Legislature(2017 - 2018)SENATE FINANCE 532

03/02/2018 09:00 AM Senate FINANCE

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09:12:21 AM Start
09:12:37 AM SB128
10:00:17 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= SB 128 MARIJUANA EDU/TREATMENT FUND/PROGRAM TELECONFERENCED
Heard & Held
                 SENATE FINANCE COMMITTEE                                                                                       
                       March 2, 2018                                                                                            
                         9:12 a.m.                                                                                              
                                                                                                                                
9:12:21 AM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair MacKinnon called the Senate Finance Committee                                                                          
meeting to order at 9:12 a.m.                                                                                                   
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Anna MacKinnon, Co-Chair                                                                                                
Senator Peter Micciche                                                                                                          
Senator Donny Olson                                                                                                             
Senator Natasha von Imhof                                                                                                       
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Lyman Hoffman, Co-Chair                                                                                                 
Senator Click Bishop, Vice-Chair                                                                                                
Senator Gary Stevens                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Senator Cathy Giessel, Sponsor; Jane Conway, Staff, Senator                                                                     
Cathy Giessel; Jill Lewis, Deputy Director, Division of                                                                         
Public Health, Department of Health and Social Services.                                                                        
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Jay Butler, Chief Medical Officer, Department of Health and                                                                     
Social Services; Eliza Muse, Substance Misuse Prevention                                                                        
Specialist, Department of Health and Social Services.                                                                           
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
SB 128    MARIJUANA EDU/TREATMENT FUND/PROGRAM                                                                                  
                                                                                                                                
          SB 128 was HEARD and HELD in committee for                                                                            
          further consideration.                                                                                                
                                                                                                                                
SENATE BILL NO. 128                                                                                                           
                                                                                                                                
     "An  Act  establishing   the  marijuana  education  and                                                                    
     treatment  fund;  and relating  to  the  duties of  the                                                                    
     Department of Health and  Social Services to administer                                                                    
     a comprehensive  marijuana use education  and treatment                                                                    
     program."                                                                                                                  
                                                                                                                                
9:12:37 AM                                                                                                                    
                                                                                                                                
Co-Chair   MacKinnon  informed   that  there   would  be   a                                                                    
presentation on  the SB  128, and asked  the sponsor  if she                                                                    
had any comments.                                                                                                               
                                                                                                                                
SENATOR CATHY GIESSEL, SPONSOR, informed  that SB 128 was //                                                                    
She relayed that  she volunteered in a middle  school in her                                                                    
district.  She  thought  many kids  in  middle  school  were                                                                    
confused  about marijuana.  She discussed  educational tools                                                                    
for various  health-related tools,  and emphasized  the lack                                                                    
of educational material available  for marijuana. She had an                                                                    
example  of  materials  that  had   been  developed  by  the                                                                    
Division of  Public Health.  The bill  also allowed  for the                                                                    
division to  gather data on  marijuana use.  Senator Giessel                                                                    
emphasized  that  the  Division  of  Public  Health  already                                                                    
distributed materials and education  related to alcohol, and                                                                    
would                                                                                                                           
                                                                                                                                
9:16:38 AM                                                                                                                    
                                                                                                                                
Senator  Olson  thought  there  was  a  pervasive  marijuana                                                                    
problem in  the state, and  wondered how to be  certain that                                                                    
funds would  be spent  on marijuana education  outside urban                                                                    
areas.                                                                                                                          
                                                                                                                                
Senator  Giessel  replied that  she  did  not name  specific                                                                    
recipients in  the bill. She  believed that the  Division of                                                                    
Public Health  was equipped to  ensure that  the information                                                                    
and the ability  to distribute the information  was all over                                                                    
the state.                                                                                                                      
                                                                                                                                
Senator  Olson  supported the  idea  of  funds being  spread                                                                    
throughout the state.                                                                                                           
                                                                                                                                
