Legislature(1999 - 2000)
02/09/2000 01:35 PM Senate HES
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SENATE HEALTH, EDUCATION AND SOCIAL SERVICES COMMITTEE
February 9, 2000
1:35 P.M.
MEMBERS PRESENT
Senator Mike Miller, Chairman
Senator Pete Kelly, Vice-Chairman
Senator Gary Wilken
Senator Drue Pearce
MEMBERS ABSENT
Senator Kim Elton
COMMITTEE CALENDAR
HOUSE CONCURRENT RESOLUTION NO. 15(title am)
Requesting the governor to proclaim March 2000 as Developmental
Disability Awareness Month.
-MOVED HCR 15 (title am) OUT OF COMMITTEE
SENATE CONCURRENT RESOLUTION NO. 12
Relating to declaring March 2000 as Sobriety Awareness Month.
-MOVED SCR 12 OUT OF COMMITTEE
SENATE BILL NO. 204
"An Act extending the termination date of the Alaska Commission on
Aging; and providing for an effective date."
-MOVED SB 204 OUT OF COMMITTEE
SENATE BILL NO. 198
"An Act increasing the base student allocation component of the
public school funding formula; and providing for an effective
date."
-MOVED SB 198 OUT OF COMMITTEE
CS FOR HOUSE BILL NO. 85(FIN) am
"An Act relating to licensure and professional discipline of
members of the teaching profession and providing for related
penalties; relating to grounds for dismissal of a teacher; relating
to the Professional Teaching Practices Commission; relating to
limited immunity for procedures under the Educator Ethics Act;
making conforming amendments; and providing for an effective date."
-MOVED CSHB 85(FIN) am OUT OF COMMITTEE
Presentation by Mr. Jerry Near and Mr. Gary Schwartz of the
Statewide Health Care Commission
PREVIOUS SENATE COMMITTEE ACTION
HJR 15 - See Resources minutes dated 4/14/99, 4/19/99 and
4/23/99 and Rules Committee minutes dated 5/5/99.
SCR 12 - No previous action to consider.
SB 204 - See HESS minutes dated 2/2/00.
SB 198 - No previous action to consider.
HB 85 - See Health and Social Services minutes dated 2/2/00.
WITNESS REGISTER
Ms. Jennifer Strickland
Aide to Speaker Brian Porter
State Capitol Bldg.
Juneau, AK 99811-1182
POSITION STATEMENT: Testified for the sponsor of HCR 15.
Ms. Angela Moss
Aide to Senator Ward
State Capitol Bldg.
Juneau, AK 99811-1182
POSITION STATEMENT: Testified for the sponsor of SCR 12.
Ms. Rene' Gayhart, Specialist
Division of Mental Health and Developmental Disabilities
Department of Health and Social Services
P.O. Box 110620
Juneau, AK 99811-214
POSITION STATEMENT: Supports SCR 12.
Ms. Pamela Watts, Executive Director
Advisory Board on Alcoholism and Drug Abuse
P.O. Box 240249
Anchorage, AK 99534-0249
POSITION STATEMENT: Supports SCR 12.
Mr. Ernie Turner, Director
Division of Alcohol and Drug Abuse
Department of Health and Social Services
P.O. Box 110607
Juneau, AK 99811-0607
POSITION STATEMENT: Supports SCR 12.
Mr. Eddy Jeans, School Finance Manager
Department of Education
801 W 10th, Suite 200
Juneau, AK 99801-1894
POSITION STATEMENT: Supports SB 198.
Mr. Carl Rose, Executive Director
Association of Alaska School Boards
316 W 11th Street
Juneau, AK 99801
POSITION STATEMENT: Supports SB 198.
Mr. John Cyr, President
National Education Association Alaska (NEA)
114 Second Street
Juneau, AK 99801
POSITION STATEMENT: Supports SB 198.
Ms. Sanna Green, Executive Director
Professional Teaching Practices Association (PTPA)
344 3rd Street, Ste 127
Anchorage, AK 99508
POSITION STATEMENT: Supports HB 85.
ACTION NARRATIVE
TAPE 00-04, SIDE A
Number 001
HCR 15-DEVELOPMENTAL DISABILITY AWARENESS MONTH
CHAIRMAN MILLER called the Senate Health, Education and Social
Services (HESS) Committee to order at 1:35 p.m. and announced HCR
15 to be up for consideration.
