Legislature(2009 - 2010)SENATE FINANCE 532

02/25/2009 09:00 AM FINANCE


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ SB 45 VETERANS' CEMETERIES/FUND/LICENSE PLATES TELECONFERENCED
Heard & Held
+ SB 13 MEDICAL ASSISTANCE ELIGIBILITY TELECONFERENCED
Heard & Held
+ SB 87 MEDICAL ASSISTANCE ELIGIBILITY TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
                  SENATE FINANCE COMMITTEE                                                                                      
                     February 25, 2009                                                                                          
                         9:03 a.m.                                                                                              
                                                                                                                                
9:03:27 AM                                                                                                                    
                                                                                                                                
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair Stedman called the Senate  Finance Committee meeting                                                                   
to order at 9:03 a.m.                                                                                                           
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Lyman Hoffman, Co-Chair                                                                                                 
Senator Bert Stedman, Co-Chair                                                                                                  
Senator Charlie Huggins, Vice-Chair                                                                                             
Senator Johnny Ellis                                                                                                            
Senator Kim Elton                                                                                                               
Senator Donny Olson                                                                                                             
Senator Joe Thomas                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
None                                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Representative  Bill  Stoltze;  Sharon Long,  Staff,  Senator                                                                   
Huggins; McHugh  Pierre, Liaison, Department of  Military and                                                                   
Veterans  Affairs; Senator  Gene  Therriault, Sponsor;  Nicki                                                                   
Neal, Director,  Division of  Personnel and Labor  Relations,                                                                   
Department of Administration;  Senator Bettye Davis, Sponsor;                                                                   
Don  Burrell,  Staff,  Senator  Bettye  Davis,  Sponsor;  Rod                                                                   
Betit, President, Alaska Hospital  Association; Jorden Nigro,                                                                   
President of  the Alaska Association  of Homes  for Children;                                                                   
Jon Sherwood, Director, Office  of Program Review, Department                                                                   
of Health  and  Social Services;  Senator Bill  Wielechowski,                                                                   
Sponsor;  Michelle Sydeman,  Staff  to Senator  Weilechowski;                                                                   
Marie Darlin, President, AARP Capital City Task Force.                                                                          
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Pat Luby,  Advocacy Director,  Alaska Association  of Retired                                                                   
Persons (AARP),  Anchorage; Joseph  Fields, Self,  Fairbanks;                                                                   
Carletta  Mack,   Director,  Covenant  House   Alaska;  Dahna                                                                   
Graham, Anchorage  Faith and  Action Congregations  Together,                                                                   
Anchorage; Lorie  Morris, Executive  Director for  AK Baptist                                                                   
Family Services; Pat Senner, Alaska Nurses Association.                                                                         
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
                                                                                                                                
SB 13     "An Act relating to eligibility requirements for                                                                      
          medical   assistance  for   certain  children   and                                                                   
          pregnant  women;  and  providing for  an  effective                                                                   
          date."                                                                                                                
                                                                                                                                
                                                                                                                                
SB 45     "An Act relating to state employment preferences                                                                      
          for veterans, former  prisoners of war, and members                                                                   
          of  the  Alaska  National  Guard;  authorizing  the                                                                   
          Department  of Military  and  Veterans' Affairs  to                                                                   
          establish    and    maintain    Alaska    veterans'                                                                   
          cemeteries;   establishing  the  Alaska   veterans'                                                                   
          cemetery fund in the  general fund; and authorizing                                                                   
          the  legislature to  appropriate  income from  fees                                                                   
          collected  for  commemorative veterans'  plates  to                                                                   
          the Alaska veterans' cemetery fund."                                                                                  
                                                                                                                                
                                                                                                                                
SB 87     "An Act expanding medical assistance coverage for                                                                     
          eligible children  and pregnant women;  relating to                                                                   
          cost  sharing  for certain  recipients  of  medical                                                                   
          assistance; and providing for an effective date."                                                                     
                                                                                                                                
SENATE BILL NO. 45                                                                                                            
                                                                                                                                
     "An  Act relating  to state  employment preferences  for                                                                   
     veterans,  former prisoners of  war, and members  of the                                                                   
     Alaska  National Guard;  authorizing  the Department  of                                                                   
     Military   and  Veterans'   Affairs  to  establish   and                                                                   
     maintain Alaska  veterans' cemeteries;  establishing the                                                                   
     Alaska veterans' cemetery  fund in the general fund; and                                                                   
     authorizing the  legislature to appropriate  income from                                                                   
     fees  collected for  commemorative  veterans' plates  to                                                                   
     the Alaska veterans' cemetery fund."                                                                                       
                                                                                                                                
SHARON   LONG,   STAFF,  SENATOR   HUGGINS,   presented   the                                                                   
legislation to create a new veterans'  cemetery in Fairbanks.                                                                   
Fairbanks is home  to a significant military  population, but                                                                   
does  not  have  a  designated  veterans'  cemetery.  Alaskan                                                                   
veterans' cemeteries are located  in Sitka and Anchorage. The                                                                   
Veteran Cemetery  Fund will  be a  subaccount of the  general                                                                   
fund  pending legislation.  The fund  would receive  deposits                                                                   
through  appropriation,  and proceeds  from  the purchase  of                                                                   
special Veterans' license plates.                                                                                               
                                                                                                                                
Senator Huggins stated that the  proposed cemetery is a state                                                                   
veterans'  cemetery,  while  the   cemeteries  in  Sitka  and                                                                   
Anchorage  are national  veterans'  cemeteries.  For a  state                                                                   
cemetery,  the state contributes  the  land, and the  federal                                                                   
government builds the cemetery.                                                                                                 
                                                                                                                                
9:07:41 AM                                                                                                                    
                                                                                                                                
Senator  Huggins   maintained  that  veterans   in  Fairbanks                                                                   
deserve the state's  efforts. The land cost  is $750,000. The                                                                   
operation  costs  are the  responsibility  of  the state  and                                                                   
equal approximately  $250,000 per  year. He stated  that $250                                                                   
thousand were removed the upcoming  budget for this effort by                                                                   
the Governor, which delays the project by one year.                                                                             
                                                                                                                                