Senator von Imhof  noticed that the bill went  from using 25                                                                    
percent  to  35  percent.  She  thought  there  could  be  a                                                                    
philosophical discussion on the  topic of perpetual programs                                                                    
and lack of flexibility in spending the funds.                                                                                  
                                                                                                                                
Senator Giessel understood Senator von Imhof's concerns.                                                                        
She relayed that she had responded to concerns within the                                                                       
drafting and intent of the bill.                                                                                                
                                                                                                                                
9:19:35 AM                                                                                                                    
                                                                                                                                
JANE CONWAY, STAFF, SENATOR CATHY GIESSEL, addressed the                                                                        
Sectional Analysis (copy on file):                                                                                              
                                                                                                                                
     Section 1  AS 43.61.010(d) is technical  and conforming                                                                    
     language that clarifies which  fund is being referenced                                                                    
     in this section that  is about the recidivism reduction                                                                    
     fund.  Since  we  are establishing  another  fund,  the                                                                    
     Marijuana  Education  and  Treatment  Fund  in  another                                                                    
     subsection  to  follow,  Legislative  Legal  wanted  to                                                                    
     correctly  name  which  fund   is  being  addressed  to                                                                    
     prevent any confusion.                                                                                                     
                                                                                                                                
     Section  2  AS  43.61.010  is  a  new  subsection  that                                                                    
     creates  the  Marijuana  Education and  Treatment  Fund                                                                    
     within the general fund.  After receiving tax collected                                                                    
     from  marijuana  sales,  the  Dept.  of  Administration                                                                    
     shall separately account for  and deposit 35 percent of                                                                    
     those proceeds  into the Fund, and  the legislature may                                                                    
     appropriate  those monies  for the  purpose of  funding                                                                    
     DHSS   programs  for   marijuana   use  education   and                                                                    
     treatment.  This section  specifies that  the money  in                                                                    
     this fund does not lapse.                                                                                                  
                                                                                                                                
     Section  3 AS  44.29.020(a)  contains  two minor  fixes                                                                    
     from  Leg Legal  that adds  the word  "the" to  (11) of                                                                    
     this section, and  also the word "to" to  item (14). It                                                                    
     also  adds to  this section  that DHSS  will administer                                                                    
     the marijuana education and  treatment program by grant                                                                    
     or contract out this  program to other organizations in                                                                    
     Alaska. This section  outlines the following components                                                                    
     of the program:                                                                                                            
                                                                                                                                
          1. A community-based marijuana misuse prevention                                                                      
          component                                                                                                             
          2. A youth services component                                                                                         
          3.  Public education  geared toward  prevention of                                                                    
          youth initiation  of marijuana use,  education re:                                                                    
          the  effects of  marijuana use  and education  re:                                                                    
          marijuana laws                                                                                                        
          4. Surveying of youth/adults to determine                                                                             
          knowledge, awareness, attitude and use of                                                                             
          marijuana products, along with need for trained                                                                       
          professionals                                                                                                         
          5. Monitoring of the public's health relating to                                                                      
          consequences of marijuana use                                                                                         
          6. Provide for substance abuse screening, brief                                                                       
          intervention, and referral to treatment                                                                               
                                                                                                                                
Co-Chair MacKinnon  referenced item  6 in  Section 3  of the                                                                    
Sectional    Analysis.   She    queried   the    intent   of                                                                    
"opportunities for positive  social leisure and recreational                                                                    
activities."                                                                                                                    
                                                                                                                                
Senator Giessel stated  that the intent of  the language was                                                                    
to target after-school programs.                                                                                                
                                                                                                                                
Co-Chair MacKinnon  asked if the  intent was to have  a more                                                                    
global, connected                                                                                                               
                                                                                                                                
Senator Giessel answered in the affirmative.                                                                                    
                                                                                                                                
Senator  Micciche gleaned  that the  bill would  provide for                                                                    
programs in  K-12 education.  He hoped  there was  a balance                                                                    
between K-12 and after-school programs.                                                                                         
                                                                                                                                
