss work and for those on pain medications for more
than 90 days, the duration of the disability is 30 percent
higher than in non-opioid prescription cases. He has
encountered some injured workers with serious disabilities who
have been on opioids for two to three years. Doctors recognize
these patients become addicted, that their doses are increasing,
and that the person may be suffering mental disabilities due to
prolonged use of the drugs. In addition, patients may encounter
physical disabilities, yet the drugs are the only remedy so
doctors keep prescribing the drugs. He said the Centers for
Disease Control uses the term "epidemic" which is not at term
that is used lightly. He said that workers' compensation cases
are a reflection of the general health care system, but he
suggested that there may be more pronounced problems within
workers' compensation than in the general population.
CHAIR OLSON commented that this bill is a result of a meeting
put on by Workers' Compensation Research Institute in fact,
about 90 percent of the meeting was used to address this issue.
He remarked that fatalities involving drivers using opioids is
close to surpassing "drunk driving" fatalities so it is a
serious problem.
4:19:48 PM
REPRESENTATIVE JOSEPHSON referred to U.S Supreme Court cases,
including [Vernonia School District 47J v. Acton, 515 U.S. 646
(1995)], a U.S. Supreme Court decision which upheld the
constitutionality of a random drug testing regimen implemented
by the local public schools in Vernonia, Oregon, and others,
including one related to customs officers and railroad workers
based on a New York State rail disaster. He asked what public
interest is being served with this bill - perhaps reduced rates
and premiums; however, the injured worker at home does not pose
any threat to anyone except himself/herself. He asked whether
Mr. Monagle has discussed the legality of the bill.
MR. MONAGLE answered that he has not discussed this bill with
the agency's attorney general. He offered his belief the
purpose for the drug testing is that states who have adopted
drug testing discovered that up to 30 percent of the injured
workers are not taking the prescribed drugs. Thus, the
assumption is that these drugs are making it on the streets.
Although nothing in the bill requires the employer to prosecute
or take any criminal action, some states have adopted "good
Samaritan or safe harbor laws." In those instances a person
reported to have a substance abuse problem could be subject to
intervention or programs without any criminal charges being
involved. He reiterated that he did not think that criminal
charges were involved in HB 370.
CHAIR OLSON referred to page 1, lines 7 or 8, of the bill. He
pointed out that the language is discretionary, that an employer
"may require an employee to undergo drug testing" after 90 days.
He summarized work taken on the bill, including holding
discussions with legal staff and other legislators. He
characterized the approach being taken in the bill as using a
"scalpel" rather than a "chain saw" in an attempt to address the
workers' compensation injured worker prescription issues.
4:23:18 PM
REPRESENTATIVE JOSEPHSON noticed an absence of ramifications in
the bill for employment, HIPPA issues, and due process. He
asked for the penalty if an injured worker shows a lower use of
opioids.
MR. MONAGLE answered that typically everything in workers'
compensation surrounds the payment of benefits. Thus, if an
injured worker has been prescribed narcotics, but the drugs do
not show up during testing, some states do not continue to pay
for the prescription drug unless convincing evidence indicates
the drugs were stolen or substantial evidence indicates the drug
should be refilled. Therefore the benefit would be cut off,
although it wouldn't impact other aspects of the claimant's care
or disability benefits. In terms of employment provisions,
which he wasn't very familiar with, he understood one provision
provides safeguards from lawsuits being filed against the
employer. He further understood that many employers have zero
tolerance drug use policies; however, he was unsure if other
drugs showed up during urinalysis (UA), whether the employer
could take any disciplinary action.
4:25:51 PM
CHAIR OLSON asked for the percentage of the Alaska workforce is
subject to UAs.
MR. MONAGLE said he was unsure.
CHAIR OLSON understood that anyone in the transportation or
licensed maritime fields would be subject to UAs.
4:26:20 PM
REPRESENTATIVE SADDLER said the bill seems to make sense
especially due to the compelling narrative that has been laid
out. He indicated the benefits seem clear. He recalled that
workers' compensation workers absent from work tend to be those
on pain medications. He asked whether causality is being
confused or is it just that those with serious injuries have
longer claims and are absent from work for a longer period.
MR. MONAGLE explained that part of the issue is related to
patients taking prescribed opioids for a long time; and most of
the medical community concerned about long-term use. The longer
injured workers are on drugs the tolerance to dosage for pain
and discomfort goes up so the patient needs more medication.
