Legislature(2015 - 2016)SENATE FINANCE 532

03/03/2016 09:00 AM FINANCE

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Audio Topic
09:04:11 AM Start
09:06:04 AM SB74
10:49:47 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+= SB 74 MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES TELECONFERENCED
Heard & Held
+ Bills Previously Heard/Scheduled TELECONFERENCED
                 SENATE FINANCE COMMITTEE                                                                                       
                       March 3, 2016                                                                                            
                         9:04 a.m.                                                                                              
                                                                                                                                
9:04:11 AM                                                                                                                    
                                                                                                                                
CALL TO ORDER                                                                                                                 
                                                                                                                                
Co-Chair  MacKinnon  called  the  Senate  Finance  Committee                                                                    
meeting to order at 9:04 a.m.                                                                                                   
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Anna MacKinnon, Co-Chair                                                                                                
Senator Pete Kelly, Co-Chair                                                                                                    
Senator Peter Micciche, Vice-Chair                                                                                              
Senator Click Bishop                                                                                                            
Senator Mike Dunleavy                                                                                                           
Senator Lyman Hoffman                                                                                                           
Senator Donny Olson                                                                                                             
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
None                                                                                                                            
                                                                                                                                
ALSO PRESENT                                                                                                                  
                                                                                                                                
Erin  Shine, Staff,  Senator Anna  MacKinnon; Jon  Sherwood,                                                                    
Deputy  Commissioner,  Medicaid   and  Health  Care  Policy,                                                                    
Department of Health and  Social Services; Heather Shadduck,                                                                    
Staff, Senator  Pete Kelly; Kate Glover,  Legislative Legal,                                                                    
Juneau; Senator  Cathy Giessel, Sponsor; Chuck  Kopp, Staff,                                                                    
Senator Peter Micciche.                                                                                                         
                                                                                                                                
PRESENT VIA TELECONFERENCE                                                                                                    
                                                                                                                                
Jay  Butler,  Chief  Medical Officer/Director,  Division  of                                                                    
Public Health,  DHSS; Jeff Jessee, Chief  Executive Officer,                                                                    
Alaska  Mental  Health   Trust  Authority;  Becky  Hultberg,                                                                    
President, AK  State Hospital and Nursing  Home Association,                                                                    
Anchorage.                                                                                                                      
                                                                                                                                
SUMMARY                                                                                                                       
                                                                                                                                
SB 74     MEDICAID REFORM/PFD/HSAS/ER USE/STUDIES                                                                               
                                                                                                                                
          SB 74 was HEARD and HELD in committee for further                                                                     
          consideration.                                                                                                        
                                                                                                                                
SENATE BILL NO. 74                                                                                                            
                                                                                                                                
     "An Act relating to  permanent fund dividends; relating                                                                    
     to a medical assistance  reform program; establishing a                                                                    
     personal  health savings  account  program for  medical                                                                    
     assistance recipients;  relating to  the duties  of the                                                                    
     Department of Health  and Social Services; establishing                                                                    
     medical   assistance    demonstration   projects;   and                                                                    
     relating to  a study  by the  Department of  Health and                                                                    
     Social Services."                                                                                                          
                                                                                                                                
9:06:04 AM                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  shared that there would  be an Amendment                                                                    
27  from  Senator Mia  Costello's  office.  She shared  that                                                                    
there may be a recess in the meeting.                                                                                           
                                                                                                                                
ERIN  SHINE,  STAFF,  SENATOR ANNA  MACKINNON,  shared  that                                                                    
there  were 26  amendments that  were before  the committee.                                                                    
She  remarked   that  she   had  worked   with  individuals,                                                                    
departments,  and staff  to address  the concerns  raised in                                                                    
the subcommittee and committee processes.                                                                                       
                                                                                                                                
Co-Chair  MacKinnon  shared   that  there  were  individuals                                                                    
online that would be available for questions and testimony.                                                                     
                                                                                                                                
Co-Chair MacKinnon  remarked that  the first  amendments had                                                                    
worked with Department of Health  and Social Services (DHSS)                                                                    
to enhance the bill.                                                                                                            
                                                                                                                                
JON SHERWOOD, DEPUTY COMMISSIONER,  MEDICAID AND HEALTH CARE                                                                    
POLICY,   DEPARTMENT   OF   HEALTH  AND   SOCIAL   SERVICES,                                                                    
introduced himself.                                                                                                             
                                                                                                                                
Vice-Chair Micciche  MOVED to ADOPT Amendment  1, 29-LS0692\                                                                    
V. l6, Bruce/Glover 2/29/16 (copy on file):                                                                                     
                                                                                                                                
     Page 11, line 8, following "on":                                                                                           
     Insert "at least"                                                                                                          
                                                                                                                                
     Page 14, line 22, following "on":                                                                                          
     Insert "at least"                                                                                                          
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood explained  the amendment.  He stated  that the                                                                    
amendment  would allow  for pharmacies  to more  than weekly                                                                    
update the database.                                                                                                            
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 1 was adopted.                                                                                             
                                                                                                                                
Vice-Chair Micciche  MOVED to ADOPT Amendment  2, 29-LS0692\                                                                    
V.46, Glover, 3/2/16 (copy on file):                                                                                            
                                                                                                                                
     Page 13, line 4:                                                                                                           
     Delete "under the program"                                                                                                 
     Insert "provided to recipients of medical assistance"                                                                      
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood  explained Amendment  2.  He  stated that  the                                                                    
amendment  would  allow  for  the  Medicaid  pharmacists  to                                                                    
examine  all prescriptions  for Medicaid  recipients, rather                                                                    
than  the  prescriptions paid  for  by  Medicaid. He  stated                                                                    
that, when someone  abused the system, they may  pay in cash                                                                    
for  prescriptions in  addition  to receiving  prescriptions                                                                    
through Medicaid.  The amendment would allow  the department                                                                    
to identify fraudulent activity.                                                                                                
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 2 was adopted.                                                                                             
                                                                                                                                
Vice-Chair  Micciche   MOVED  to  ADOPT  Amendment   3,  29-                                                                    
LS0692\V. l7, Glover, 2/29/16 (copy on file):                                                                                   
                                                                                                                                
