Legislature(2019 - 2020)SENATE FINANCE 532
02/13/2019 09:00 AM Senate FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| SB37 | |
| Consideration of Governor's Appointees | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 37 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
SENATE FINANCE COMMITTEE
February 13, 2019
9:00 a.m.
9:00:49 AM
CALL TO ORDER
Co-Chair von Imhof called the Senate Finance Committee
meeting to order at 9:00 a.m.
MEMBERS PRESENT
Senator Natasha von Imhof, Co-Chair
Senator Bert Stedman, Co-Chair
Senator Click Bishop
Senator Peter Micciche
Senator Donny Olson
Senator Bill Wielechowski
Senator David Wilson
MEMBERS ABSENT
Senator Mike Shower
Senator Lyman Hoffman
ALSO PRESENT
Senator Cathy Giessel, Sponsor; Jane Conway, Staff, Senator
Cathy Giessel; Doctor Lily Lou, Chief Medical Officer,
Department of Health and Social Services; Jill Lewis,
Deputy Director, Alaska Division of Public Health; Dan
Sullivan, Appointee, Regulatory Commission of Alaska.
PRESENT VIA TELECONFERENCE
Matt Hirschfelt, Alaska Pediatric Partnership, Anchorage;
Jody Butto, AVAP Board, Anchorage; Ken McCarty, Appointee,
Alaska Mental Health Board of Trustees; John Sturgeon,
Appointee, Alaska Mental Health Board of Trustees.
SUMMARY
SB 37 RENEWAL OF VACCINE ASSESSMENT PROGRAM
SB 37 was HEARD and HELD in committee for further
consideration.
CONSIDERATION OF GOVERNOR'S APPOINTEES
A. MENTAL HEALTH BOARD OF TRUSTEES: KEN MCCARTY, JOHN
STURGEON
B. REGULATORY COMMISSION OF ALASKA: DAN SULLIVAN
SENATE BILL NO. 37
"An Act relating to the statewide immunization
program."
9:02:29 AM
SENATOR CATHY GIESSEL, SPONSOR, introduced the bill.
9:07:47 AM
JANE CONWAY, STAFF, SENATOR CATHY GIESSEL, discussed the
Sectional Analysis (copy on file):
Section 1:
Amends AS 18.09.200(b) by removing the "phase in"
language from statute as the Alaska Vaccine Assessment
Program is now fully implemented.
Section 2:
Amends AS 18.09.220(a) by removing the "phase in"
language from statute as the Alaska Vaccine Assessment
Program is now fully implemented.
Section 3:
Repeals AS 18.09.220(e) by removing the opt out option
for assesses since the program is no longer in the
"phase-in" stage
Section 4:
Repeals the sunset provisions (to repeal the program
in 2021) that were in section 5 of the original bill,
SB 169 in 2014.
9:09:33 AM
DOCTOR LILY LOU, CHIEF MEDICAL OFFICER, DEPARTMENT OF
HEALTH AND SOCIAL SERVICES, (DHSS) disclosed that she was
the president of the American Academy of Pediatrics Alaska
Chapter. She noted that one of the letters was written by
her in that capacity, prior to her taking the role of chief
Medical Officer. She stated that the Alaska Vaccine
Assessment Program made access to vaccines universal for
all Alaskans, and paid for itself. She stated that the
payers of the program for the covered lives, and provided
for Alaskans to receive a 20 to 30 percent discount on the
price of vaccines. She noted the figure, which showed the
cumulative savings since the program's inception, which
showed a savings of approximately $11 million on the cost
of vaccine. She stated that the program streamlined a
previously complicated procurement and distribution system
into a single system, providing a cost savings and
efficiency.
Senator Micciche queried the chart.
Dr. Lou replied that the graph was in the packet.
9:13:21 AM
AT EASE
9:13:51 AM
RECONVENED
9:14:08 AM
Dr. Lou continued that the department felt that the program
was effective.
Senator Wielechowski noted that the state would get the
vaccines at a discount and distributes them at no cost. He
wondered whether the health care providers could charge the
patients for the administration of the vaccination.
Dr. Lou replied that the provider would still provide for
the office visit, but the patient did not need to pay for
the actual vaccine.
Senator Wielechowski wondered whether the provider could
charge for the vaccine itself.