The threshold most states use is a 120 milligrams of morphine
equivalent. He agreed that it seems reasonable to have progress
reports. If no functional benefit is derived from that sort of
dosage, something needs to be done to wean the patient off the
drugs. He didn't think the medical and workers' compensation
community was as concerned about 30-day use, which is why the
bill recommends it. He said this bill doesn't address the
overarching problem of drug addiction or other patient issues;
however, the bill does allow the division to put in regulation
some tools to address long-term use of opioids.
4:28:51 PM
REPRESENTATIVE SADDLER said he certainly could see the common
sense for 30-day prescription use. He reviewed the large list
of drugs prescribed. He wondered if the bill should be limited
to schedule I drugs since schedule II drugs include some pain
relievers.
MR. MONAGLE answered that page 2, lists schedule IA, IIIA, and
VA drugs that would be affected under the bill.
4:29:35 PM
REPRESENTATIVE SADDLER asked whether schedule IA, IIA, and IIIA,
are a matter of drug intensity or if they represent categories
of drugs.
MR. MONAGLE answered that the drugs are various concentrations
of the opioids. He pointed out that class I represents the
greatest threat to life and health, particularly if used in
combination with other drugs.
REPRESENTATIVE SADDLER understood that schedule I is the most
powerful.
4:30:14 PM
REPRESENTATIVE MILLETT related a scenario in which a person has
a serious back injury but doesn't want surgery and continues to
take medications. She understood that it isn't possible to
force someone to have surgery, but ultimately workers'
compensation claim could be never ending if the medical
recommendation is surgery.
MR. MONAGLE said the consensus in the medical community is for
patients to choose to undergo conservative care such as physical
therapy and other types of treatment before deciding on surgery.
He offered his belief that it is not in anyone's interest to
stay on opioids indefinitely. In some states, after a
prescribed period of time, in consultation with the physician, a
plan is put in place to step the patient down to a lower level,
and probably to recommend the patient attend a pain management
clinic to learn other ways to deal with the pain. He agreed
that these drugs were never intended to be long-term drugs and
are intended for short-term use.
4:32:56 PM
REPRESENTATIVE MILLETT asked whether drugs other than OxyContin
have the same effect. She said she is aware of people who move
to disability benefits when the solution might be to have spinal
fusion. She asked how to avoid the path of patients moving to
disability.
MR. MONAGLE answered that those patients represent about one
percent of the cases. Certainly, it is not in anyone's best
interest to stay on these types of drugs for the duration of
their lives. He said that the general consensus for chronic
pain management is for doctors to work with their patients to
minimize the need for these opioid equivalent drugs. In
response to a question, he offered to work with Representative
Millett on the workers' compensation issue to help get the
workers back to work.
4:36:17 PM
SIDNEY SEE stated that she previously worked for procurement for
the University of Alaska, but fell on the ice, had two wrist
surgeries, a shoulder surgery, and ten months later doctors
discovered she had severed her rotator cuff and suffered bad
disc damage. She then had neck surgery. She offered her belief
that the money in workers' compensation goes to adjusters who
have top paid lawyers and require independent medical exams
(IME). She estimated the cost for an IME at $10,000. She said
she was moving boxes and hurt her lower back. She related she
has an excellent doctor who has never prescribed more than 30
days of prescriptions. She signs an annual form and the doctors
perform random drug tests to avoid drug abuse. She
characterized spinal pain as horrific. Fortunately her lumbar
issue on October 31 seemed fine, but Northern Adjusters has
scheduled another IME to fly in a doctor from San Diego. She
said this problem should probably be resolved over time. She
has good treatment, her doctor gives her some injections, and
her goal is to work. She did not think the big cost is
prescriptions. She said she feels knowledgeable and would like
to see the system changed. She offered her belief that patients
get the bottom lawyers whereas the insurance adjusters have
better lawyers. She offered to provide more details on her
five-year recovery from her fall, noting she subsequently had a
disc replacement and two spinal fusions. She concluded by
saying she had a wonderful job in procurement and her boss and
co-workers were very supportive, but she did not find her
insurance adjuster helpful.
[HB 370 was held over.]
4:40:52 PM
The committee took an at-ease from 4:40 p.m. to 4:41 p.m.
HB 152-PERS TERMINATION COSTS
4:41:53 PM
CHAIR OLSON announced that the final order of business would be
HOUSE BILL NO. 152, "An Act requiring certain employers who
terminate participation in the defined benefit retirement plan
or the defined contribution retirement plan of the Public
Employees' Retirement System to make contributions related to
past service liability and pay termination costs; repealing a
requirement that employers who terminate participation in the
defined contribution retirement plan or the defined benefit
retirement plan of the Public Employees' Retirement System pay
for a termination cost study; and providing for an effective
date." [Before the committee was Version Y, labeled 28-KS9272\Y,
Wayne, 2/26/14.]