Senator  Giessel  stated  that   ideally  Girl  Scouts,  Boy                                                                    
Scouts, and  faith-based programs would utilize  the intent.                                                                    
She  added  that  drug  misuse  crossed  all  socio-economic                                                                    
boundaries.                                                                                                                     
                                                                                                                                
9:25:32 AM                                                                                                                    
                                                                                                                                
Senator  von  Imhof  mentioned the  sponsor's  reference  to                                                                    
"access  to  materials."  She wondered  if  the  bill  would                                                                    
result in  supplanting existing programs,  growing programs,                                                                    
or forming new programs.                                                                                                        
                                                                                                                                
Senator  Giessel referred  the  question to  staff from  the                                                                    
Division of Public Health, who  could address the subject in                                                                    
greater detail.                                                                                                                 
                                                                                                                                
JAY BUTLER, CHIEF MEDICAL OFFICER,  DEPARTMENT OF HEALTH AND                                                                    
SOCIAL  SERVICES (via  teleconference), remarked  that there                                                                    
was  a concern  about underage  youth and  early initiation;                                                                    
driving under  the influence; and  use during  pregnancy. He                                                                    
stated that there  was a report that  examined motor vehicle                                                                    
fatalities, which showed a small  spike that occurred in the                                                                    
evening hours of April 20.  That day correlates with the day                                                                    
that   many   younger   people   celebrate   marijuana.   He                                                                    
appreciated  the goal  of ensuring  that  the programs  were                                                                    
focused  and  high  quality.  He   also  wanted  to  provide                                                                    
flexibility for the local variability.                                                                                          
                                                                                                                                
9:30:02 AM                                                                                                                    
                                                                                                                                
JILL  LEWIS, DEPUTY  DIRECTOR,  DIVISION  OF PUBLIC  HEALTH,                                                                    
DEPARTMENT OF HEALTH AND SOCIAL  SERVICES, informed that the                                                                    
changes  in the  committee substitute  would not  affect the                                                                    
presentation by the department.                                                                                                 
                                                                                                                                
ELIZA   MUSE,   SUBSTANCE  MISUSE   PREVENTION   SPECIALIST,                                                                    
DEPARTMENT    OF   HEALTH    AND   SOCIAL    SERVICES   (via                                                                    
teleconference),  spoke  to   the  presentation,  "Marijuana                                                                    
Education and Treatment Fund" (copy on file).                                                                                   
                                                                                                                                
Ms.  Muse  turned  to  slide  2,  "Marijuana  Education  and                                                                    
Treatment Fund ("Fund")":                                                                                                       
                                                                                                                                
     ?This bill establishes a Marijuana Education and                                                                           
     Treatment Fund ("Fund")                                                                                                    
                                                                                                                                
     ?The Fund is similar to the Tobacco Use Education and                                                                      
     Cessation Fund                                                                                                             
                                                                                                                                
Ms.  Muse spoke  to  slide  3, "This  bill  would direct  35                                                                    
percent  of  the  marijuana  excise   tax  levied  under  AS                                                                    
43.61.010 to  the Marijuana  Education and  Treatment Fund,"                                                                    
which   showed    two   pie   charts    entitled,   'Current                                                                    
Allocations,' and 'Proposed Allocations.'                                                                                       
                                                                                                                                
Ms.  Muse   reviewed  slide  4,  "Marijuana   Education  and                                                                    
Treatment   Fund"  which   showed   Venn  diagram   entitled                                                                    
'Overarching Goals.'                                                                                                            
                                                                                                                                
Ms. Muse displayed slide 5,  "DHSS  Marijuana Use Education,                                                                    
and Treatment Program":                                                                                                         
                                                                                                                                
     Statewide Coordination                                                                                                     
                                                                                                                                
     Comprehensive program:                                                                                                     
                                                                                                                                