     Page 17, lines 14- 15:                                                                                                     
                                                                                                                                
     Delete "An  enrolled medical assistance  provider shall                                                                    
     conduct  at least  one annual  review or  audit of  all                                                                    
     claims  submitted to  the department  for reimbursement                                                                    
     and, if'                                                                                                                   
                                                                                                                                
     Insert  "Unless a  provider is  being audited  under AS                                                                    
     47.05.200(a), an  enrolled medical  assistance provider                                                                    
     shall  conduct   a  biennial  review  or   audit  of  a                                                                    
     statistically valid  sample of claims submitted  to the                                                                    
     department for reimbursement. If'                                                                                          
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood explained  Amendment  3.  The amendment  would                                                                    
make  a  change  to  replace   the  original  language  with                                                                    
language  that would  reduce  the  administrative burden  of                                                                    
providers who  would be undergoing  a review.  The amendment                                                                    
would change to  a statistically valid sample  of claims, as                                                                    
defined in statute.                                                                                                             
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 3 was adopted.                                                                                             
                                                                                                                                
9:10:32 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche   MOVED  to  ADOPT  Amendment   4,  29-                                                                    
LS0692\V.8, Glover, 2/26/16 (copy on file):                                                                                     
                                                                                                                                
     Page 20, line 5, following "include":                                                                                      
     Insert "one or more of the following:"                                                                                     
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood explained Amendment 4.  He stated that it was a                                                                    
minor  language clarification  to  allow  the department  to                                                                    
redesign the payment system with  more than one of the items                                                                    
listed in A through D of that section.                                                                                          
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 4 was adopted.                                                                                             
                                                                                                                                
Vice-Chair  Micciche   MOVED  to  ADOPT  Amendment   5,  29-                                                                    
LS0692\V. I 8, Glover, 2/29/16 (copy on file):                                                                                  
                                                                                                                                
     Page 20, line 19, following "models":                                                                                      
     Insert "supported by evidence-based practices"                                                                             
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood explained Amendment 5.  He stated that it was a                                                                    
minor  language  clarification  to ensure  that  the  health                                                                    
delivery  model  was  designed  to  encourage  wellness  and                                                                    
disease prevention as an evidence-based practice.                                                                               
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 5 was adopted.                                                                                             
                                                                                                                                
Vice-Chair  Micciche   MOVED  to  ADOPT  Amendment   6,  29-                                                                    
LS0692\V.20, Glover, 2/29/16 (copy on file):                                                                                    
                                                                                                                                
     Page 21, line 10:                                                                                                          
     Delete "October"                                                                                                           
     Insert "November"                                                                                                          
                                                                                                                                
     Page 27, line 18:                                                                                                          
     Delete "June 30, 2019"                                                                                                     
     Insert "November 15, 2019"                                                                                                 
                                                                                                                                
     Page 27, line 20:                                                                                                          
     Delete "June 30"                                                                                                           
     Insert "November 15"                                                                                                       
                                                                                                                                
     Page 28, line 17:                                                                                                          
     Delete "October"                                                                                                           
     Insert "November"                                                                                                          
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood  explained Amendment 6.  He stated that  it was                                                                    
the department's  recommendation to simplify.  The amendment                                                                    
would standardize reporting dates as  November 15 as the due                                                                    
date. The date was chosen,  because often the data would not                                                                    
be available until November.                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 6 was adopted.                                                                                             
                                                                                                                                
Vice-Chair Micciche  MOVED to ADOPT Amendment  7, 29-LS0692\                                                                    
V.9, Nauman/Glover, 2/26/16 (copy on file):                                                                                     
                                                                                                                                
     Page 22, line 8:                                                                                                           
     Delete "average"                                                                                                           
                                                                                                                                
     Page 22, line 9:                                                                                                           
     Delete "each"                                                                                                              
     Insert "the average"                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood explained  Amendment 7.  He remarked  that the                                                                    
department  assumed that  the committee  would want  to know                                                                    
the  average cost,  rather  than  each Medicaid  recipient's                                                                    
expenses from year to year.                                                                                                     
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 7 was adopted.                                                                                             
                                                                                                                                
Vice-Chair Micciche  MOVED to ADOPT Amendment  8, 29-LS0692\                                                                    
V.35, Nauman/Glover, 3/1/16 (copy on file):                                                                                     
                                                                                                                                
     Page 22, line 26, following "of':                                                                                          
     Insert "appropriate"                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood explained  Amendment 8.  It would  clarify the                                                                    
language to say  that the contract would be  to increase the                                                                    
appropriate  use  of  primary   and  preventative  care;  as                                                                    
opposed to "just" increase the use.                                                                                             
                                                                                                                                
Senator   Dunleavy    queried   documented    instances   of                                                                    
inappropriate   use,   as   the   reason   for   the   word,                                                                    
"appropriate."  Mr. Sherwood  replied  that some  preventive                                                                    
measures may not be appropriate  for certain individuals. He                                                                    
stated that  an individual  be screened  for an  issue every                                                                    
year.                                                                                                                           
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 8 was adopted.                                                                                             
                                                                                                                                
9:15:22 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche   MOVED  to  ADOPT  Amendment   9,  29-                                                                    
LS0692\V. l9, Glover, 2/29/16 (copy on file).                                                                                   
                                                                                                                                
     Page 23, line 1, following "subsection":                                                                                   
     Insert", except that the department may exempt                                                                             
     recipients with chronic, acute, or terminal medical                                                                        
     conditions from the requirement under this paragraph"                                                                      
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood  explained Amendment  9.  He  stated that  the                                                                    
language  was  intended  to  ensure  that  individuals  with                                                                    
multiple  hospitalizations in  the  normal  course of  their                                                                    
condition,   would  not   necessarily  be   subject  to   an                                                                    
additional layer of case management.  He used the example of                                                                    
individuals in hospital care.                                                                                                   
                                                                                                                                
Senator Bishop stated that he question was addressed.                                                                           
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 9 was adopted.                                                                                             
                                                                                                                                