MS. JENNIFER STRICKLAND, aide to Representative Brian Porter, said
the resolution simply establishes this coming March as
developmental disability awareness month. Representative Porter
decided to introduce this legislation as a resolution instead of a
citation to bring broader recognition to the issue. Passage of
HCR 15 will give strength to the efforts of many groups, especially
the Key Campaign, and promote a greater understanding of the
capabilities of Alaskans with developmental disabilities and the
challenges they face. This has been a tradition in Alaska for a
number of years and coincides with a similar designation on the
national level, as proclaimed by President Reagan in 1983.
SENATOR WILKEN moved to report HCR 15 from committee with
individual recommendations and its zero fiscal note. There were no
objections and it was so ordered.
SENATE CONCURRENT RESOLUTION NO. 12
Relating to declaring March 2000 as Sobriety Awareness Month.
CHAIRMAN MILLER announced SCR 12 to be up for consideration.
MS. ANGELA MOSS, aide to Senator Ward, sponsor of SCR 12, declares
March 2000 as sobriety awareness month. Alcohol and drug abuse has
been identified as the single most destructive health problem in
Alaska. Its devastating effects have been felt within every
racial, ethnic, and economic background. SCR 12 reinforces
Alaskans' commitment to a clean and healthy lifestyle.
CHAIRMAN MILLER announced an at-ease. He called the meeting back
to order and said that a person signed up to testify on the
previous bill. He said the committee would take testimony now.
MS. RENE' GAYHART, Developmental Disabilities (DD) Program,
Division of Mental Health and Developmental Disabilities, stated
support for HCR 15. HCR 15 is important because it recognizes
nearly 12,000 Alaskans with DD and their need for life-long
supports to be fully included in the community where they live.
The Division welcomes the advocacy consumers, the Key Campaign, and
the Key coalition branch of the DD Program. They also support the
efforts of service provider agencies, families, and the Governor's
Council on Disabilities and Special Education to ensure that more
Alaskans with DD are able to participate in and contribute to
community life. The programs in her division accomplish the
important goals of integration and inclusion in one's community.
Recognition of March as developmental disabilities awareness month
will demonstrate the power of community that is exemplified by
people with disabilities.
CHAIRMAN MILLER apologized for missing her testimony when the bill
was before them. He then returned to SCR 12.
Number 465
MS. PAMELA WATTS, Executive Director, Advisory Board on Alcoholism
and Drug Abuse, stated support for SCR 12. She said March has been
proclaimed DD awareness month since 1995 in recognition and
appreciation of the example set by citizens who believe in and
support a life of sobriety. Alcoholism and drug abuse has had a
negative impact on our society, but most unfortunately on our
families and communities. Our high national ranking in child abuse
and neglect is significantly impacted by alcohol and drug abuse.
The cost to Alaska in terms of human and financial resources is
staggering. This resolution reflects the mission, strategies, and
goals of the Advisory Board's state plan for alcohol and drug abuse
services. The Board strongly supports individual, organizational,
community, and statewide efforts toward prevention and intervention
of alcohol and drug abuse problems. The Board recognizes the
efforts of those who lead the way. They appreciate the leadership
of the Legislature in paving the way for continued reenforcement of
the improved quality of life for all Alaskans.
Number 585
MR. ERNIE TURNER, Director, Division on Alcohol and Drug Abuse,
stated support for SCR 12. He fully endorsed the previous
testimony.
SENATOR WILKEN moved to pass SCR 12 out of committee with
individual recommendations. There were no objections and it was so
ordered.
SB 204-EXTEND ALASKA COMMISSION ON AGING
CHAIRMAN MILLER announced SB 204 to be up for consideration and
announced that the committee had already held a public hearing on
this legislation.
SENATOR KELLY asked for a fiscal note.
CHAIRMAN MILLER noted that it has a zero fiscal note.
There being no one else wishing to testify, SENATOR WILKEN moved to
pass SB 204 from committee with individual recommendations and its
attached fiscal note. There were no objections and it was so
ordered.
SB 198-INCREASE BASE ALLOCATION FOR EDUCATION
CHAIRMAN MILLER announced SB 198 to be up for consideration.
SENATOR WILKEN, sponsor of SB 198, said the State of Alaska's
education funding formula is based on a specific dollar amount per
student. Currently, the base student allocation is $3,940. SB 198
increases this allocation by $50, making the base allocation
$3,990. In FY01, the foundation program, which funds K-12 Alaska
public schools, will require approximately $19 million less in
state aid than the amount authorized in FY00. Several key factors
contribute to this drop in state aide while continuing to fund the
foundation formula. One is a decline in projected student
enrollment which is projected to be about .8 percent; another is a
required increase in the local effort per the formula (an increase,
depending on where you live, of around 2-5 percent); another is an
increase in assessed values across the state; and last, an increase
in the deductible impact aid, known as PL 874 money (an increase of
$11 million or 15 percent over last year).