9:08:40 AM                                                                                                                    
                                                                                                                                
Co-Chair Hoffman  noted his  support for  SB 45. He  informed                                                                   
that Bethel  developed  a veterans' cemetery,  with the  city                                                                   
absorbing  some   costs.  He  wondered  if   the  legislation                                                                   
utilizes fees to assist municipal veterans' cemeteries.                                                                         
                                                                                                                                
9:09:27 AM                                                                                                                    
                                                                                                                                
Senator Huggins commented on Bethel's  successful efforts. He                                                                   
noted  that  Bethel  received   a  grant  to  assist  in  the                                                                   
cemetery's establishment.                                                                                                       
                                                                                                                                
Co-Chair  Stedman expressed  concern  about creating  another                                                                   
fund  while  the legislature  worked  to  eliminate  existing                                                                   
funds.  He asked  why the  expense  was not  included in  the                                                                   
capital budget  process, which  would eliminate the  need for                                                                   
an additional fund.                                                                                                             
                                                                                                                                
Senator  Huggins   answered  that  veterans   are  purchasing                                                                   
cemetery  license plates  to  display pride  in  representing                                                                   
their country  and supporting  their cause. He  preferred not                                                                   
to debate  the amount of existing  funds and the  creation of                                                                   
new funds.                                                                                                                      
                                                                                                                                
9:12:23 AM                                                                                                                    
                                                                                                                                
Co-Chair Stedman  asked about  the new  fiscal note  from the                                                                   
Department of  Military and  Veterans Affairs (DMVA)  showing                                                                   
$750  thousand  in  general  fund   appropriations  for  site                                                                   
planning and architectural design  work. The funding reflects                                                                   
an approximately $5 million federal match in FY11.                                                                              
                                                                                                                                
Senator Huggins  explained that  the legislation was  a group                                                                   
effort  shared by  Senator  Thomas, Senator  Therriault,  and                                                                   
himself.  He stressed  that  the effort  was  to benefit  the                                                                   
community and to support veterans.                                                                                              
                                                                                                                                
MCHUGH PIERRE,  LIAISON, DEPARTMENT OF MILITARY  AND VETERANS                                                                   
AFFAIRS, discussed  the fiscal note.  The current plan  is to                                                                   
accumulate $750 thousand over  three years, beginning in FY11                                                                   
and ending in FY13, with the receipt  of the federal money in                                                                   
FY14. Currently,  34 cemeteries  exist in the  national queue                                                                   
before Alaska.  Eight cemeteries  achieve funding  each year.                                                                   
The  pre-application  will be  submitted  next  week and  the                                                                   
veterans' affairs  administrator will review  the application                                                                   
with   the  federal   veterans'  administrator   in  DC,   to                                                                   
recommended changes.                                                                                                            
                                                                                                                                
Mr.  Pierre  explained  that the  fiscal  note  reflects  the                                                                   
bill's monetary requirement. The  bill requires $750 thousand                                                                   
in  capital  money.  A  land   donation  from  the  state  is                                                                   
necessary.                                                                                                                      
                                                                                                                                
Co-Chair  Stedman stated  that the  federal government  might                                                                   
produce funds for SB 45.                                                                                                        
                                                                                                                                
9:15:36 AM                                                                                                                    
                                                                                                                                
Senator Huggins  clarified that the  $750 thousand is  in the                                                                   
Governor's  budget.  Mr.  Pierre  stated  that  the  original                                                                   
estimate for the  project was $1 million, budgeted  from 2010                                                                   
to 2013,  spanning four years,  but the current low  price of                                                                   
oil led to removal of the first year.                                                                                           
                                                                                                                                
Co-Chair  Hoffman asked  about the  possibility of  beginning                                                                   
the  first year  with  a smaller  sum  of money.  Mr.  Pierre                                                                   
answered  that there  would  not be  official  action by  the                                                                   
federal  veteran's association  until the  $750 thousand  was                                                                   
appropriated.                                                                                                                   
                                                                                                                                
Senator Thomas wanted greater  understanding of the requested                                                                   
funds. He understood the federal  action fund contingency. He                                                                   
asked about the federal government's time limits.                                                                               
                                                                                                                                
Mr. Pierre  answered that the  application period is  July 2,                                                                   
2008  to July  2 2009.  He believed  that  date would  remain                                                                   
consistent  as long  as the  legislature  allocated the  $750                                                                   
thousand. The project  will be delayed by one  fiscal year if                                                                   
the date is missed.                                                                                                             
                                                                                                                                
9:18:18 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stedman  emphasized  that  the  committee  requires                                                                   
additional   information   from  the   administration   about                                                                   
removing  $250 thousand  from  the FY10  capital budget.  Mr.                                                                   
Pierre  explained  that  the expense  spans  four  years.  He                                                                   
clarified  that the  fiscal  note  is not  a  request by  the                                                                   
administration  or by DMVA.  The $750 thousand  appropriation                                                                   
is necessary to receive federal funding in one year.                                                                            
                                                                                                                                
Senator  Huggins intended  to  pursue additional  information                                                                   
regarding  the  Governor's  budget items.  He  supposed  that                                                                   
there  were  substitute  items that  this  legislation  could                                                                   
submit to enable this effort.                                                                                                   
                                                                                                                                
9:20:33 AM                                                                                                                    
                                                                                                                                
Co-Chair Hoffman  MOVED to ADOPT CSSB45 (STA)  as the working                                                                   
document.                                                                                                                       
                                                                                                                                
Senator  Thomas  MOVED to  ADOPT  Amendment  1,  26-LS0277\P.2,                                                                 
Bullock/Wayne:                                                                                                                  
                                                                                                                                