Dr. Lou replied in the negative.
Senator Olson wondered whether the clinic could charge for
the actual vaccine vial.
Dr. Lou replied that the clinic could not charge for the
actual vaccine, but they could charge for the act of
administering the vaccine.
9:17:48 AM
JILL LEWIS, DEPUTY DIRECTOR, ALASKA DIVISION OF PUBLIC
HEALTH, discussed the presentation, "SB 37 Renewal of
Vaccine Assessment Program, Senate and Social Services
Committee, February 6, 2019" (copy on file).
Ms. Lewis looked at slide 2, "SB 37":
? Reauthorizes the statewide Alaska Vaccine Assessment
Program in the Department of Health and Social
Services, scheduled for sunset January 1, 2021.
? Eliminates a temporary phase-in period that ended in
2017.
? Uses the state Vaccine Assessment Account to fully
fund the program.
o No unrestricted general funds are involved.
Ms. Lewis highlighted slide 3, "What is the Alaska Vaccine
Assessment Program?"
Established in 2014, AVAP is a public-private
partnership making access to vaccines universal for
all Alaskans at no cost to the state.
? Provides all childhood and certain adult vaccines
for privately insured children and some adults.
? Covers vaccine costs through assessments collected
from private health insurers, third party
administrators, and other program participants.
? Purchases vaccines at discounted rates off a bulk
contract.
? Distributes vaccine directly to healthcare providers
at no charge who administer the vaccines to their
patients.
Ms. Lewis looked at slide 4, "What is the Alaska Vaccine
Assessment Program?"
Through AVAP, Alaska continues to demonstrate
leadership in creating innovative solutions for
difficult public health issues.
? Alaska is one of only 11 states that has a universal
childhood vaccine program and one of only 3 states
that offers adult vaccines.
? Alaska is the only state that offers healthcare
providers the option of purchasing state-supplied
vaccine to serve uninsured adults.
Ms. Lewis addressed slide 5, "AVAP":
Alaska Vaccine Assessment Council sets the annual
assessment rate
Payers pay into the assessment quarterly based on
their reported covered lives
The Division of Public Health purchases vaccine off a
discounted bulk contract
The Division of Public Health ships vaccine at no cost
to providers or through the Vaccine Depot
Providers vaccinate covered patients, only billing
payers for office visit.
Providers report administered vaccines to the Division
of Public Health
The Division of Public Health provides data to the
Council for rate setting
Co-Chair von Imhof wondered whether privately insured
included Medicaid. She asked for information about the
purchase of state-supplied vaccine for the uninsured.
Ms. Lewis replied that the program had several different
components. The assessments were mandated for health care
insurers, and to the extent allowed to health plan
administrators.
9:24:08 AM
Senator Micciche noted that the cost for treating the
unvaccinated would be greatly reduced, because the program
resulted in a savings.
Ms. Lewis agreed that they were a cost-efficient
preventative measure.
Senator Wielechowski queried the percentage of providers in
the state participated in the program. He wondered why
someone might not participate in the program.
Ms. Lewis pointed to a status update that shows the
percentage of covered lives. She stated that the number of
covered lives was approximately 8 percent from providers
that opted in. She stated that approximately 30,000
Alaskans benefited from the program.
Ms. Lewis discussed slide 6, "Vaccine Cost." She
highlighted slide 7, "Vaccine Coverage":
2018
? 366,000 Alaskans covered
? 50 percent of the population
? 86,000 children
? 44 percent of all children
? 280,000 adults
? 52 percent of all adults
Vaccination Coverage Awards
Most improved among adolescents for HPV
Most improved among adults aged 65+ for pneumonia
Ms. Lewis looked at slide 8, "Successes":
? The Division of Public Health reduces vaccine
preventable diseases.
? Providers have improved health outcomes for
vaccinated individuals and easier vaccine stock
management.
? The health insurance industry pays less to vaccinate
individuals.
? All Alaskans save more money in the long run due to
fewer medical costs from vaccine-preventable diseases.
Senator Micciche looked at slide 7, and noted that the
number only related to the percentage of Alaskans that were
covered by the program.
Ms. Lewis deferred to Dr. Lou.