SB 198 keeps a portion of these savings within K-12 education and
provides a modest increase in school funding equally across the
state. He encouraged their support.
MR. EDDY JEANS, School Finance Manager, Department of Education
(DOE), said the Governor has introduced SB 244 which would direct
an increase in funding through the quality schools grant component
of the foundation program. Specifically, it targets the money to
improve student performance. The Department of Education prepared
a fiscal note for SB 198 and the $50 increase in the base student
allocation equals $10,489,300. He emphasized that he feels
strongly that new dollars in the foundation program need to be
targeted to improve student performance. He offered to answer any
questions at this time.
Number 908
MR. JOHN CYR, President, National Education Association - Alaska,
stated support for SB 198. NEAA believes the need for more money
for schools is critical. It believes the foundation formula needs
to be increased.
NEAA is also concerned about teacher salaries. More and more young
professionals are leaving the state because they can't make a
living here. For instance, his son-in-law is moving away with his
two grandchildren. He has been teaching in Homer for the last
three years but cannot make an adequate living. The same thing is
happening to other folks, too; and it's a shame to see it happen.
The State needs to provide the basic infrastructure that schools
require. Alaska schools need help all over, not just in the
quality schools initiative. He urged committee members to pass the
bill.
Number 1021
MR. CARL ROSE, Executive Director, Association of Alaska School
Boards, stated support for SB 198 and made the following comments.
The quality of life in Alaska and across the U.S. will be directly
proportionate to the quality of the education we provide the young
people today. The issue is one of quality and he agrees with the
Department of Education that we need to pay strict attention to
that.
There is a system in place right now and quality initiatives have
been introduced that will require additional money. We don't have
the option of stopping what we do right now and focus strictly on
the quality of improvements. We have to continue providing the
services they do right now and, in many cases, schools are doing a
good job.
Their needs are tremendous and the way the foundation is set up ...
we have a strong economy in Alaska and it's reflected in our
property values. It calls for more local contributions as a result
of declining enrollment and the additional impact aid money. The
actual money to public education will be less than what was
appropriated last year and the question is not that we have fewer
needs today; we have more needs.
They support the quality initiatives. He understands the
Governor's position, but he is perplexed by the comment that
dollars won't be siphoned off or redirected to salaries,
maintenance and administration. Students have to be housed
somewhere, which is maintenance. Our students have to be taught
and that is largely salaries for our teachers. These schools have
to be administered; that's not the responsibility of professionals
in the class room. They are under tremendous mandates; schools have
to be administered to provide the public with some level of
accountability.
He concluded by saying that schools have great needs and this
should get us part of the way there. There is some merit to the
Governor's proposal. We are $19 million short and he wanted to do
everything he could to get those dollars into our schools, because
they need the money.
SENATOR WILKEN moved to report SB 198 out of committee with
individual recommendations with the attached fiscal note. There
were no objections and it was so ordered.
HB 85-TEACHERS'LICENSES, DISCIPLINE & ETHICS
MS. SANNA GREEN, Deputy Director, Professional Teaching Practices
Commission (PTPC), said the purpose of the bill is essentially to
consolidate statutes in a single place and add some new provisions.
In order to make things consistent, the word "certification" has
been changed to "license."
The rest of the bill gives the PTPC the authority to do some of the
things it has been doing in practice. She said one of the new
sections is a compilation of the grounds for denial of
applications.
The PTPC would like reciprocal discipline in Alaska for an educator
who has been disciplined in another jurisdiction. To do that now,
the PTPC has to go through the whole hearing process. Notification
is available through the national clearinghouse, but the PTPC has
to go through a hearing process. This change would speed things
up.
The PTPC would like to expand the waiting period from one to five
years for reinstatement, because one year is not sufficient. It
wants to add that misrepresentation of a material fact on an
employment application is grounds for discipline. Right now the
PTPC can discipline if a fact is misrepresented on an application
for certification, but they want to include misrepresentation on an
application to a school district.
The PTPC would like the authority to put conditions on teaching
licenses.
The PTPC wants the authority to impose a civil fine against a
person who is regulated by state law but does not hold a license.
The main people covered by that provision would be teachers in
higher education who are under their jurisdiction by statute but
have no license. There are hardly any disciplinary sanctions the
PTPC can impose on that group. The PTPC would like the ability to
impose a civil fine of up to $5,000 (although that amount is
limited in the proposed legislation).