     Page 1, following line 7:                                                                                                  
          Insert a new bill section to read:                                                                                    
        "*  Section 1.  The uncodified  law of  the State  of                                                               
     Alaska is amended by adding a new section to read:                                                                         
          LEGISLATIVE INTENT. It is the intent of the                                                                           
     legislature   that,  during   fiscal   year  2010,   the                                                                   
     Department  of   Military  and  Veterans'   Affairs,  in                                                                   
     cooperation   with   federal  authorities,   begin   the                                                                   
     planning  and design  of an  Alaska veterans'  cemetery,                                                                   
     authorized by  AS 44.35.035, enacted by sec.  10 of this                                                                   
     Act, to  be located in or  near Fairbanks, and  that the                                                                   
     Department  of Military and  Veterans' Affairs  submit a                                                                   
     report  on the  status of  the cemetery  project to  the                                                                   
     president of the senate and  the speaker of the house of                                                                   
     representatives before December 15, 2009."                                                                                 
                                                                                                                                
     Page 1, line 8:                                                                                                            
          Delete "Section 1"                                                                                                  
          Insert "Sec. 2"                                                                                                     
                                                                                                                                
Co-Chair Stedman OBJECTED for discussion                                                                                        
                                                                                                                                
Senator Thomas  explained the amendment expresses  the intent                                                                   
that DMVA  begin planning the  design of the  dedicated state                                                                   
veterans'  cemetery in  the Interior  during the coming  year                                                                   
and  provide  the  legislature  with  a  status  report  this                                                                   
December. The  amendment was constructed  with the  idea that                                                                   
projects move forward quickly  when information is adequately                                                                   
provided.  The  status  reports  will  keep  the  legislature                                                                   
informed  about the  use of  the $750  thousand while  aiding                                                                   
understanding  of the cemetery's  architectural design  while                                                                   
monitoring the  federal process.  He noted that  construction                                                                   
would not be included in the fiscal budget until FY11.                                                                          
                                                                                                                                
Senator Huggins  supported the  amendment because  it brought                                                                   
about accountability.                                                                                                           
                                                                                                                                
9:23:55 AM                                                                                                                    
                                                                                                                                
Senator  Olson wanted  to know the  department's position  on                                                                   
the legislation,  and he understood  that they  were required                                                                   
to coordinate with the Department  of Natural Resources (DNR)                                                                   
to acquire  land for the  cemetery. Mr. Pierre  answered that                                                                   
the department's  intention was to move forward  with all due                                                                   
diligence to pursue  this project. The project  is a priority                                                                   
to  the  veteran's  community  and the  goal  is  to  proceed                                                                   
quickly  in a  responsible manner.  The department  supported                                                                   
the amendment.                                                                                                                  
                                                                                                                                
SENATOR  GENE   THERRIAULT,  SPONSOR,   commented   that  the                                                                   
Fairbanks Borough  government was  in support of  the effort,                                                                   
and was willing to aid in locating  land for the cemetery. He                                                                   
expressed awareness  about potential  land. He supported  the                                                                   
amendment and felt that it lent focus and communication.                                                                        
                                                                                                                                
Co-Chair Stedman REMOVED his objection                                                                                          
                                                                                                                                
Amendment 1 was ADOPTED                                                                                                         
                                                                                                                                
9:26:53 AM                                                                                                                    
                                                                                                                                
Senator Huggins  stated that  one section  of the bill  deals                                                                   
with hiring preferences. He noted  that a representative from                                                                   
the administration  was present  to speak. He  expressed that                                                                   
the bill does  have a personnel hiring portion  that deserves                                                                   
consideration.                                                                                                                  
                                                                                                                                
NICKI  NEAL,  DIRECTOR,  DIVISION   OF  PERSONNEL  AND  LABOR                                                                   
RELATIONS,  DEPARTMENT  OF ADMINISTRATION,  stated  that  the                                                                   
bill  only  clarifies  the  language  as  opposed  to  making                                                                   
changes to the existing current preference.                                                                                     
                                                                                                                                
Senator Huggins  noted one change  expanding the  cemetery to                                                                   
include the National Guard.                                                                                                     
                                                                                                                                
Ms.  Neal noticed  that the  summery  by Legislative  Council                                                                   
stated   that   National  Guard   Members   already   receive                                                                   
preference.                                                                                                                     
                                                                                                                                
9:28:44 AM     AT EASE                                                                                                        
9:28:56 AM     RECONVENED                                                                                                     
                                                                                                                                
Ms. Neal  discussed  section 6  line 16 and  the language  on                                                                   
Page  7 of  the bill.  The language  deletes  members of  the                                                                   
National Guard and moves it to section 7.                                                                                       
                                                                                                                                
Senator Huggins asked  if members of the National  Guard were                                                                   
denied preference.  Ms. Neal could not recall  an instance in                                                                   
which veterans  did not  have preference. Veteran  applicants                                                                   
receive  consideration and  opportunities  to interview,  but                                                                   
they must first meet the minimum  qualifications for the job.                                                                   
She wondered if the problem was  that the person did not meet                                                                   
the minimum qualifications and  therefore, did not advance to                                                                   
consideration or interview.                                                                                                     
                                                                                                                                
Senator  Olson asked how  the veteran's  cemetery applies  to                                                                   
the Alaska territory or guard  members when disputes exist as                                                                   
to whether or not they are veterans.                                                                                            
                                                                                                                                
Ms.  Neal  asked  if  the  question  was  about  the  veteran                                                                   
cemeteries.  Senator  Olson answered  yes  and  asked if  the                                                                   
Alaska   Guard  members   that  were   part  of  the   Alaska                                                                   
Territorial  Guard  (ATG) were  eligible  for  burial in  the                                                                   
veteran cemeteries.                                                                                                             
                                                                                                                                
9:31:48 AM                                                                                                                    
                                                                                                                                
Mr. Pierre  answered that  ATG members  will be eligible  for                                                                   
burial  in  the veteran  cemetery.  Recognition  as  veterans                                                                   
occurs once they receive official discharge from the Army.                                                                      
                                                                                                                                
Senator  Olson asked  how many  veterans  have completed  the                                                                   
paperwork establishing them as  veterans. Mr. Pierre answered                                                                   
that  there  are  1200  to  1500  applications  pending  with                                                                   
approximately  700  certifications  delivered.  He  explained                                                                   
that the  majority of  buried veterans  exist on record.  The                                                                   
remaining veterans are difficult to locate.                                                                                     
                                                                                                                                
Senator Olson asked  if living ATG members were  not eligible                                                                   
for burial in the veteran cemetery.                                                                                             
                                                                                                                                