           Community-based marijuana misuse prevention,                                                                         
          with a focus on youth prevention including                                                                            
          support for afterschool programming                                                                                   
           Assessment  of knowledge  and awareness  of laws,                                                                    
          and use of marijuana products                                                                                         
           Monitoring  of population  health impact  related                                                                    
          to marijuana use and legalization                                                                                     
           Workforce training                                                                                                   
           Marijuana education                                                                                                  
          ?Substance  abuse  screening, brief  intervention,                                                                    
          and referral to treatment                                                                                             
                                                                                                                                
Ms. Muse referenced slide 6, "Community-based marijuana                                                                         
misuse prevention":                                                                                                             
                                                                                                                                
     Local efforts to prevent misuse before it starts:                                                                          
           Mitigating risk factors                                                                                              
           Strengthening protective factors                                                                                     
                                                                                                                                
     Enhance existing programs for public health and                                                                            
     education to address substance misuse prevention                                                                           
           Alaska Adolescent Health Program                                                                                     
           Department of Education and Early Development                                                                        
           Division of Juvenile Justice                                                                                         
          ?Community-based  programs  including support  for                                                                    
          afterschool programming                                                                                               
                                                                                                                                
9:35:28 AM                                                                                                                    
                                                                                                                                
Ms. Muse discussed slide 7, "Assessment and Monitoring":                                                                        
                                                                                                                                
     Assessment   of   trends   in   knowledge,   awareness,                                                                    
     attitudes, and behaviors to address misperceptions and                                                                     
     knowledge gaps                                                                                                             
                                                                                                                                
     Monitoring health status and use trends to identify                                                                        
    any health or health system effects of legalization                                                                         
                                                                                                                                
     Needs assessment to guide training and program                                                                             
     development for professionals                                                                                              
                                                                                                                                
     Some questions that require answers:                                                                                       
           Do  youth perceive  marijuana as  a less  harmful                                                                    
          substance due to legalization?                                                                                        
           Do  youth  and  adults   see  driving  under  the                                                                    
          influence of marijuana as dangerous?                                                                                  
          ?How    has   marijuana    legalization   affected                                                                    
          Alaskan's health and safety?                                                                                          
                                                                                                                                
Ms. Muse reviewed slide 8, "Marijuana education":                                                                               
                                                                                                                                
     Will  be  used  to   improve  the  public's  knowledge,                                                                    
     attitudes,  and awareness  about marijuana  and educate                                                                    
     the  public about  healthy  behavior  choices in  their                                                                    
     lives.  Materials  will   be  designed  to  communicate                                                                    
     messages to                                                                                                                
          1) help prevent youth initiation of marijuana use                                                                     
          2) educate the public about the health effects of                                                                     
          marijuana use                                                                                                         
          3) educate the public about marijuana laws.                                                                           
                                                                                                                                
Ms. Muse spoke to slide 9, "Treatment":                                                                                         
                                                                                                                                
     Provider  education  and  awareness  of  substance  use                                                                    
     screening.                                                                                                                 
                                                                                                                                
     Substance  abuse  screening,  brief  intervention,  and                                                                    
     referral to treatment (SBIRT)                                                                                              
                                                                                                                                
      Assesses for the presence of substance use behaviors                                                                      
     ?Tools for  clinicians and  other service  providers to                                                                    
     identify  at-risk clients and  give immediate  feedback                                                                  
     and coaching  regarding strategies to lower  their risk                                                                    
     behaviors                                                                                                                  
                                                                                                                                
Ms. Muse displayed slide 10, "Why does this matter?":                                                                           
                                                                                                                                
     Public health and safety:                                                                                                  
           Adolescent health                                                                                                    
           Reproductive/maternal/child health                                                                                   
           Injury prevention and control (drugged driving,                                                                      
          accidental consumption/ingestion)                                                                                     
           Environmental health (pesticides, lab testing,                                                                       
          food safety, secondhand smoke exposure)                                                                               
          Mental health and other substance abuse                                                                               
           Occupational health                                                                                                  
          ?Health Equity/Disparities                                                                                            
                                                                                                                                