The bill also contains a provision that a person's license is
suspended or revoked from employment as a member of the teaching
profession even if the position does not require a license. There
is a case where it revoked the certificate of a superintendent and
then the school district wished to rehire him back in the same
position as a noncertificated employee.
It would also like to strengthen the provisions of confidentiality
of minors.
The PTPC would like a provision to provide immunity from liability
for persons who participate in good faith in their proceedings.
They have this now, but it is a little restrictive.
They would like to mandate that a person who accepts a job that
requires a certificate and doesn't have one could be charged with
a class B misdemeanor if they don't petition to get one. This has
happened, because the person can just say they have applied for the
certificate when they are hired for 90 days (while presumably the
Department is going through the process of getting them licensed).
Number 1605
SENATOR WILKEN asked if the PTPC supports the legislation
unanimously.
MS. GREEN replied that it does.
SENATOR WILKEN added that the Department of Education is in full
support also.
CHAIRMAN MILLER said he thought this was a worthy piece of
legislation, but it bothers him when state agencies do something
and then ask for the authority to do it later; this is the reverse
of the way things should be done.
SENATOR KELLY moved to pass HB 85 from committee with individual
recommendations and the attached zero fiscal note. There were no
objections and it was so ordered.
Number 1693
CHAIRMAN MILLER announced that was all the legislation the
committee would take up today, but they would now receive a
presentation from Mr. Jerry Near and Gary Schwartz with the Health
Care Commission.
MR. GARY SCHWARTZ, member of the Community Care Foundation Board of
Directors, said their purpose is to conduct intensive study and
public hearings regarding the establishment of a self-funded state
health care delivery organization. It's not a government
organization; it could be public, private, coop, or 501(C)(3) type
of organization. It could offer and administer a basic health
benefit plan available to all Alaskans. He said the bill they
prepared is modeled after the Long-term Care Task Force that they
have all supported.
The Statewide Health Care Commission, after about a year's work,
had recommendations for the legislature on appropriate and
affordable health services for Alaskans to be covered in a
statewide plan. The projected health insurance premium costs could
be approximately 30% lower than what we are now seeing.
He asked the legislature to encourage the creation of a health care
market more directly driven by consumers and health care providers
responsive to the needs of Alaskans. Under the statewide health
care delivery system envisioned, Alaskans would be able to have a
choice of their physicians from a panel of providers who meet
participation criteria and want to provide health care to Alaskans.
The physicians' panels would provide a full continuum of medically
necessary services for the enrolled population. The Alaska Health
Care Delivery System does not need to be overhauled; we need to
fine tune the existing system. We have excellent physicians and
hospitals in Alaska who, they believe, are committed to providing
high quality, accessible, and cost effect services.
They need support and encouragement from Alaskans to improve
efficiencies in delivering health and medical care - a basic
standard program that provides medically necessary services
throughout Alaska covering physician services, institutional or in-
patient care, emergency care, out patient procedures, preventive
services, and prescription to create the proper marketing climate
for improvements in provider productivity and efficiency.
In addition to addressing a statewide health plan, they envision
the Commission recommending health care efficiencies and the
elimination of unnecessary services. The ultimate goal is to
ensure that every Alaskan has access to affordable and appropriate
health care services. The Alaska Health Plan should become the
obvious choice for health care financing by virtue of its
affordability, quality of services, superior health outcomes and
demonstrated commitment to excellence.
MR. SCHWARTZ said that there are limited numbers of health
insurance companies competing in the Alaska market which seriously
impacts the cost availability of coverage and patient access to
quality medical care.
There are between 80,000 to 100,000 uninsured Alaskans who cannot
afford health insurance premiums. He understands that they run a
good 35 - 40% more than they do in the lower 48. If we had our own
program, we could probably reduce those costs by at least 30%.
He said they are concerned that about 40% of our health and
hospital services are provided out-of-state in spite of the fact
that we have excellent physicians and hospitals in the state. We
bypass our own resources. They thought that an Alaska plan for
Alaskans and by Alaskans would address that issue. They would also
like to see the administration of private and public health
insurance claims done here in Alaska. There is no reason why you
can't process claims, determine eligibility, and provide an
administrative service right here in Alaska.
The Commission would like to see the state form a partnership with
the health insurance company, but they have to meet a certain
criteria. They have to use Alaskans, provide jobs and keep those
resources and people here.
There really is no means for Alaskans to compare existing health
insurance plans and the relative costs of operation, medical, and
hospital services, as well as administrative efficiency. They
believe the Commission in its public hearings could address these
issues as well.