Vice-Chair Micciche MOVED to ADOPT Amendment 10, 29-                                                                            
LS0692\V.ll, Glover, 2/26/16 (copy on file):                                                                                    
                                                                                                                                
     Page 25, line 22:                                                                                                          
     Delete "projects"                                                                                                          
     Insert "at least one project"                                                                                              
     Following "may":                                                                                                           
     Insert  "annually  request   proposals  for  additional                                                                    
     projects under this  section thereafter. The department                                                                    
     may"                                                                                                                       
                                                                                                                                
     Page 25, line 23, following "AS 36.30.308":                                                                                
     Insert "to  award a contract  for a project  under this                                                                    
     section"                                                                                                                   
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood explained Amendment 10. He shared that the                                                                         
amendment would make the care coordination demo projects an                                                                     
annual process, rather than a one-time process.                                                                                 
                                                                                                                                
Co-Chair MacKinnon WITHDREW her OBJECTION. There being NO                                                                       
OBJECTION, Amendment 10 was adopted.                                                                                            
                                                                                                                                
Vice-Chair Micciche MOVED to ADOPT Amendment 11, "29-                                                                           
LS0692\ V .41, Glover, 3/2/16 (copy on file):                                                                                   
                                                                                                                                
     Page 27, line 29:                                                                                                          
     Delete "identify"                                                                                                          
     Insert "include the following information:"                                                                                
                                                                                                                                
     Page 28, lines 14 - 15:                                                                                                    
     Delete all material and insert:                                                                                            
     "(8)  the most  recent payment  error rate  measurement                                                                    
     report  for the  medical assistance  program, including                                                                    
     fee  for service  programs and  pilot or  demonstration                                                                    
     projects; the report must also  explain the reasons for                                                                    
     the payment  errors and the  total amount of  state and                                                                    
     federal  funds  paid  in  error  during  the  reporting                                                                    
     period and not recovered by  the department at the time                                                                    
     of the report;"                                                                                                            
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood announced that he had lost his place.                                                                              
                                                                                                                                
                                                                                                                                
Ms. Shine  stated that  there may be  a drafting  error, and                                                                    
should read, "page 28, line 29."                                                                                                
                                                                                                                                
9:17:48 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:18:15 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Mr. Sherwood  continued to explain  Amendment 11.  He stated                                                                    
that it  amended page  28, lines  14 and  15 to  replace the                                                                    
language  related to  reporting  on the  Payment Error  Rate                                                                    
Measurement (PERM).  He stated  that the PERM  was conducted                                                                    
by the  federal government every three  years. The amendment                                                                    
would  require the  department to  provide  the most  recent                                                                    
PERM report.                                                                                                                    
                                                                                                                                
Co-Chair MacKinnon  remarked that  there was  some confusion                                                                    
with the amendment.                                                                                                             
                                                                                                                                
Ms.  Shine clarified  that on  page  27, line  29, it  would                                                                    
identify  and  include the  information  to  conform to  the                                                                    
changes presented on  page 28, lines 14 through  15 with the                                                                    
PERM audit changes.                                                                                                             
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 11 was adopted.                                                                                            
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  12,  29-                                                                    
LS0692\V.26, Glover, 2/29/16 (copy on file):                                                                                    
                                                                                                                                
     Page 28, line 22:                                                                                                          
     Delete "[COMMUNITY]"                                                                                                       
     Insert "community"                                                                                                         
                                                                                                                                
     Page 28, line 30:                                                                                                          
     Delete "[COMMUNITY]"                                                                                                       
     Insert "community"                                                                                                         
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr. Sherwood  explained Amendment  12. He remarked  that, in                                                                    
Alaska  statutes, "Community  Health  Clinic" is  a term  of                                                                    
art. The department  felt that aligning with  the term would                                                                    
be easiest.                                                                                                                     
                                                                                                                                
                                                                                                                                
Co-Chair MacKinnon surmised that the amendment was                                                                              
reinserting original language. Mr. Sherwood responded in                                                                        
the affirmative.                                                                                                                
                                                                                                                                
Co-Chair MacKinnon WITHDREW her OBJECTION. There being NO                                                                       
OBJECTION, Amendment 12 was adopted.                                                                                            
                                                                                                                                
Vice-Chair Micciche MOVED to ADOPT Amendment 13, 29-                                                                            
LS0692\V.12, Nauman, 2/26/16 (copy on file):                                                                                    
                                                                                                                                
     Page 30, line 9:                                                                                                           
     Delete "adopts a final rule updating its"                                                                                  
     Insert "issues a final"                                                                                                    
                                                                                                                                
     Page 30, line 12, following "notify":                                                                                      
     Insert "and submit a report to"                                                                                            
                                                                                                                                
     Page 30, line 12, following the second occurrence of                                                                       
     "the":                                                                                                                     
     Insert "house and"                                                                                                         
                                                                                                                                
     Page 30, line 12:                                                                                                          
     Delete "committee"                                                                                                         
     Insert "committees"                                                                                                        
                                                                                                                                
     Page 30, lines 12 - 13:                                                                                                    
     Delete "and submit a report to the co-chairs of the                                                                        
     senate finance committee"                                                                                                  
                                                                                                                                
     Page 30, line 14:                                                                                                          
     Delete "rule change"                                                                                                       
     Insert "final policy"                                                                                                      
                                                                                                                                
     Page 30, line 15:                                                                                                          
     Delete "adopts the final rule"                                                                                             
     Insert "issues the final policy"                                                                                           
                                                                                                                                
     Page 30, line 16:                                                                                                          
     Delete "rule"                                                                                                              
     Insert "policy"                                                                                                            
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Mr.  Sherwood  explained  Amendment 13.  The  amendment  was                                                                    
intended  to  reflect  the  fact  that  the  federal  policy                                                                    
referenced  was not  issued as  a  final rule,  rather as  a                                                                    
policy letter to state health officials. The                                                                                    
                                                                                                                                
Co-Chair MacKinnon  shared that  the intent of  the language                                                                    
was to allow the department to integrate the policy.                                                                            
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 13 was adopted.                                                                                            
                                                                                                                                