Mr. Pierre  answered that the  opposite was true,  and stated                                                                   
that the living ATG members who  have received their official                                                                   
discharge certificate  are eligible for burial  in a national                                                                   
cemetery or a state veteran cemetery.                                                                                           
                                                                                                                                
9:33:37 AM                                                                                                                    
                                                                                                                                
PAT LUBY,  ADVOCACY DIRECTOR,  ALASKA ASSOCIATION  OF RETIRED                                                                   
PERSONS (AARP), ANCHORAGE (testified  via teleconference). He                                                                   
stated that AARP  strongly supports SB45. He  maintained that                                                                   
SB  45  would  offer many  veterans  and  their  families  an                                                                   
opportunity to have a closer burial.                                                                                            
                                                                                                                                
JOSEPH    FIELDS,    SELF,     FAIRBANKS    (testified    via                                                                   
teleconference). He spoke in support  of SB 45. He maintained                                                                   
that  Fairbanks  was  the appropriate  location  for  such  a                                                                   
cemetery.                                                                                                                       
                                                                                                                                
SB45   was  HEARD   and  HELD   in   Committee  for   further                                                                   
consideration.                                                                                                                  
                                                                                                                                
9:38:36 AM                                                                                                                    
                                                                                                                                
SENATE BILL NO. 13                                                                                                            
                                                                                                                                
     "An Act relating to eligibility requirements for                                                                           
     medical assistance for certain children and pregnant                                                                       
     women; and providing for an effective date."                                                                               
                                                                                                                                
SENATOR BETTYE DAVIS, SPONSOR,  noted that there had not been                                                                   
opposition to this particular  bill. She stated that the bill                                                                   
had  received  support  in  the   form  of  telephone  calls,                                                                   
letters,   and  e-mails   with  the  goal   of  raising   the                                                                   
eligibility level for Denali Kid  Care (DKC) from 150 percent                                                                   
to 200 percent of the federal poverty level (FPL). She                                                                          
requested that the committee refrain from amending the bill.                                                                    
                                                                                                                                
     DON BURRELL, STAFF, SENATOR DAVIS, explained that SB                                                                       
     13 increases and restores the qualifying income                                                                            
     eligibility standard for the Denali Kid Care Program                                                                       
     to 200% of the Federal Poverty Line (FPL) to its                                                                           
     original levels 12 years ago. As you know, Alaska is                                                                       
    one of the nation's wealthiest states yet Alaska is                                                                         
     only one of five states that still fund our SCHIP                                                                          
     program below 200% FPL. SB 13 makes health insurance                                                                       
     accessible to approximately 1,277 uninsured children                                                                       
     and 225 pregnant women in Alaska.                                                                                          
                                                                                                                                
     Denali Kid Care is an "enhanced" reimbursement program                                                                     
     with Alaska currently receives about 66% under the                                                                         
     federal government's State Children's Health Insurance                                                                     
     Program (SCHIP), created in 1997.  Congress                                                                                
     reauthorized the SCHIP program and President Obama                                                                         
     signed into law on February 4, 2009. This                                                                                  
     reauthorization expanded the coverage to 4 million                                                                         
     additional children and is re-authorized through                                                                           
     2013.                                                                                                                      
                                                                                                                                
     Consider the following information from the Kaiser                                                                         
     Commission on Medicaid and the Uninsured, January,                                                                         
     2009:                                                                                                                      
                                                                                                                                
           · 45 states, including D.C., cover children in                                                                       
             families with incomes at 200% FPL or higher.                                                                       
                                                                                                                                
           · 33 states cover children in families with                                                                          
             income between 200% and 250% FPL.                                                                                  
                                                                                                                                
           · 19 states including D.C., cover children in                                                                        
             families with income at 250% or higher.  10 of                                                                     
             these states cover children in families with                                                                       
             income at 300% FPL or higher.                                                                                      
                                                                                                                                
           · 35 states allow premiums or enrollment fees,                                                                       
             and 24 states have co-payments for selected                                                                        
             services in SCHIP programs on a sliding scale                                                                      
             of  FPL.                                                                                                           
                                                                                                                                
          · 46 states do not require asset tests.                                                                               
                                                                                                                                
                                                                                                                                
     Denali Kid Care serves an estimated 7,900 Alaska                                                                           
     children and remains one  of the least costly medical                                                                      
     assistance programs in the  state at about $1,700 per                                                                      
     child with full coverage,  including dental, which is                                                                      
     about 20% of the cost of adult senior coverage.                                                                            
                                                                                                                                
     It is estimated that uninsured children with a medical                                                                     
    need are five times as likely not to have a regular                                                                         
     doctor as insured children and four times more likely                                                                      
     to use emergency rooms at  a much higher cost. Early                                                                       
     intervention and preventative  care under SB 13 will                                                                       
     greatly increase Alaska children's  health and yield                                                                       
     substantial savings to the  state, public and private                                                                      
     sector hospitals, emergency  rooms which are required                                                                      
     to admit indigent and uninsured patients for non-                                                                          
     emergency treatment.                                                                                                       
                                                                                                                                
     There are still an estimated 18,000 uninsured children                                                                     
     in Alaska. This is about 9% of the children age 18 and                                                                     
     under.  Private health care coverage for children has                                                                      
     declined over 30% in the last ten years, and the                                                                           
     deepening recession is pulling more children and                                                                           
     families into the uninsured  ranks.  Alaska should do                                                                      
     its share and take advantage of available federal                                                                          
     matching funds by insuring its low income children and                                                                     
     pregnant women up to and  including 200% FPL under SB                                                                      
     13.                                                                                                                        
                                                                                                                                
                                                                                                                                
9:45:36 AM                                                                                                                    
                                                                                                                                
Co-Chair  Stedman asked  for additional  questions. He  noted                                                                   
three fiscal notes  from the Department of Health  and Social                                                                   
Services  (DHSS) showing  an $886  thousand  increase in  the                                                                   
general fund spending for FY10.                                                                                                 
                                                                                                                                
Senator  Bettye Davis  asked if  the  committee received  the                                                                   
updated fiscal notes.                                                                                                           
                                                                                                                                