SENATOR WILKEN asked what was different about their proposal
compared to what the situation is today.
Number 2116
MR. JERRY NEAR answered that it would be an Alaskan citizen-owned
system.
SENATOR WILKEN asked if it would compete with Aetna and the rest.
MR. SCHWARTZ answered that it certainly could compete with the
other insurance companies, or they could become a partner. The
point is they are really trying to lower the cost of medical care
and would like to get a basic benefit program available to all
Alaskans at their option. It's intolerable when you have 80,000 to
100,000 uninsureds. A fourth of those are children and nobody is
really addressing that.
SENATOR WILKEN asked who pays for the 75,000 people who are
presently uninsured.
MR. NEAR answered that a part of it could be having a health
insurance plan that is not as expensive as they are now. When they
testified yesterday in the House HESS Committee there was an
avalanche of people responding to their ideas, like the Denali Kid
Program, a participatory program with federal funds. This program
is going to grow and next year there will be the need for more
support than there is this year.
When health insurance is getting to be $600-$700 per month, a lot
of employees are not covering their families. Unless they can do
something about the cause, they will have a fix-it program that
will continue to grow.
MR. NEAR pointed out that the World Health Organization has
identified key elements to achieve better health: peace, shelter,
education, decent income, and stable economy, sustainable
resources, social justice, and equity. They don't even mention the
intervention of our health care system that we currently pay a lot
of money for. Further, they say that a society that spends so much
in health care may be reducing health because they end up
neglecting other key elements. Alaska needs to become more self
sufficient.
The Organization also winnowed through all the elements to figure
out what other elements relate to the health of a nation and it got
down to economics. Unless you have a decent job at a decent wage
that is sustainable, it's going to be more of what we've got.
MR. NEAR said you don't really have to work with a partner, but
ramping up our citizen owned system is fairly expensive and demands
quite a bit of talent, hardware, and expertise. He noted that the
Anchorage school system, which is close to being the second largest
employer in the state, is having discussions about their current
program. Overall, the state spends close to $3 billion and if we
could manufacture a 10% savings on those amounts, that's
significant. They request that the legislature look seriously at
their proposal.
TAPE 00-04, SIDE B
Number 2361
SENATOR KELLY said it seems like the goals of increasing health
care and driving down the cost are mutually exclusive. He asked if
they have any idea of how that would work.
MR. SCHWARTZ said yes; that last year Representative Gary Davis
provided a business plan on how that would happen. They received
letters from both the House and the Senate encouraging them to go
forward. They laid out one model based on what the large and small
business coalitions are doing by forming group purchasing
capability, working directly with providers whether they are
physicians or hospitals.
His experience in the Twin Cities with a large business coalition
was that they were able to reduce the cost of health care by about
14% and providing care to about 485,000 people. It was getting
doctors, patients, and purchasers together and reaching some common
understanding of what the basics were going to be, how they would
be communicated, and how they were going to demonstrate quality and
outcomes. They worked with the providers and negotiated an
equitable reimbursement system which was competitive. He did not
mean that just Minneapolis and St. Paul were the model; this has
been done in a number of areas in the private sector.
They feel that by reducing premium costs, more demand would be
generated, but you're improving, and with preventive services,
you're actually improving health care. As a result, they can save
20-30 percent. People will be able to buy coverage again. Some of
the small margin, the profit, can help subsidize the uninsured.
Number 2361
MR. NEAR said there is a lot of activity in forming associations
for grouping so that you get a greater mass of participation. The
whole theory of insurance is to share the risk; the more
participants, the per individual risk goes down. The optimal size
for a group seems to be 500,000-1,000,000 enrollees. Alaska fits
in that scenario. If you get more than that, it doesn't improve
much. He reiterated that the state had done a lot of studies on
moose, caribou, and fish; the amount of money involved in those
entities nowhere compares to what we're spending on health care.
He thought it merited a good close look by the legislature.
SENATOR KELLY asked if their model would have price controls
attached to it.
MR. SCHWARTZ answered that he didn't want to have mandates; he
wanted insurance companies to stay and compete. He thought the
Commission could develop a very affordable plan that would lower
the insurance premiums of other companies that want to stay in this
market. He would be shocked if they had to impose price controls.
Also, they are not out to "gore" the provider with this either. A
number of physicians in Fairbanks are looking for ways to improve
administrative efficiencies and provide better care.
Everyone thanked each other for their efforts.
CHAIRMAN MILLER adjourned the meeting at 2:40 p.m.
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