Co-Chair   MacKinnon  wondered   if   the  following   three                                                                    
amendments  should  be   addressed  immediately.  Ms.  Shine                                                                    
replied that it was at the chair's discretion.                                                                                  
                                                                                                                                
9:23:00 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:23:13 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
9:24:14 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  24,  29-                                                                    
LS0692\V.43, Nauman/Glover, 3/2/16 (copy on file):                                                                              
                                                                                                                                
     Page 14, line 7:                                                                                                           
     Delete"~"                                                                                                                  
     Insert "review the information in"                                                                                         
     Page 14, line 9, following "patient":                                                                                      
     Insert  ";   the  regulations   must  provide   that  a                                                                    
     pharmacist or  practitioner is  not required  to review                                                                    
     the  information  in  the database  before  dispensing,                                                                    
     prescribing,  or administering  a controlled  substance                                                                    
     to a person who is receiving treatment                                                                                     
     (A) in an inpatient setting                                                                                                
     (B) at  the scene of  an emergency or in  an ambulance;                                                                    
     in  this  subparagraph,  "ambulance"  has  the  meaning                                                                    
     given in AS 18.08.200;                                                                                                     
     (C) in an emergency room; or                                                                                               
     (D)  immediately before,  during, or  within the  first                                                                    
     hours after surgery"                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
JAY  BUTLER,  CHIEF  MEDICAL OFFICER/DIRECTOR,  DIVISION  OF                                                                    
PUBLIC   HEALTH,   DHSS  (via   teleconference),   explained                                                                    
Amendment 24.                                                                                                                   
                                                                                                                                
                                                                                                                                
Co-Chair  MacKinnon queried  the reason  for the  amendment.                                                                    
Ms. Shine  replied that there  was work with  the department                                                                    
to  consider the  committee's  concerns.  She remarked  that                                                                    
there  was a  thought that  there may  be an  inhibited best                                                                    
practice, should there be a  mandate to check the BDMP prior                                                                    
to  administering a  controlled substance  in an  emergency,                                                                    
inpatient, or surgery situation.                                                                                                
                                                                                                                                
Senator Olson looked at line  7 of the amendment, he queried                                                                    
the  interplay between  community health  aides. Dr.  Butler                                                                    
replied  that the  amendment focused  on providers  who were                                                                    
prescribing  opioids,  which  required  a  Drug  Enforcement                                                                    
Administration (DEA)  number. He explained that  any opioids                                                                    
administered  under   the  prescriptive  authority   of  the                                                                    
regional  medical  director  or supervisor;  so  the  health                                                                    
aides would be covered.                                                                                                         
                                                                                                                                
Senator Olson looked  at line 8 of the  amendment, and noted                                                                    
that the  word "opioid" was  not included. He  remarked that                                                                    
controlled  substances  included other  medications  besides                                                                    
opioids. Dr.  Butler agreed. He explained  that the language                                                                    
addressed  the potential  mixed substance  preparations that                                                                    
may include an opioid and  other substances. He felt that it                                                                    
may clarify  the class of substances  that included opioids,                                                                    
while  capturing   a  broader  collection   of  prescription                                                                    
medications that could be abused.  He remarked that focusing                                                                    
on only  on opioids  could potentially  drive people  to use                                                                    
other substances.                                                                                                               
                                                                                                                                
9:29:04 AM                                                                                                                    
                                                                                                                                
Senator  Olson  remarked  that  opioids  were  high  on  the                                                                    
schedule list.  He did not  understand why the PDMP  must be                                                                    
consulted  in  the  lesser  addictive  substances.  Co-Chair                                                                    
MacKinnon  felt that  the  following  amendment may  address                                                                    
some concerns.                                                                                                                  
                                                                                                                                
Dr.  Butler  agreed,  and  felt that  the  question  may  be                                                                    
addressed in the following amendment.                                                                                           
                                                                                                                                
Vice-Chair  Micciche  remarked  that  the  amendment  was  a                                                                    
reasonable compromise,  and would limit  overprescribing. He                                                                    
appreciated the proposed solution.                                                                                              
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 24 was adopted.                                                                                            
                                                                                                                                
Vice-Chair Micciche MOVED to  ADOPT Amendment 25, 29-LS0692\                                                                    
V.44, Bruce/Glover, 3/2/16 (copy on file).                                                                                      
                                                                                                                                
Co-Chair MacKinnon OBJECTED for DISCUSSION.                                                                                     
                                                                                                                                
Ms.  Shine  explained  Amendment  25. She  stated  that  the                                                                    
amendment addressed  the sections related to  which drugs on                                                                    
the  federal and  state  levels would  be  addressed in  the                                                                    
PDMP.  She remarked  that someone  prescribing a  controlled                                                                    
substance would have a DEA  number that would align with the                                                                    
federal  controlled substance  list. She  believed that  the                                                                    
state   controlled  substance   list   was   used  for   law                                                                    
enforcement. She stressed that  in all sections of 17.30.200                                                                    
state  classes  1.A,  2.A,  3.A,  4.A,  and  5.A,  would  be                                                                    
removed.  She furthered  that the  federal classes  1 and  5                                                                    
were removed.                                                                                                                   
                                                                                                                                
Dr. Butler explained  that the goal of the  amendment was to                                                                    
decrease the  burden of  the requirement of  the use  of the                                                                    
PDMP as much as possible. He echoed Ms. Shine's comments.                                                                       
                                                                                                                                
Vice-Chair  Micciche  remarked  that the  intention  was  to                                                                    
relieve  the burden  on  physicians,  while also  protecting                                                                    
Alaskans from overprescribing  for Class 2, 3,  and 4 drugs,                                                                    
which included the opioids. Dr. Butler agreed.                                                                                  
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 25 was adopted.                                                                                            
                                                                                                                                
Dr. Butler thanked  the committee for the hard  work to what                                                                    
is best  for Alaskans,  and address  the challenges  of drug                                                                    
overdose.                                                                                                                       
                                                                                                                                
9:36:43 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  14,  29-                                                                    
LS0692\V.34, Glover, 3/1/16 (copy on file):                                                                                     
                                                                                                                                