4:42:23 PM
JANE PIERSON, Staff, Representative Steve Thompson, Alaska State
Legislature, explained that HB 152 does away with termination
studies, the costs associated with conducting termination
studies, the actuarial costs to employers for future benefits to
employees whose coverage is terminated, and the past service
cost annually on each position terminated until the unfunded
obligation is paid off decades from now.
4:43:07 PM
MICHAEL BARNHILL, Deputy Commissioner, Department of
Administration (DOA), stated shortly prior to the last hearing
[March 10, 2014] the DOA did not have the backup information
from the actuary, Buck Consultants, but has since received it.
He remarked that the fiscal note is complex, but he was somewhat
surprised at the $75 million fiscal note.
MR. BARNHILL explained termination studies. When an employer
terminates a group classification under current statute a
termination study is required and costs are accrued for three
different items. First, a termination study costs from $2,500-
$5,000. Secondly, costs accrue when a new unfunded liability is
created by a new group of employees being terminated. Under
Alaska statutes employees have the option of refunding the PERS
balance or immediately vesting. The actuary assumes some of the
employees will immediately vest; however, when that date is
prior to the anticipated date of retirement, an unfunded
liability is associated with that because the state hasn't had
time to collect enough funds to pay the expected benefit.
Third, costs accrue when an employer terminates a group
classification in a department. In this instance, an employer
must pay the entire past service liability cost, not capped at
22 percent, until the unfunded liability is entirely
extinguished, which is currently projected at 2031.
4:46:08 PM
MR. BARNHILL related that various PERS employers have objected
to Senate Bill 125, the statute enacted in 2008. These
employers have raised concerns about this impairing their
ability to be flexible with their payroll and employers wanting
to avoid the unfunded liability costs just described. The
department recognizes their concerns but there will be cost
shifting from the state. Last year, one version of the bill had
a sliding-scale threshold when termination studies would "kick
in." Under the prior version of the bill, the sliding scale
depended on the size of the payroll. For large employers, with
$5 million or more in annual payroll, the employers would need
to terminate 20 percent or more of their payroll before a
termination study will "kick in." Anything under that, such as
new unfunded liability or past service cost would be picked up
by the state. For medium-sized employers with $1-$5 million in
payroll, the threshold was set at 50 percent or more. Thus, the
employers would need to terminate 50 percent or more of their
employees in order for a termination study to "kick in." And
for small employers, with $1 million or less in payroll, the
state would pick up the costs, he said.
4:47:59 PM
MR. BARNHILL related that Buck Consultants used an assumption
that all employers terminated all employees from PERS service to
determine the new unfunded liability when someone retires
earlier than expected, which cost $375 million. Thus the
system, due to the early retirements, would not collect $375
million. The actuary then allocated that amount on the sliding
scale using the aforementioned threshold. Buck Consultants
determined the state would end up picking up $99 million and
employers would pick up $375 million. The $99 million
represented the amounts under the sliding scale, including the
costs to pick up all the small employer costs, 50 percent of the
mid-range employer costs, and 20 percent of the large employer
costs, he said.
MR. BARNHILL said that Buck Consultants made another assumption,
which was that only 20 percent of the employees would opt out.
He acknowledged that the percentage could be debated, but it was
the figure that Buck Consultants used, so 20 percent of the
costs fall to the state, which is approximately $20 million. In
addition, the past service costs shifted to the state because as
the payroll costs shrink the amount of past service cost also
shrinks. He related a scenario in which an employer had a $1
million payroll with 22 percent of the employees terminated. In
that scenario, the payroll would be multiplied by the 22 percent
contribution rate on $800,000 instead of $1 million, which means
the state collects less money and must pick up the difference.
4:50:39 PM
MR. BARNHILL explained last year's fiscal note, which computed
the annual cost. The first line referred to the retroactive
effect, which is no longer relevant in Version Y; the second
line related to the shift of the past service cost payments to
the state [due to the repeal of AS 39.35.625] due to a smaller
payroll, and the third line represented the new past service
costs associated with the new unfunded liability of $800,000,
and when computed would be $25 million. That is the methodology
behind last year's fiscal note, he said.