Dr. Lou replied that there was information on vaccination
rates and information about covered rates. She noted that
the vaccination rates of Alaskans, compared to the rest of
the country, were below average. She remarked that there
was a hope to continue to see a gradual improvement in the
immunization rates. She stated that there was not an exact
correlation between the number covered and the number
vaccinated, but there was a close proportionate
relationship.
Co-Chair von Imhof looked at slide 5, which said, "The
provider's report administered vaccines to the Division of
Public Health." She felt that it would be the count of
everyone vaccinated.
Dr. Lou replied that she would provide further information
on those numbers.
9:30:08 AM
Ms. Lewis discussed slide 9, "Return on Health":
Lowers direct and long-term healthcare costs and yields
numerous
public health benefits:
? Ensures that every child and some adults who enter a
participating doctor's office or hospital can receive
recommended vaccines at no cost.
? More healthcare providers can offer vaccination
services
? less up-front costs to finance out of their own
pockets for vaccines, and
? reduces staff burdens required to separate
private and public vaccine stock.
? Allows the State to manage the supply of vaccines,
? ensuring that the state can quickly supply
vaccines to vulnerable patient groups during
emergencies or vaccine shortages, and
? reducing waste through centralized inventory
management.
9:31:41 AM
Senator Bishop wondered how the supplies were stored.
Ms. Lewis replied that most of the vaccines were shipped
directly to the providers. She remarked that, where that
was not practical, it was shipped to a central location
operated by the Division of Public Health called, "The
Vaccine Depot."
Senator Wilson wondered how the Vaccine Population's output
functioned toward at risk populations.
Ms. Lewis replied that the depot was able to rapidly give
the vaccine, and provided the ability to work with
partners.
Ms. Lewis addressed slide 10, "For every $1 spent on a
vaccine in the US?" She highlighted slide 11, " In
Closing?":
Reauthorizing the Alaska Vaccine Assessment Program
ensures a healthier future for all Alaskans at the
lowest possible cost.
9:36:14 AM
MATT HIRSCHFELT, ALASKA PEDIATRIC PARTNERSHIP, ANCHORAGE
(via teleconference), spoke in support of the legislation.
9:37:29 AM
JODY BUTTO, AVAP BOARD, ANCHORAGE (via teleconference),
spoke in support of the bill.
Co-Chair von Imhof CLOSED public testimony.
Co-Chair von Imhof noted that bulk purchasing had its
benefits, and hoped that the department would examine other
ways to use bulk purchasing.
SB 37 was HEARD and HELD in committee for further
consideration.
9:40:21 AM
AT EASE
Co-Chair von Imhof handed the gavel to Co-Chair Stedman.
9:41:51 AM
RECONVENED
^CONSIDERATION OF GOVERNOR'S APPOINTEES
9:43:34 AM
KEN MCCARTY, APPOINTEE, ALASKA MENTAL HEALTH BOARD OF
TRUSTEES (via teleconference), discussed his background.
Co-Chair Stedman asked about formal education.
Mr. McCarty replied that he had a Master's Degree in
Education and Marital and Family Therapy. He had pursued a
Doctorate, but purchased a school in the midst of those
studies. He was a licensed marital and family therapist in
Alaska.
9:45:30 AM
Co-Chair Stedman wondered whether he was familiar with the
recent audit of the Board.
Mr. McCarty responded in the affirmative.
Co-Chair Stedman asked whether he followed the Trust
settlement.
Mr. McCarty replied in the affirmative.
Senator Micciche noted the Doctorate was not included on
the education list.
Mr. McCarty replied that he began to pursue the Doctorate,
but halted that path once he had purchased a school.
Senator Micciche noted that a Board responsibility was
ensuring that the Land Office had adequate stewardship for
the nonfinancial assets; and ensuring appropriate financial
and operational controls. He queried a background in
finance or land management.
Mr. McCarty replied that he had no background in land
management. He stated that had experience in finance
through his for profit organization of Discovery Cove.
Co-Chair Stedman wondered whether the resume was accurate.
Mr. McCarty replied that his resume should be accurate.
9:49:00 AM
JOHN STURGEON, APPOINTEE, ALASKA MENTAL HEALTH BOARD OF
TRUSTEES (via teleconference), discussed his education and
qualifications. He believed that he could contribute to the
board, because of his extensive experience in land
management.