     Page 23, line 29, following "(d)":                                                                                         
     Insert "and (f)"                                                                                                           
                                                                                                                                
     Page 24, following line 8:                                                                                                 
     Insert a new subsection to read:                                                                                           
     "(f) Notwithstanding (a) - (c)  of this section, and in                                                                    
     addition to  the projects and services  described under                                                                    
     ( d)  and (  e) of this  section, the  department shall                                                                    
     apply  for  a  section  1115  waiver  under  42  U.S.C.                                                                    
     1315(a)   to  establish   one  or   more  demonstration                                                                    
     projects  focused on  improving the  state's behavioral                                                                    
     health  system for  medical assistance  recipients. The                                                                    
     department shall engage  stakeholders and the community                                                                    
     in the development of a  project or projects under this                                                                    
     subsection. The demonstration  project or projects must                                                                    
     be  consistent with  the  comprehensive and  integrated                                                                    
     behavioral   health   program    described   under   AS                                                                    
     47.05.270(b)."                                                                                                             
                                                                                                                                
     Reletter the following subsection accordingly.                                                                             
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
JEFF JESSEE,  CHIEF EXECUTIVE OFFICER, ALASKA  MENTAL HEALTH                                                                    
TRUST AUTHORITY (via teleconference), introduced himself.                                                                       
                                                                                                                                
Ms.  Shine  explained  Amendment  14. She  stated  that  the                                                                    
section  was  attempting  to address  some  behavior  health                                                                    
issues.                                                                                                                         
                                                                                                                                
Mr.  Jessee stressed  that the  amendment  was an  important                                                                    
amendment to make the Medicaid program sustainable.                                                                             
                                                                                                                                
Co-Chair  MacKinnon  surmised  that the  amendment  did  not                                                                    
commit  Alaska  to  a  long-term group,  but  rather  was  a                                                                    
project. Mr. Jessee agreed.                                                                                                     
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 14 was adopted.                                                                                            
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  15,  29-                                                                    
LS0692\V.36, Bruce/Glover, 3/1/16 (copy on file):                                                                               
                                                                                                                                
     Page 20, line 31:                                                                                                          
     Delete "primary care providers"                                                                                            
     Insert  "licensed   or  certified  mental   health  and                                                                    
     primary care professionals"                                                                                                
                                                                                                                                
     Page 21, line 1, following "services":                                                                                     
     Insert ", minimize administrative burdens,"                                                                                
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Ms. Shine explained Amendment 15.                                                                                               
                                                                                                                                
                                                                                                                                
Mr. Jessee  explained that it  was important to  ensure that                                                                    
in integrated  settings there was  the ability to  utilize a                                                                    
range of professionals who  could provide services necessary                                                                    
to  ensure immediate  and efficient  services. He  furthered                                                                    
that the amendment also clarified  that it was the intent to                                                                    
minimize the administrative burdens on providers.                                                                               
                                                                                                                                
Senator  Olson looked  at the  language related  to licenses                                                                    
and  the   certified  professionals.  He  wondered   if  the                                                                    
licenses were  issued on a  national or regional  level. Mr.                                                                    
Jessee  stated that  there were  a  number of  certification                                                                    
entities.                                                                                                                       
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 15 was adopted.                                                                                            
                                                                                                                                
9:42:25 AM                                                                                                                    
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  16,  29-                                                                    
LS0692\V.13, Glover, 2/26/16 (copy on file):                                                                                    
                                                                                                                                
     Page 31, line 13:                                                                                                          
     Delete "Alaska Mental Health Trust Authority"                                                                              
     Insert "Department of Health and Social Services, in                                                                       
     conjunction with the Alaska                                                                                                
     Mental Health Trust Authority,"                                                                                            
                                                                                                                                
     Page 31, line 14, following "The":                                                                                         
     Insert "Department of Health and Social Services and                                                                       
     the"                                                                                                                       
                                                                                                                                
     Page 31, line 15, following "a":                                                                                           
     Insert "joint"                                                                                                             
                                                                                                                                
     Page 31, line 15, following the second occurrence of                                                                       
     "the":                                                                                                                     
     Insert "Department of Health and Social Services and                                                                       
     the"                                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Ms.  Shine  explained  Amendment  16.  He  shared  that  the                                                                    
amendment was crafted with the help of Mr. Jessee.                                                                              
                                                                                                                                
Mr.  Jessee announced  that the  amendments was  intended to                                                                    
have a  feasibility study of privatizing  services delivered                                                                    
at  the Alaska  Psychiatric  Institute. He  shared that  the                                                                    
trustees were willing to participate.                                                                                           
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 16 was adopted.                                                                                            
                                                                                                                                
Mr. Jessee thanked the committee and staff.                                                                                     
                                                                                                                                
9:45:03 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:45:31 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
9:45:36 AM                                                                                                                    
                                                                                                                                
Co-Chair Kelly MOVED to  ADOPT Amendment 17, 29-LS0692\V.3l,                                                                    
Glover, 3/1/16 (copy on file).                                                                                                  
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
HEATHER  SHADDUCK,  STAFF,  SENATOR  PETE  KELLY,  explained                                                                    
Amendment 17.  She stated that  the amendment  addressed the                                                                    
current  Section   3  as  related  to   the  Alaska  Medical                                                                    
Assistance False  Claim and Reporting  Act. She  shared that                                                                    
there was feedback from providers  across the state who felt                                                                    
that  the current  provisions relating  a private  plaintiff                                                                    
and their right of action was  "a little scary." There was a                                                                    
concern  about  frivolous  lawsuit. A  sunset  was  inserted                                                                    
after three years  related to all provisions  related to the                                                                    
private plaintiff. The  intent was to allow  for enough time                                                                    
to  explore the  possibility of  frivolous lawsuits  against                                                                    
providers. The amendment also allowed  for the Department of                                                                    
Law to present  to the legislature in three  years to either                                                                    
remove the sunset or alter problems in the sections.                                                                            
                                                                                                                                
KATE GLOVER, LEGISLATIVE LEGAL, JUNEAU, spoke aloud.                                                                            
                                                                                                                                