9:46:32 AM     AT EASE                                                                                                        
9:46:42 AM     RECONVENED                                                                                                     
                                                                                                                                
Co-Chair Stedman  stated that the committee did  not have the                                                                   
updated fiscal notes.                                                                                                           
                                                                                                                                
Co-Chair Hoffman noted that approximately  7,900 children are                                                                   
served  today by  Denali  Kid Care  (DKC)  and 18,000  remain                                                                   
uninsured.    The    proposed   legislation    would    allow                                                                   
approximately  1300  additional  children into  the  program,                                                                   
increasing the number served to  9,200. The change would drop                                                                   
the number  of uninsured  children to  16,700. Senator  Davis                                                                   
agreed that Senator Hoffman's estimates were correct.                                                                           
                                                                                                                                
9:48:07 AM                                                                                                                    
                                                                                                                                
CARLETTA  MACK, DIRECTOR,  COVENANT  HOUSE ALASKA  (testified                                                                   
via  teleconference). She  spoke  in support  of  SB 13.  She                                                                   
maintained that  Covenant House seeks health  care outside of                                                                   
the emergency  room for cost benefit purposes.  Expanding the                                                                   
number of youth eligible for health  care coverage would lead                                                                   
to greater  health and  decreased use  of the emergency  room                                                                   
for medical care and long-term costs.                                                                                           
                                                                                                                                
DAHNA  GRAHAM,  ANCHORAGE  FAITH   AND  ACTION  CONGREGATIONS                                                                   
TOGETHER (AFACT),  ANCHORAGE (testified via  teleconference).                                                                   
She  spoke  in  support  of  SB  13.  She  opined  that  this                                                                   
legislation  was a  bargain for  the state,  in light of  the                                                                   
federal  contribution.  She  stated   that  a  visit  to  the                                                                   
emergency room fee would equal that of DKC's annual fee.                                                                        
                                                                                                                                
9:51:45 AM                                                                                                                    
                                                                                                                                
ROD BETIT,  PRESIDENT, ALASKA HOSPITAL ASSOCIATION  (ASHNHA),                                                                   
noted  that   his  membership  strongly  supports   SB13.  He                                                                   
believed  that  the legislation  was  the next  logical  step                                                                   
considering  the  available  economic   stimulus  funds.  The                                                                   
members of ASHNHA  do not believe that the  legislation would                                                                   
preempt recommendations of the Health Care Commission.                                                                          
                                                                                                                                
Senator Huggins asked  about elements of the  task force. Mr.                                                                   
Betit answered  that there were many recommendations,  but he                                                                   
could not report on the outcome.  He believed that DHSS would                                                                   
have the information regarding recommendations.                                                                                 
                                                                                                                                
9:53:38 AM                                                                                                                    
                                                                                                                                
JORDEN NIGRO,  PRESIDENT OF THE  ALASKA ASSOCIATION  OF HOMES                                                                   
FOR  CHILDREN, approved  of preventative  care and  supported                                                                   
the bill in its entirety. She  explained that raising the DKC                                                                   
eligibility  rate to  200 percent  of  the FPL  would have  a                                                                   
drastic affect  on behavioral health  services, as it  is the                                                                   
primary funding  source. Many  children are unable  to access                                                                   
services because they are on the cusp of eligibility.                                                                           
                                                                                                                                
MARIE  DARLIN, COORDINATOR,  AARP  CAPITOL  CITY TASK  FORCE,                                                                   
spoke in favor  of SB 13. She  noted that AARP is  one of the                                                                   
nation's   largest   organizations  of   grandparents.   Many                                                                   
grandparents  are  responsible  for raising  children,  while                                                                   
dependent on  Medicare themselves.  She expressed  support of                                                                   
SB 13.                                                                                                                          
                                                                                                                                
9:57:35 AM                                                                                                                    
                                                                                                                                
LORIE  MORRIS,  EXECUTIVE  DIRECTOR  FOR  AK  BAPTIST  FAMILY                                                                   
SERVICES (testified  via teleconference),  She noted  support                                                                   
for SB 13.                                                                                                                      
                                                                                                                                
JON SHERWOOD, DIRECTOR, OFFICE  OF PROGRAM REVIEW, DEPARTMENT                                                                   
OF HEALTH  AND SOCIAL  SERVICES, (DHSS)  spoke in support  of                                                                   
increasing the eligibility limits  to 200 percent of the FPL,                                                                   
and expressed  the administration's interest in  cost sharing                                                                   
provisions.                                                                                                                     
                                                                                                                                
Senator  Elton asked what  the administration  meant  by cost                                                                   
sharing. Mr. Sherwood answered  that cost sharing can include                                                                   
premiums  or co-payments.  He  noted that  there are  federal                                                                   
limits to  cost sharing  of 5 percent  of a family's  income.                                                                   
The department  prefers premiums  because they are  easier to                                                                   
track, although there are also advantages to co-payments.                                                                       
                                                                                                                                
Senator  Elton  asked if  support  for  the bill  depends  on                                                                   
additional  cost sharing  provisions.  Mr. Sherwood  answered                                                                   
that  the department  does  not oppose  an  expansion to  200                                                                   
percent of the FPL.                                                                                                             
                                                                                                                                
10:01:22 AM                                                                                                                   
                                                                                                                                
Senator Huggins  referred to a  memorandum to  Senator Bettye                                                                   
Davis from  Jennifer Saunders (Copy  on File). He  noted that                                                                   
the  second paragraph  stated  that under  provisions of  the                                                                   
Deficit  Reduction Act,  states  generally  could not  impose                                                                   
cost sharing  on children  in families  with an income  below                                                                   
150  percent of  the federal  poverty  guidelines, except  in                                                                   
certain  circumstances. He  asked about  the increase  to 200                                                                   
percent of the FPL given this information.                                                                                      
                                                                                                                                
Mr. Sherwood answered that the  department looked at imposing                                                                   
cost sharing on  income groups above 175 percent  of the FPL.                                                                   
Below 150  percent of  the FPL,  limitations on cost  sharing                                                                   
are cumbersome.  A limited ability  to cost share  exists due                                                                   
to the exclusion of children.                                                                                                   
                                                                                                                                