Co-Chair Stedman referenced questions posed to the previous
applicant. He asked if Mr. Sturgeon wanted to address the
trust settlement and budget experience.
Mr. Sturgeon thought there was work to be done. He had been
CEO of large companies with over $7 million in revenue. He
read financial statements on a regular basis.
Co-Chair Stedman asked if Mr. Sturgeon would follow the
trust settlement.
Mr. Sturgeon replied in the affirmative.
Co-Chair Stedman suggested that the applicant's timber
background would be helpful to the board.
9:53:22 AM
DAN SULLIVAN, APPOINTEE, REGULATORY COMMISSION OF ALASKA,
discussed his background and qualifications.
Co-Chair Stedman wondered whether the resume was accurate.
Mr. Sullivan felt his resume was accurate.
Senator Wielechowski remarked on the opposition to the
Chugach Electric Association and the merger. He wondered if
there was a plan to recuse himself from that issue, should
it come before the RCA.
Mr. Sullivan his main opposition was to the change of the
vote requirement from 60 percent to 50 percent.
Senator Wielechowski noted that he was originally seeking
the Alaska Oil and Gas Conservation Commission (AOGCC)
seat. He wondered why there was application for a seat that
should be filled for the upcoming two years.
Mr. Sullivan replied that he was a long-term thinker.
Senator Wielechowski noted the issue with Enstar when Mr.
Sullivan was mayor. Anchorage had agreed to return more
than $1 million in property taxes collected from Enstar. He
stated that the assessor resigned over the dispute, and
stated that he was concerned about "cozy relationships with
the oil and gas industry." He wondered if there was a plan
to recuse himself from Enstar issues in the future.
Mr. Sullivan replied that it would depend on the issue.
Co-Chair Stedman FORWARDED the appointments of Ken McCarty,
John Sturgeon, and Dan Sullivan for consideration in
accordance with Alaska Statute. He relayed that this did
not reflect an intent by any member Senate Finance
Committee to vote for or against the confirmation of the
individuals during any further sessions.
Co-Chair Stedman discussed committee business.
ADJOURNMENT
10:01:04 AM
The meeting was adjourned at 10:01 a.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB37 Sponsor Statement 1-28-19.cg.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document WA Post Anti Vaccine NC outbreak 11-18.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Alaska Public Health Advisory 1-29-19.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document AVAP Annual Report 2018.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document AVAP Status Update 2017.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Sectional Analysis 2-3-19.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document NPR 2-2-19.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document DHSS Vaccine Formulary 2019.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document AVAP Payers.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document AVAP Providers.pdf |
HHSS 4/23/2019 3:00:00 PM SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Status Update 2018.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Letters of Support SFIN Bundled.pdf |
SFIN 2/13/2019 9:00:00 AM |
SB 37 |
| SB37 Supporting Document PPt AVAP DPH 2-5-19.pdf |
SFIN 2/13/2019 9:00:00 AM |
SB 37 |
| SB37 Supporting Document AVAP Payers.pdf |
SFIN 2/13/2019 9:00:00 AM |
SB 37 |
| SB37 Letter of Support AK Ped Partnership 2-6-19.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Who Pays AVAP.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document PPt AVAP DPH 2-5-19.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Measles Info CDC.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Vaccination Rate Trends 2013-17.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| SB37 Supporting Document Measles Info DHSS.pdf |
SFIN 2/13/2019 9:00:00 AM SHSS 2/6/2019 1:30:00 PM |
SB 37 |
| Confirmation Resume FIN Mental Health Trust McCarty .pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| Confirmation Resume FIN Mental Health Trust Riggs 2019.pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| Confirmation Resume FIN Regulatory Commission of Alaska Sullivan 2019.pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| Confirmation Resume FIN Mental Health Trust Sturgeon 2019.pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| SB37 Supporting Document AVAP Cumulative Cost Savings.pdf |
SFIN 2/13/2019 9:00:00 AM |
SB 37 |
| 021319 RCA Fact Sheet.pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| 021319 Board of Trustees - Charter.pdf |
SFIN 2/13/2019 9:00:00 AM |
Confirmations 2019 |
| SB 37 SFC Aetna Support Letter.pdf |
SFIN 2/13/2019 9:00:00 AM |
SB 37 |