Ms.  Shadduck  outlined the  details  of  Amendment 17.  She                                                                    
noted the new Section 4,  which referred back to the sunset.                                                                    
The section of the bill  related to subpoenas would continue                                                                    
in  law after  the  sunset. The  section  would take  effect                                                                    
after July  1, 2019, which  coincided with the  sunset date.                                                                    
The added Section 5 would  be a similar provision related to                                                                    
the Whistleblower Act,  so it would remove  the reference to                                                                    
the private  plaintiff. That section would  also take effect                                                                    
after July 1, 2019.                                                                                                             
                                                                                                                                
Co-Chair  MacKinnon asked  for  more  information about  the                                                                    
technical aspects of the amendment.  Ms. Glover replied that                                                                    
the amendment would remove statutes  that had been repealed.                                                                    
She  shared that  there was  also a  reference to  the court                                                                    
rules  that   would  affected  by  the   repeal  of  certain                                                                    
sections.                                                                                                                       
                                                                                                                                
Ms. Shadduck noted  that the actual sunset was on  page 2 of                                                                    
the amendment.                                                                                                                  
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
further OBJECTION, Amendment 17 was adopted.                                                                                    
                                                                                                                                
9:49:39 AM                                                                                                                    
                                                                                                                                
Co-Chair Kelly MOVED to  ADOPT Amendment 18, 29-LS0692\V.38,                                                                    
Glover, 3/2/16 (copy on file):                                                                                                  
                                                                                                                                
     Page 25, line 25:                                                                                                          
     Delete "one"                                                                                                               
     Insert "three"                                                                                                             
                                                                                                                                
     Page 25, line 28, following the second occurrence of                                                                       
     services":                                                                                                                 
     Insert "and coordination of long-term services and                                                                         
     support"                                                                                                                   
                                                                                                                                
     Page 26, line 8:                                                                                                           
     Delete "benefits and services"                                                                                             
     Insert    "benefits,    services,    and    utilization                                                                    
     management"                                                                                                                
                                                                                                                                
     Page 26, lines 15 - 16:                                                                                                    
     Delete all material and insert:                                                                                            
     "(2) the commissioner of administration, or the                                                                            
     commissioner's designee;"                                                                                                  
                                                                                                                                
     Page 26, line 19:                                                                                                          
     Delete "three"                                                                                                             
     Insert "two"                                                                                                               
                                                                                                                                
     Page 26, line 20, following "governor":                                                                                    
     Insert "for staggered three-year terms"                                                                                    
                                                                                                                                
     Page 26, lines 27 - 29:                                                                                                    
     Delete "A contract  shall provide for a fee  based on a                                                                    
     per capita expense that is fair and economical."                                                                           
                                                                                                                                
     Page 26, line 29:                                                                                                          
     Following "structure":                                                                                                     
     Insert "for a contract under this subsection"                                                                              
     Following the second occurrence of "payments,":                                                                            
     Insert "capitated payments,"                                                                                               
                                                                                                                                
     Page 26, line 30, following "structures.":                                                                                 
     Insert "The department shall work  with the division of                                                                    
     insurance,  Department  of   Commerce,  Community,  and                                                                    
     Economic  Development,  to streamline  the  application                                                                    
     process  for  a  company  to obtain  a  certificate  of                                                                    
     authority required  under AS  2 l .09.010  as necessary                                                                    
     to participate  in a  demonstration project  under this                                                                    
     section."                                                                                                                  
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Ms. Shadduck explained Amendment 18. She stated that                                                                            
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, There  being NO OBJECTION,  and Amendment  18 was                                                                    
adopted.                                                                                                                        
                                                                                                                                
Senator Olson MOVED to ADOPT  Amendment 19, 29-LS0692\ V.25,                                                                    
Glover, 2/29/16 (copy on file):                                                                                                 
                                                                                                                                
     Page 22, line 27, following "the":                                                                                         
     Insert "unnecessary"                                                                                                       
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Senator  Olson  explained Amendment  19.  He  felt that  the                                                                    
change would ensure  that there was not undue  burden on the                                                                    
entities.                                                                                                                       
                                                                                                                                
Co-Chair MacKinnon  wondered if the department  accepted the                                                                    
amendment.                                                                                                                      
                                                                                                                                
Mr.  Sherwood   responded  that  the  department   felt  the                                                                    
amendment was reasonable clarifying language.                                                                                   
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
further OBJECTION, Amendment 19 was adopted.                                                                                    
                                                                                                                                
9:55:02 AM                                                                                                                    
AT EASE                                                                                                                         
                                                                                                                                
9:57:18 AM                                                                                                                    
RECONVENED                                                                                                                      
                                                                                                                                
Senator Bishop WITHDREW Amendment 20.                                                                                           
                                                                                                                                
Co-Chair   MacKinnon  appreciated   that  the   offices  had                                                                    
submitted amendments.                                                                                                           
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  21,  29-                                                                    
LS0692\V.30, Glover, 3/1/16 (copy on file).                                                                                     
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Vice-Chair  Micciche explained  Amendment 21.  The amendment                                                                    
was  a  response to  the  recommendation  of the  2015  DHSS                                                                    
performance review,  which estimated  that the  change would                                                                    
provide  an annual  savings of  approximately $927,000.  The                                                                    
amendment would  require Pioneer  Home Seniors  applying for                                                                    
payment  assistance to  submit  to the  department proof  of                                                                    
Medicaid application  documentation of  Medicaid acceptance.                                                                    
He shared  that the department  agreed that this could  be a                                                                    
cost-saving  measure,  as  long  as   it  was  tied  to  the                                                                    
application   for  payment   assistance   rather  than   the                                                                    
application for  admittance to the  Pioneer Home  wait list.                                                                    
He  noted that  the  amendment clearly  stated  that it  was                                                                    
simply a condition for receipt of payment assistance.                                                                           
                                                                                                                                
Co-Chair MacKinnon detailed the amendment.                                                                                      
                                                                                                                                