Senator Huggins  agreed that all children  deserve affordable                                                                   
health  insurance.  He  asked   for  an  explanation  of  the                                                                   
hesitation he noticed during Mr. Sherwood's testimony.                                                                          
                                                                                                                                
Mr. Sherwood  expressed that his  hesitation was  due largely                                                                   
to  the  fact  that  the  department   had  proposed  federal                                                                   
regulations on cost sharing. The  new administration withdrew                                                                   
the regulations, and the department  expects to see new ones.                                                                   
He stated that he was reluctant  to disclose specifics due to                                                                   
the  possibility  that  federal regulations  may  change.  He                                                                   
thought that  above 150 percent  of the FPL,  co-payments for                                                                   
emergency  services,   care  for  the  terminally   ill,  and                                                                   
preventative care  remained acceptable. Above 150  percent of                                                                   
the FPL,  the rules are  straightforward, yet are  limited to                                                                   
charging  less  than  5  percent   of  the  family's  income.                                                                   
Tracking co-pays  can prove cumbersome, but  he believed that                                                                   
there were reasonable methods available.                                                                                        
                                                                                                                                
10:05:10 AM                                                                                                                   
                                                                                                                                
Co-Chair Stedman asked  if the cost and burden  placed on the                                                                   
department to track the co-pays  above 150 percent of the FPL                                                                   
equated  to  a  net  benefit  for  the  state.  Mr.  Sherwood                                                                   
answered that  the administration  does support some  kind of                                                                   
cost sharing. Premiums  are easier to track  against the five                                                                   
percent cap.                                                                                                                    
                                                                                                                                
Co-Chair   Hoffman   noted   that   the   sponsor   statement                                                                   
illustrates  that   Alaska  currently  receives   66  percent                                                                   
federal  funds under  this  program, and  will  receive a  70                                                                   
percent  match.  He  asked  if   the  70  percent  match  was                                                                   
contingent upon the passage of this legislation.                                                                                
                                                                                                                                
Mr. Sherwood believed that the  70 percent is the combination                                                                   
of children  served for  which the current  match rate  is 66                                                                   
percent. Services  provided through  tribal health  providers                                                                   
are  included   and  claimed   at  100  percent.   The  State                                                                   
Children's  Health Insurance  Program (SCHIP)  match rate  is                                                                   
currently under 66  percent and will move down  to 65 percent                                                                   
in  the  next  few years.  Co-pays  or  premiums  may  offset                                                                   
expenditures.                                                                                                                   
                                                                                                                                
Senator Olson  asked if  Mr. Sherwood  referred to  5 percent                                                                   
per family  or 5 percent  per child. Mr. Sherwood  understood                                                                   
that the  5 percent  limit exists  for the individual  versus                                                                   
the whole family, and pregnant  women are not subject to cost                                                                   
sharing provisions.                                                                                                             
                                                                                                                                
10:08:43 AM                                                                                                                   
                                                                                                                                
Senator Thomas  asked when the  administration would  be able                                                                   
to  present information  regarding  cost  sharing within  the                                                                   
federal  regulations.  Mr.  Sherwood  answered  that  he  was                                                                   
hesitant  to set a  target date.  He planned  to address  the                                                                   
subject  later.  He  hoped  to revisit  the  committee  in  a                                                                   
reasonable amount of time.                                                                                                      
                                                                                                                                
Senator  Thomas opined  that the  payment  of premiums  would                                                                   
encourage individuals  to seek lesser  plans that may  or may                                                                   
not include preventative care.                                                                                                  
                                                                                                                                
10:11:05 AM                                                                                                                   
                                                                                                                                
Mr. Sherwood  stated that  the department  intended  to offer                                                                   
all  enrolled recipients  of  Medicaid  full benefits,  which                                                                   
includes  preventative care.  Federal  law does  not allow  a                                                                   
program  to  offer health  care  to  children that  does  not                                                                   
include preventative care.                                                                                                      
                                                                                                                                
Senator Davis wrapped up by repeating  her initial statement.                                                                   
She  stated  that she  had  an  opportunity to  address  cost                                                                   
sharing, and  had consulted with  the National  Conference of                                                                   
State  Legislatures  (NCSL),  and  she  understood  that  the                                                                   
administration's  intention  was to  cost  share. She  stated                                                                   
that  she had  not found  evidence  of administrative  action                                                                   
regarding cost  sharing. She recommended against  waiting for                                                                   
the  administration  to  create   a  plan  including  federal                                                                   
regulations. She understood that  the money is present in the                                                                   
current  budget to  cover the  increase. She  asked that  the                                                                   
bill pass out in a timely manner.  There is not opposition to                                                                   
this  bill.  She  maintained  that  her  goal  was  to  bring                                                                   
eligibility  requirements for  DKC up to  200 percent  of the                                                                   
FPL.                                                                                                                            
                                                                                                                                
Co-Chair  Stedman appreciated  the volume  of Senator  Davis'                                                                   
voice as it made it easy to understand her position.                                                                            
                                                                                                                                
SB  13   was  HEARD  and   HELD  in  Committee   for  further                                                                   
consideration.                                                                                                                  
                                                                                                                                
10:15:14 AM                                                                                                                   
                                                                                                                                
SENATE BILL NO. 87                                                                                                            
                                                                                                                                
     "An  Act  expanding  medical   assistance  coverage  for                                                                   
     eligible children  and pregnant women; relating  to cost                                                                   
     sharing  for certain recipients  of medical  assistance;                                                                   
     and providing for an effective date."                                                                                      
                                                                                                                                
SENATOR BILL  WIELECHOWSKI, SPONSOR, explained  that the goal                                                                   
of SB 87 is to increase the eligibility  requirements for DKC                                                                   
to  200  percent.  He stated  that  80  percent  of  children                                                                   
without health  insurance are from working  families. Private                                                                   
insurance for children can cost  thousands of dollars, with a                                                                   
large deductable  and co-pay. This bill would  allow families                                                                   
with incomes  up to 300  percent of the  FPL to buy  into DKC                                                                   
using a sliding  fee scale for premiums and a  20 percent co-                                                                   
pay. Those with the greatest means  would reimburse the state                                                                   
roughly 90  percent of  its costs.  An opportunity  exists to                                                                   
take advantage  of millions  of federal  dollars and  provide                                                                   
the  opportunity  to  allow all  children  access  to  health                                                                   
insurance.                                                                                                                      
                                                                                                                                