Ms.  Muse  showed slide  11,  "Adolescent  Health: A  closer                                                                    
look,"  which  had  a line  graph  entitled  'Percentage  of                                                                    
Alaska traditional high school  students who use marijuana.'                                                                    
She remarked  that the blue line  represented the proportion                                                                    
of Alaska traditional high school  students use; and the red                                                                    
line represented  youth in the  past 30 days. She  felt that                                                                    
it served as a surrogate measure of current or ongoing use.                                                                     
                                                                                                                                
9:39:55 AM                                                                                                                    
                                                                                                                                
Ms. Muse turned  to slide 12, "Adults can  help reduce youth                                                                    
marijuana use":                                                                                                                 
                                                                                                                                
     Supportive  Teachers:  Youth  who agree  that  teachers                                                                    
     care and encourage  them are 52 percent  less likely to                                                                    
     have used marijuana in the past month.                                                                                     
                                                                                                                                
     Talking  with Parents:  Youth whose  parents talk  with                                                                    
     them about what they are  doing in school every day are                                                                    
     29 percent less  likely to have used  marijuana in past                                                                    
     month.                                                                                                                     
                                                                                                                                
     Community  Connections:  Youth  who feel  connected  to                                                                    
     their  community are  38 percent  less  likely to  have                                                                    
     used marijuana in the past month.                                                                                          
                                                                                                                                
     Afterschool   Programs:   Youth   who  take   part   in                                                                    
     afterschool activities  are 29  percent less  likely to                                                                    
     have used marijuana in the past month.                                                                                     
                                                                                                                                
9:40:27 AM                                                                                                                    
                                                                                                                                
Ms.  Muse   reviewed  slide   13,  "Prevalence   of  Current                                                                    
Marijuana Use*, OR,  WA, CO, and AK, 2016."  She shared that                                                                    
the adult  trend for Alaska  was stable  at around 15  to 16                                                                    
percent, which  was similar to  other states  with legalized                                                                    
retail sales.                                                                                                                   
                                                                                                                                
Ms. Muse referenced slide 14:                                                                                                   
                                                                                                                                
     Oregon,  Colorado,  Washington,   California  have  all                                                                    
     funded programs in their states to aid in                                                                                  
                                                                                                                                
          ?public education                                                                                                     
          ?monitoring health status                                                                                             
          ?community-based programming                                                                                          
          ?screening and treatment                                                                                              
                                                                                                                                
9:41:06 AM                                                                                                                    
                                                                                                                                
Senator  Micciche  observed  that there  was  a  correlation                                                                    
between legalization and the increase of usage in youth.                                                                        
                                                                                                                                
Ms. Muse stated  that the data on youth use  showed a stable                                                                    
degree of  usage over the  previous ten years.  She remarked                                                                    
that tobacco use had declined  by 70 percent in the previous                                                                    
few years.                                                                                                                      
                                                                                                                                
Senator  Micciche referenced  slide 11,  and asked  when the                                                                    
initiative passed to legalize marijuana in Alaska.                                                                              
                                                                                                                                
Ms. Muse  recalled that the  initiative passed in  2014, and                                                                    
stores opened in fall of  2016. She remarked that perception                                                                    
of  harm  was  an   important  protective  factor,  and  the                                                                    
department  had been  tracking that  perception. She  shared                                                                    
that, in 2017, only 19 percent  of youth felt that there was                                                                    
a great use  of harm in using marijuana products  one to two                                                                    
times per week.                                                                                                                 
                                                                                                                                
Senator  Micciche  asked  if  Ms.  Muse  could  discuss  how                                                                    
tobacco use and cessation funds that were dispersed.                                                                            
                                                                                                                                
Ms. Muse remarked  that the program was  designed looking at                                                                    
the  Comprehensive  Tobacco  Use  and Education  Fund  as  a                                                                    
model.  She stated  that the  fund was  used for  community-                                                                    
based  work, public  education,  monitoring, and  treatment.                                                                    
The  comprehensiveness  of  the tobacco  program  drove  the                                                                    
design   of  the   proposed  program.   She  stressed   that                                                                    
comprehensive programs were most impactful.                                                                                     
                                                                                                                                