Vice-Chair Micciche  felt that the amendment  was adequately                                                                    
covered.  The remaining  pages  were  renumbering the  other                                                                    
sections accordingly.                                                                                                           
                                                                                                                                
Senator Olson  looked at the  inserted language on  page 29,                                                                    
and wondered what would occur without the decision letter.                                                                      
                                                                                                                                
10:00:10 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:08:16 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
10:08:49 AM                                                                                                                   
                                                                                                                                
Vice-Chair Micciche replied  that in order for  the state to                                                                    
realize the  $927,000, there was  the hope to  use federally                                                                    
sponsored  programs.  He stressed  that  the  intent was  to                                                                    
initially utilize federal programs.                                                                                             
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 21 was adopted.                                                                                            
                                                                                                                                
Vice-Chair Micciche MOVED to  ADOPT Amendment 22, 29-LS0692\                                                                    
V.45, Glover, 3/2/16 (copy on file).                                                                                            
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
BECKY  HULTBERG, PRESIDENT,  AK STATE  HOSPITAL AND  NURSING                                                                    
HOME ASSOCIATION, ANCHORAGE  (via teleconference), explained                                                                    
the amendment. She shared that  the amendment clarified that                                                                    
it was  a "team approach"  to the  project with the  goal of                                                                    
minimizing  the number  of frequent  users of  the emergency                                                                    
department services. The  amendment also removed unnecessary                                                                    
language,  and more  clearly  defined  the information  that                                                                    
would be shared through the electronic data interchange.                                                                        
                                                                                                                                
Co-Chair   MacKinnon   queried  additional   comments.   Ms.                                                                    
Hultberg thanked the committee.                                                                                                 
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 22 was adopted.                                                                                            
                                                                                                                                
10:14:40 AM                                                                                                                   
                                                                                                                                
Co-Chair Kelly MOVED to  ADOPT Amendment 26, 29-LS0692\V.49,                                                                    
Glover, 3/2/16 (copy on file).                                                                                                  
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Co-Chair MacKinnon explained that  most of the amendment was                                                                    
on page 31, lines 19 through 21.                                                                                                
                                                                                                                                
Ms.  Shadduck explained  Amendment  26. She  noted that  the                                                                    
first  section of  the  amendment was  the  title change  to                                                                    
reflect the remaining changes in the amendment.                                                                                 
                                                                                                                                
Co-Chair  MacKinnon  wondered  if  the  amendment  addressed                                                                    
Senator  Bishop's concerns.  Senator Bishop  replied in  the                                                                    
affirmative.   He  appreciated   that  there   were  several                                                                    
references to the private marketplace.                                                                                          
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 26 was adopted.                                                                                            
                                                                                                                                
10:18:27 AM                                                                                                                   
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  23,  29-                                                                    
LS0692\V.42, Glover, 3/2/16 (copy on file).                                                                                     
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
10:18:32 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:19:06 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
Ms. Shine  explained Amendment 23.  She stressed  that there                                                                    
were many changes within the amendment.                                                                                         
                                                                                                                                
10:21:26 AM                                                                                                                   
                                                                                                                                
Co-Chair  MacKinnon shared  that  Senator  Giessel would  be                                                                    
available at 10:30 am.                                                                                                          
                                                                                                                                
10:21:49 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:23:02 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
10:23:34 AM                                                                                                                   
                                                                                                                                
SENATOR  CATHY  GIESSEL,  SPONSOR announced  that  the  term                                                                    
"telehealth"  was   a  more  modern   term  than   the  word                                                                    
"telemedicine."  She  stressed that  telehealth  encompassed                                                                    
the word, telemedicine. She shared  that most state programs                                                                    
used the word, "telehealth.                                                                                                     
                                                                                                                                
Senator Olson  queried the definition of  AS 47.05270(e) Ms.                                                                    
Shine replied that  the definition was on page  22, line 15,                                                                    
which  was a  new  definition that  would  be inserted  into                                                                    
statute.  She noted  that there  were  two definitions  that                                                                    
were  exactly   the  same,  so  referencing   later  in  the                                                                    
amendment  addressed  back  to   statute.  She  stated  that                                                                    
telehealth  was  the  practice   of  health  care  delivery,                                                                    
evaluation, diagnosis, consultation,  or treatment using the                                                                    
transfer of health care data  through audio, visual, or data                                                                    
communications  that   were  performed  over  two   or  more                                                                    
locations  between providers  who were  physically separated                                                                    
for the  recipient; from each  other; or between  a provider                                                                    
and  a recipient  who were  physically  separated from  each                                                                    
other.                                                                                                                          
                                                                                                                                
Senator Olson  queried the definition of  "telehealth" under                                                                    
statute. Ms. Shine  replied that she did not  believe it was                                                                    
in existing statute.                                                                                                            
                                                                                                                                
Ms. Glover  stated that  there was  no definition  of either                                                                    
telehealth  or   telemedicine  currently  in   statute.  The                                                                    
definitions in the bill would be new definitions.                                                                               
                                                                                                                                
Senator  Olson queried  AS 47.05.270(e).  Ms. Shine  replied                                                                    
that it would be a new statute.                                                                                                 
                                                                                                                                
Co-Chair MacKinnon queried the  department's position of the                                                                    
use  of   telehealth.  Mr.   Sherwood  responded   that  the                                                                    
department   was  supportive   of  the   use  of   the  word                                                                    
"telehealth."                                                                                                                   
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, There  being NO OBJECTION,  and Amendment  23 was                                                                    
adopted.                                                                                                                        
                                                                                                                                
10:28:32 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:33:11 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
10:33:22 AM                                                                                                                   
                                                                                                                                
Vice-Chair  Micciche  MOVED  to   ADOPT  Amendment  27,  29-                                                                    
LS0692\V.48, Glover, 3/2/16 (copy on file).                                                                                     
                                                                                                                                
Co-Chair MacKinnon OBJECTED for discussion.                                                                                     
                                                                                                                                
Vice-Chair Micciche explained Amendment 27.                                                                                     
                                                                                                                                
Co-Chair   MacKinnon  shared   that   the  amendment   would                                                                    
incorporate SB 98 into the legislation.                                                                                         
                                                                                                                                