10:19:53 AM                                                                                                                   
                                                                                                                                
Mr. Wielechowski  opined that the  bill would save  the state                                                                   
money.  He   stated  that  Providence  and   Alaska  Regional                                                                   
Hospitals  in  Anchorage  report  providing  $89  million  in                                                                   
uncompensated care  in 2006. All premiums are  increased when                                                                   
hospital care  is uncompensated. In  2005, the total  cost of                                                                   
health  care in  Alaska for  the  uninsured (excluding  costs                                                                   
paid  out-of-pocket  by  the   uninsured)  was  $125  million                                                                   
(Families USA). He estimated that  every Alaskan family would                                                                   
pay $2248  in 2010  for increased  premiums. The  opportunity                                                                   
exists  to spend  millions of  federal  dollars resulting  in                                                                   
significant  cost  savings  for all  Alaskans  including  the                                                                   
state's  14,000  employees.  Providing  health  insurance  to                                                                   
multiple families  will ultimately save millions  of dollars.                                                                   
He noted that there  was not an increment in  the HESS budget                                                                   
for DKC, which  leads him to believe that  the administration                                                                   
is  not  anticipating  increase  costs  due  to  raising  the                                                                   
eligibility limits.                                                                                                             
                                                                                                                                
10:22:38 AM                                                                                                                   
                                                                                                                                
Co-Chair  Stedman  stated  that   the  fiscal  note  included                                                                   
language  regarding  staff  increases.  Senator  Wielechowski                                                                   
answered that he had been working  with the administration to                                                                   
seek efficiencies in the administration of the bill.                                                                            
                                                                                                                                
Co-Chair Hoffman  stated that even  though the money  for the                                                                   
expanded program  is not in the operating budget,  the fiscal                                                                   
note  is a  method  of accommodating  the  increases, if  the                                                                   
legislation passes.                                                                                                             
                                                                                                                                
10:24:13 AM                                                                                                                   
                                                                                                                                
MICHELLE SYDEMAN, STAFF, SENATOR  WEILECHOWSKI, mentioned the                                                                   
original fiscal note. She noted  that there had been numerous                                                                   
meetings with the  department to review the  overall costs in                                                                   
terms of the general  fund as well as the number  of required                                                                   
positions.  She stated that  there is  a revised fiscal  note                                                                   
based  on new  understanding about  available federal  funds.                                                                   
She assured that  the amount was substantially  less than the                                                                   
one  listed before  the  committee.  The assumption  is  that                                                                   
there would  be some changes in  the bill with regard  to the                                                                   
co-pay amount. The new fiscal  note shows significantly fewer                                                                   
staff.                                                                                                                          
                                                                                                                                
Co-Chair Stedman asked for the  number of staff listed on the                                                                   
new  fiscal note.  Ms.  Sydeman  understood that  there  were                                                                   
eleven  staff listed  on the  most current  fiscal note.  She                                                                   
stated that she had not seen the note.                                                                                          
                                                                                                                                
Senator Huggins asked how many staff are employed.                                                                              
                                                                                                                                
Senator Thomas  asked how many  full time positions  would be                                                                   
required for the changes in the bill.                                                                                           
                                                                                                                                
Senator Wielechowski  answered that the number  of additional                                                                   
children  in  SB  13  is roughly  1500,  and  the  number  of                                                                   
additional children in SB 87 is roughly 1500.                                                                                   
                                                                                                                                
Co-Chair Stedman stated  that he would like to  wait until he                                                                   
had updated information on SB 13.                                                                                               
                                                                                                                                
10:27:13 AM                                                                                                                   
                                                                                                                                
Senator  Elton questioned  the  point that  there  was not  a                                                                   
requested  increment  for  DKC,  even  with  the  eligibility                                                                   
increase from  175 percent of the  FPL to 200 percent  of the                                                                   
FPL.  He  suggested  that  there might  not  be  a  requested                                                                   
increment because there is anticipation  by the department of                                                                   
a co-pay/premium structure in  place by the next fiscal year.                                                                   
Senator  Wielechowski  answered that  the  Health and  Social                                                                   
Services(HSS)  committee  had  not  addressed  the  increment                                                                   
increase.  The  co-pay  and  premium   system  would  require                                                                   
additional staff.                                                                                                               
                                                                                                                                
Senator  Elton suggested  that new staff  would be  necessary                                                                   
with a co-pay  system. He asked for the  additional increment                                                                   
of positions needed if the program  increased from 200 to 300                                                                   
percent of the FPL.                                                                                                             
                                                                                                                                
Senator Wielechowski stated that  SB 87 does include a co-pay                                                                   
system from 200 to 300 percent of the FPL.                                                                                      
                                                                                                                                
Senator Elton asked that if additional  staff are required to                                                                   
implement a  co-pay system for  a program serving 150  to 200                                                                   
percent of  the FPL, could the  same level of staff  handle a                                                                   
co-pay  system  between  200  and 300  percent  of  the  FPL?                                                                   
Senator Wielechowski  answered that  he would rather  see the                                                                   
co-pay begin  at 200  percent of  the FPL  and extend  to 300                                                                   
percent of  the FPL. He felt  concern about dropping  the co-                                                                   
pay system down to 150 percent of the FPL.                                                                                      
                                                                                                                                
Senator Elton explained  that he was not suggesting  that the                                                                   
co-pay drop  to serve 150  percent of  the FPL. He  wanted to                                                                   
know  what  the  number  of  additional   staff  required  to                                                                   
implement the increase to 200-300 percent of the FPL.                                                                           
                                                                                                                                