9:44:58 AM                                                                                                                    
                                                                                                                                
Senator Micciche thought it would  be interesting to see the                                                                    
chart  on  slide  11  with  tobacco  use  in  the  place  of                                                                    
marijuana   use.  He   thought   that   the  youth   tobacco                                                                    
education/cessation  program  had  been very  effective.  He                                                                    
thought the marijuana program could be similarly effective.                                                                     
                                                                                                                                
Ms. Lewis thought  it might be helpful in  comparing the two                                                                    
programs  to note  that the  tobacco program  was listed  on                                                                    
page 2, line 22 of the bill.                                                                                                    
                                                                                                                                
Senator  von  Imhof  found  it  ironic  that  marijuana  was                                                                    
legalized, and then subsequent tax  funds were allocated for                                                                    
substance abuse programs.                                                                                                       
                                                                                                                                
Senator  Micciche  believed  that   Senator  von  Imhof  had                                                                    
captured the definition of irony.                                                                                               
                                                                                                                                
Co-Chair MacKinnon thought that  the issue would continue to                                                                    
grow,  and   would  affect   the  Medicaid   population  and                                                                    
healthcare.  She  shared that  she  had  voted "no"  on  the                                                                    
initiative.                                                                                                                     
                                                                                                                                
Co-Chair MacKinnon  asked about  slide 12, and  had observed                                                                    
through various  studies that supportive adults  made a huge                                                                    
difference in the lives of youth.                                                                                               
                                                                                                                                
9:51:09 AM                                                                                                                    
                                                                                                                                
Co-Chair  MacKinnon  referenced  slide 13,  and  noted  that                                                                    
Alaska was slightly above the  norm with regard to marijuana                                                                    
use. She wondered if there  was a correlation with marijuana                                                                    
use and profession or occupation.                                                                                               
                                                                                                                                
Ms.  Muse thought  that  it would  be  possible to  complete                                                                    
special surveys.                                                                                                                
                                                                                                                                
Co-Chair  MacKinnon  was  interested in  a  survey  question                                                                    
related to occupations of marijuana users.                                                                                      
Senator von Imhof  thought there would be a  census in 2020,                                                                    
and wondered about the questions that would be asked.                                                                           
                                                                                                                                
Ms. Lewis stated that the  census asked strictly demographic                                                                    
questions, but  also had a  follow-up survey in  which there                                                                    
were different questions.                                                                                                       
                                                                                                                                
9:55:06 AM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  asked Dr. Butler  if it was  possible to                                                                    
determine  whether  the  federal  government  could  provide                                                                    
survey  questions on  opioid use,  and some  of the  harmful                                                                    
effects.  She wanted  to understand  both the  opioid crisis                                                                    
and the trend to legalize marijuana.                                                                                            
                                                                                                                                
Senator  von  Imhof thought  because  there  was a  move  to                                                                    
legalize marijuana  throughout the country, it  was a timely                                                                    
concern. S                                                                                                                      
                                                                                                                                
Co-Chair MacKinnon  referenced a  survey she had  taken that                                                                    
had questioned her appliance purchases.  She asked if it was                                                                    
possible to reach out the U.S. Department of Labor.                                                                             
                                                                                                                                
Dr.  Butler  deferred to  the  committee's  will as  to  who                                                                    
should conduct the outreach.                                                                                                    
                                                                                                                                
Co-Chair MacKinnon asked  Dr. Butler to make  the request to                                                                    
the federal government.                                                                                                         
                                                                                                                                
Dr. Butler agreed to carry out the request.                                                                                     
                                                                                                                                
Co-Chair MacKinnon stated that any proposed amendments to                                                                       
the bill were due to her office by the following Monday.                                                                        
                                                                                                                                
SB 128 was HEARD and HELD in committee for further                                                                              
consideration.                                                                                                                  
                                                                                                                                
ADJOURNMENT                                                                                                                   
10:00:17 AM                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:00 a.m.                                                                                         

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