10:34:16 AM                                                                                                                   
                                                                                                                                
CHUCK  KOPP, STAFF,  SENATOR PETER  MICCICHE, explained  the                                                                    
amendment. He remarked that a  recent report showed that the                                                                    
use  of tele  psychiatry had  saved API  over $1  million in                                                                    
physician fees; $600,000 in  hospitalization; and $70,000 in                                                                    
travel in FY  15. He noted that one of  the challenges was a                                                                    
prohibition of out-of-state physicians  who were licensed in                                                                    
Alaska from  being able  to provide  health care.  He shared                                                                    
that  there was  a similar  problem with  the Department  of                                                                    
Corrections  (DOC)  being  able  to  stabilize  patients  in                                                                    
psychotic episodes; and the short supply of psychiatrists.                                                                      
                                                                                                                                
Mr.  Kopp noted  that  Sections  6 and  7  of the  amendment                                                                    
referred to the Board  of Professional Counselors; the Board                                                                    
of   Marital   and   Family   Therapists;   the   Board   of                                                                    
Psychologists  and  Psychological Associate  Examiners;  and                                                                    
the  Board  of  Social  Work Examiners.  The  amendment  was                                                                    
offered  by Senator  Giessel to  incorporate the  behavioral                                                                    
health therapists  who work in teams  at different locations                                                                    
with the same client.                                                                                                           
                                                                                                                                
10:39:26 AM                                                                                                                   
                                                                                                                                
Co-Chair MacKinnon wondered if  the remarks referred to page                                                                    
5, line 21.                                                                                                                     
                                                                                                                                
Mr. Kopp clarified that  the telemedicine business directory                                                                    
was created  through Department  of Commerce,  Community and                                                                    
Economic Development (DCCED). He  remarked that the name and                                                                    
contact  information of  each business  must be  included in                                                                    
the directory.                                                                                                                  
                                                                                                                                
Co-Chair  MacKinnon  hoped   that  a  forthcoming  committee                                                                    
substitute would incorporate the  changes. She remarked that                                                                    
the  final version  may not  move from  committee until  the                                                                    
following Monday.                                                                                                               
                                                                                                                                
Senator Olson noted that there  was a comment related to the                                                                    
Alaska State  Medical Association, but that  association did                                                                    
not  have regulatory  authority. He  queried the  opinion of                                                                    
the Alaska Medical Board on  the amendment. Mr. Kopp replied                                                                    
that the State  Medical Board was not in favor  of the build                                                                    
out of telemedicine.                                                                                                            
                                                                                                                                
Senator  Olson queried  the opposition  to telemedicine.  He                                                                    
wondered if  there was  merely a  resistance to  change. Mr.                                                                    
Kopp  replied  that  that he  agreed  with  that  assertions                                                                    
proposed  by Senator  Olson. He  stressed that  there was  a                                                                    
still an in state licensing requirement.                                                                                        
                                                                                                                                
10:42:39 AM                                                                                                                   
                                                                                                                                
Vice-Chair Micciche  remarked that the  board had a  list of                                                                    
requests.  He   felt  that  the  bill   may  make  providers                                                                    
uncomfortable, but  wanted to move  past the  resistance. He                                                                    
stressed that the  amendment would address the  high cost of                                                                    
health  care. He  felt that  the  board may  not oppose  the                                                                    
current version                                                                                                                 
                                                                                                                                
Senator Hoffman wondered why  the definition of telemedicine                                                                    
was different from the definition on page 22 of the bill.                                                                       
                                                                                                                                
10:44:24 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:44:50 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
10:44:52 AM                                                                                                                   
                                                                                                                                
Ms.  Shine explained  that the  definition in  the bill  was                                                                    
previously amended.                                                                                                             
                                                                                                                                
Co-Chair   MacKinnon   queried    the   previously   adopted                                                                    
amendment.  Ms.  Shine  replied that  she  believed  it  was                                                                    
Amendment 23.                                                                                                                   
                                                                                                                                
Vice-Chair   Micciche   felt   that  the   amendment   would                                                                    
significantly reduce travel costs  for lower level of health                                                                    
care.  He thanked  various members  of  the legislature  and                                                                    
legislative personnel.                                                                                                          
                                                                                                                                
Co-Chair MacKinnon  WITHDREW her  OBJECTION. There  being NO                                                                    
OBJECTION, Amendment 27 was adopted.                                                                                            
                                                                                                                                
10:47:09 AM                                                                                                                   
AT EASE                                                                                                                         
                                                                                                                                
10:48:09 AM                                                                                                                   
RECONVENED                                                                                                                      
                                                                                                                                
10:48:18 AM                                                                                                                   
                                                                                                                                
Co-Chair  MacKinnon  shared  that  Legislative  Legal  would                                                                    
incorporate the amendments into  a new committee substitute.                                                                    
She  shared  that  she  did  not  know  when  the  committee                                                                    
substitute  would be  available. She  hoped that  the fiscal                                                                    
notes would be available.                                                                                                       
                                                                                                                                
SB 74 was HEARD and HELD in committee for further                                                                               
consideration.                                                                                                                  
                                                                                                                                
ADJOURNMENT                                                                                                                   
10:49:47 AM                                                                                                                   
                                                                                                                                
The meeting was adjourned at 10:49 a.m.                                                                                         
                                                                                                                                
                                                                                                                                

Document Name Date/Time Subjects
SB 74 DCCED SFC Committee Followup 030216.pdf SFIN 3/3/2016 9:00:00 AM
SB 74
SB 74 ABHA Testimony letter re-Grant Req.pdf SFIN 3/3/2016 9:00:00 AM
SB 74
SB 74 GCDSE Support Testimony.pdf SFIN 3/3/2016 9:00:00 AM
SB 74
SB 74 Public Testimony Geneva Woods Medical.pdf SFIN 3/3/2016 9:00:00 AM
SB 74
SB 74 Amendment Packet 1-26.pdf SFIN 3/3/2016 9:00:00 AM
SB 74
SB 74 Amendment 27 - Micciche D.pdf SFIN 3/3/2016 9:00:00 AM
SB 74