10:31:02 AM                                                                                                                   
                                                                                                                                
Senator Olson  asked how the same  number of staff  needed to                                                                   
serve 200 percent of the FPL could  also serve 300 percent of                                                                   
the  FPL. Senator  Wielechowski  answered  that the  increase                                                                   
from  175 percent  to  200 percent  adds  an additional  1579                                                                   
people. To extend from 200 percent  of the FPL to 300 percent                                                                   
of  the  FPL  with  the  co-pay  system  adds  an  additional                                                                   
estimated 1500 children and pregnant women to the program.                                                                      
                                                                                                                                
10:31:52 AM                                                                                                                   
                                                                                                                                
DAHNA  GRAHAM   ANCHORAGE  FAITH  AND  ACTION   CONGREGATIONS                                                                   
TOGETHER (AFACT)  (testified via  teleconference).  She spoke                                                                   
in favor of income  limits for DKC at 200 percent  of poverty                                                                   
level. Above  200 percent of the  FPL, she maintained  that a                                                                   
co-pay or premium system would be appropriate.                                                                                  
                                                                                                                                
PAT  SENNER,   ALASKA  NURSES   ASSOCIATION  (testified   via                                                                   
teleconference)  She   requested  the  exploration   of  cost                                                                   
sharing  methods. She  did not  agree with  cost sharing  for                                                                   
people below  200 percent of the  FPL. She spoke in  favor of                                                                   
exploring  all  options  to allow  an  increase  of  children                                                                   
covered above 200 percent of the FPL.                                                                                           
                                                                                                                                
10:35:38 AM                                                                                                                   
                                                                                                                                
ROD BETIT, PRESIDENT,  ALASKA HOSPITAL ASSOCIATION,  spoke in                                                                   
support  of   SB  87.  He   agreed  with  sharing   financial                                                                   
responsibility as  income increases. He agreed  with language                                                                   
in SB 87 discouraging a shift  of people currently covered by                                                                   
private  plans to a  public plan.  The approach  in SB  87 is                                                                   
similar to that of other countries'  successful health plans.                                                                   
                                                                                                                                
JORDEN  NIGRO, PRESIDENT,  ALASKA  ASSOCIATION  OF HOMES  FOR                                                                   
CHILDREN,  stated that  the Alaska Association  of Homes  for                                                                   
Children would like to see a co-pay  established for families                                                                   
over 200 percent of the FPL only.                                                                                               
                                                                                                                                
MARIE DARLIN, PRESIDENT, AARP  CAPITAL CITY TASK FORCE, spoke                                                                   
in support  of SB 87.  She agreed that  raising the  floor to                                                                   
200 percent was the most important factor.                                                                                      
                                                                                                                                
10:41:06 AM                                                                                                                   
                                                                                                                                
Co-Chair Stedman  asked for the administration's  view of the                                                                   
program   expansion.    Mr.   Sherwood   stated    that   the                                                                   
administration  supports  expanding   the  program  and  cost                                                                   
sharing. He  stated that he could  not provide a  position on                                                                   
the bill.                                                                                                                       
                                                                                                                                
Senator Elton asked if additional  staff would be required to                                                                   
implement cost sharing for 200 to 300 percent of the FPL.                                                                       
                                                                                                                                
Mr. Sherwood  answered that the administration's  position is                                                                   
not to  implement cost sharing  for groups currently  served.                                                                   
Pregnant   women   are   exempt  from   cost   sharing.   The                                                                   
administration  does not have  plans to administer  new staff                                                                   
to collect premiums or administer the co-pay provisions.                                                                        
                                                                                                                                
Senator  Elton   asked  if   the  department  was   exempting                                                                   
expansion. He  asked if the  department was considering  cost                                                                   
sharing from 175 to 200 percent of the FPL if SB 13 passes.                                                                     
                                                                                                                                
Mr.  Sherwood stated  that the  administration's response  to                                                                   
cost sharing has not been determined  in regard to SB 13. The                                                                   
department  will not implement  cost sharing  with SB  13. He                                                                   
assumed  that   the  department  would  respect   legislative                                                                   
intent.                                                                                                                         
                                                                                                                                
10:44:59 AM                                                                                                                   
                                                                                                                                
SB87 was HEARD and HELD in Committee for further                                                                                
consideration.                                                                                                                  
                                                                                                                                
10:46:08 AM                                                                                                                   
                                                                                                                                
ADJOURNMENT                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:45 AM.                                                                                          

Document Name Date/Time Subjects
2009-02-25 Denali KidCare, CHIP.PDF SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
2009-02-25 Denali KidCare, CHIP.PDF SFIN 2/25/2009 9:00:00 AM
SB 87
Prese Release.doc SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 Changes in CS vs.P.doc SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 Sponsor Stmt.doc SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 Support. Am Legion,VFW,DAV.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
Repercussions.pdf SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
Poverty Guidelines.pdf SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
Kaiser Report.pdf SFIN 2/25/2009 9:00:00 AM
SB 13
Background of SCHIP.pdf SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
SB 45 Support Ak Com on Aging022309.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
Amendment 1 Thonmas.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 Support. US Sen Begich 022009.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 Support.AARP to SFIN co Chairs.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
SB 45 vs E sectional.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
SB013-DHSS-PAFS-02-24-09.pdf SFIN 2/25/2009 9:00:00 AM
SB 13
SB013-DHSS-PAFS-02-24-09.pdf SFIN 2/25/2009 9:00:00 AM
SB 13
SCHIP Cost Sharing Rules.pdf SFIN 2/25/2009 9:00:00 AM
SB 13
SB45-DMVA-VS-2-23-09.pdf SFIN 2/25/2009 9:00:00 AM
SB 45
sectional.pdf SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
Sponsor statement 4 - No Child Left Uninsured.doc SFIN 2/25/2009 9:00:00 AM
SB 87
sponsor statement.pdf SFIN 2/25/2009 9:00:00 AM
SFIN 3/11/2009 9:00:00 AM
SB 13
Wielechowski kid's health care facts 2.doc SFIN 2/25/2009 9:00:00 AM
SB 87
Wielechowski kid's health care facts 3.doc SFIN 2/25/2009 9:00:00 AM
SB 87
Wielechowski kid's health care facts 4.doc SFIN 2/25/2009 9:00:00 AM
SB 87
Wielechowski kid's health care facts.doc SFIN 2/25/2009 9:00:00 AM
SB 87