MR. BARNHILL related that this year under Version Y, the
requirement for termination costs and studies all would be
repealed. Under this version, all of the costs shift to the
state, which means a new unfunded liability of $75 million;
however, since Buck Consultants assumed only 20 percent will
terminate, the computation for 20 percent of $375 million is $75
million. This provides the background on the $75 million
projected for the unfunded liability, which is reflected on page
2 of Buck Consultants' letter of 3/18/14. He said the effect of
shrinking payrolls by 20 percent is that since payroll costs are
smaller, that amount is not available to compute past service
costs on so the past service costs also shift to the state.
4:52:38 PM
MR. BARNHILL turned to the letter of 3/18/14 from Buck
Consultants and noted that line one is incorrect since there is
not any retroactive effect in Version Y. The second line
relates to the shift of past serve cost payments to the state
due to the repeal of AS 39.35.625 due to smaller municipal
payrolls. The third line represents the new past service
liability associated with the $75 million new unfunded liability
due to people retiring earlier than anticipated.
4:53:17 PM
REPRESENTATIVE HERRON expressed concern about the bill, noting
he has served on the Alaska Public Entity Insurance Board. He
said that everything is based on 2008 legislation as a starting
point and suggested reviewing the figure used as a base for
2008. He further asked whether a six-year window should be
defined and updated as the base.
MR. BARNHILL acknowledged a whole variety of approaches could be
used to accomplish the objective of the 2008 legislation, which
was essentially to prevent or limit cost shifting from
municipalities to the state. He explained that effort was taken
since the state was picking up a fair amount of additional
liability in the form of state assistance under Senate Bill 125.
As previously stated, the state has contributed over $600,000 on
behalf of municipalities to PERS. Furthermore, Senate Bill 125
had two ways to address cost shifting: One, through the 2008
salary floor. For example, if a PERS employer payroll dipped
below the 2008 salary floor, the 22 percent employer
contribution rate would be computed on 2008 instead of the
current payroll. Second, the bill would address the cost
shifting through the termination cost and study requirements.
Both are important since the further removed from 2008, assuming
payroll are growing at a rate of two to five percent per year,
the 2008 salary floor becomes less and less meaningful. For
some PERS employers, the 2008 salary floor is quite meaningful
since their PERS payrolls have declined below the 2008 salary
floor; however, he estimated that would only affect a handful of
employers. He agreed it may be worth it at some point to take a
fresh look at how to preserve a certain portion of the payment
of the unfunded liability within the PERS municipal community.
4:56:36 PM
REPRESENTATIVE HERRON said the fundamental question everyone is
facing is that although the 2008 legislation was important at
the time, whether it is still relevant six years later.
MR. BARNHILL said that for certain employers it is still quite
relevant. The largest employer whose PERS payroll dipped below
the 2008 salary floor is the University of Alaska, primarily
since it offers other retirement programs to new professors,
with a 14 percent employer contribution rate and a 401(k) style
retirement plan, which he deemed as being pretty attractive.
4:57:39 PM
REPRESENTATIVE HERRON commented that the Elected Public
Officials Retirement System (EPOR) is almost finished since
these legislators are gradually dying. He remarked that those
legislators were careful to craft a provision that allowed them
to receive raises each time current EPOR members receive raises.
4:58:36 PM
CHAIR OLSON asked how many people were covered under EPOR.
MR. BARNHILL answered 34 people. He related that this type of
linkage is also found in the judicial retirement system so when
judges receive a raise, it also boosts benefits for the retired
judges. He explained that the department delivers its fiscal
note and a letter from the actuary to the legislature. Last
week the DOA submitted [dated 3/14/14] the fiscal note with the
$75 million [page 2 of the fiscal note], and the backup letter
from Buck Consultants arrived today, he reported.
5:00:16 PM
REPRESENTATIVE JOSEPHSON said he was pretty convinced that
smaller communities have a larger problems with termination
costs. He questioned what certainty exists if an agreement was
reached in 2008 but now the plan is to "back end" the costs. He
asked how the legislature will know that won't be revised.
MR. BARNHILL said he thought Representative Josephson was
referring to the governor's proposal to appropriate $1.9 billion
to PERS, which is part A of the proposal and that Part B is a
$157 million capped payment from 2015-2036. That capped payment
is very important since it can secure certainty with respect to
the demands on the undesignated general funds of the state. If
that were to go into effect, one idea is that it would mean that
any new unfunded liability associated with PERS employers -
taking 20 percent of payroll out of service - will be tacked on
to the end in 2036. He acknowledged that there is a cost to
that, but any new unfunded liability will be shared by state and
municipalities. He said that hasn't been the case since 2008
when Senate Bill 125 was enacted. Any new unfunded liabilities
are borne entirely by the state, which has had some fairly
dramatic impacts on the state's general fund. Thus, state
assistance to PERS employers has increased substantially so that
combining PERS and TRS would place a call on the general fund of
upwards of $1 billion, he said.
REPRESENTATIVE JOSEPHSON asked whether the compromise is that
the relief will be afforded to local governments now, but the
quid pro quo will be a sharing of new unfunded liability later.
MR. BARNHILL acknowledged that is a fair statement, but the flip
side of that is that if the reverse of unfunded liability is
created - an actuarial gain - happens it will also be shared and
under the governor's proposal these gains will be shared in the
form of a shorter amortization term. The municipal employers
would pay up to 22 percent contributions rate through 2036 if
there were actuarial gains during that time period and the 22
percent employer contribution rate cap could be adjusted prior
to 2036. He said this is entirely speculative since the state
can't predict the net gains or losses.
5:04:02 PM
REPRESENTATIVE MILLETT asked what will happen to MOA if the
municipality is short funded by $5 million and HB 152 doesn't
pass.
MR. BARNHILL said then the status quo continues and it will
depend on whether the MOA pulls PERS employees out of service,
for example, if the municipality were to terminate a group
classification or department. In smaller municipalities,
sometimes a fire chief position is terminated. He related a
scenario in which MOA privatized a utility of $5 million. This
would trigger a termination study, the MOA would pay $5,000 for
the study, and Buck Consultants would project how many people
will vest early and it would create a new unfunded liability,
for example, perhaps $600,000. The DOR would bill the MOA, and
the entire past service cost for those employees would need to
be paid via the final payoff of the unfunded liability in 2036.
5:06:32 PM
REPRESENTATIVE MILLETT asked whether the MOA could pay this at
22 percent over the life span.
MR. BARNHILL said the current statutes provide municipalities to
work out a plan with the Division of Retirement and Benefits.
He acknowledged options could be explored.
5:07:23 PM
KATHY LEA, Deputy Director, Retirement and Benefits, Department
of Administration (DOA), answered that the statutes are broad
and an increased contribution over time is a possibility.
REPRESENTATIVE MILLETT asked whether a payment plan could be
flexible.
MS. LEA answered yes; it would be payable upon receipt or the
municipality would work out a payment plan with the division.
5:08:10 PM
KATHIE WASSERMAN, Executive Director, Alaska Municipal League
(AML), stated that the AML represents 161 communities.
Depending on what happens with this bill, municipalities will
need help and more tools. She anticipated that if lean times
are forthcoming, municipalities will need to lay people off.
She said that municipalities need help in finding tools to deal
with any consequences that might come their way. The AML has
been supporting the governor's cash infusion, hoping that
termination costs can be tacked on the end of the 25-year
amortization. The amount of termination study costs would be so
small compared to a potential $12 billion liability that
municipalities could pay the costs. She assured members that
they are not "trying to get out of anything" but also to
recognize municipalities can only pay so much in order to keep
rates at a steady, predictable 22 percent that can be budgeted.
5:10:42 PM
REPRESENTATIVE MILLETT said that her municipality is concerned
that at some point in time it will need to increase property
taxes to the cap, which still won't cover the unfunded liability
to PERS. This means that smaller municipalities will need to
take on a greater cost percentage based on their property taxes
and population base.
MS. WASSERMAN said that is exactly right. She added that some
small communities without a tax base don't have any way to make
up those costs, which leaves everyone in a bind. She stated
that municipalities are not trying to get out of obligations,
but the legislature must find an affordable solution.
[HB 152 was held over.]
5:12:18 PM
ADJOURNMENT
There being no further business before the committee, the House
Labor and Commerce Standing Committee meeting was adjourned at
5:12 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB370 ver A.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB370 Sponsor Statement.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB370 Sectional Analysis.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB370 Fiscal Note-DOLWD-WC-03-14-14.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB370 Supporting Documents-Report Workers Compensation 2012 Issues by Joseph Paduda.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB370 Supporting Documents-Report Lockton & Associates 08-2012.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB152 CS(L&C) Fiscal Note-DOA-DRB-03-14-14.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 152 |
| HCR15 Supporting Documents-Resolution Fairbanks EDC 2014-01.pdf |
HL&C 3/19/2014 3:15:00 PM |
HCR 15 |
| HB370 Supporting Documents-AK Drug Overdose Deaths2008-12.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 370 |
| HB152 Letter-Buck Consulting 3-18-2014.pdf |
HL&C 3/19/2014 3:15:00 PM |
HB 152 |