Legislature(2007 - 2008)BUTROVICH 205

03/12/2007 01:30 PM HEALTH, EDUCATION & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 27 MEDICAL ASSISTANCE ELIGIBILITY TELECONFERENCED
Moved CSSB 27(HES) Out of Committee
*+ SB 87 MEDICAL ASSISTANCE ELIGIBILITY TELECONFERENCED
Moved CSSB 87(HES) Out of Committee
= SB 62 TASK FORCE ON HEALTH CARE INFECTIONS
Moved SB 62 Out of Committee
= SB 76 TUITION FOR CERTAIN CHILDREN
Moved CSSB 76(HES) Out of Committee
                    ALASKA STATE LEGISLATURE                                                                                  
SENATE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE                                                               
                         March 12, 2007                                                                                         
                           1:35 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Bettye Davis, Chair                                                                                                     
Senator Joe Thomas, Vice Chair                                                                                                  
Senator Kim Elton                                                                                                               
Senator Fred Dyson                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator John Cowdery                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 62                                                                                                              
"An Act  establishing the Advisory Committee  on Public Reporting                                                               
of Health  Care Associated Infections; relating  to reporting and                                                               
dissemination   of  data   concerning   health  care   associated                                                               
infections; and providing for an effective date."                                                                               
     MOVED SB 62 OUT OF COMMITTEE                                                                                               
                                                                                                                                
SENATE BILL NO. 76                                                                                                              
"An  Act  establishing a  higher  education  savings program  for                                                               
eligible  children who  were placed  in out-of-home  care by  the                                                               
state;   and  providing   for   confidentiality  of   identifying                                                               
information of a beneficiary under the program."                                                                                
     MOVED CSSB 76(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
SENATE BILL NO. 27                                                                                                              
"An  Act   relating  to  eligibility  requirements   for  medical                                                               
assistance for  certain children, pregnant women,  and persons in                                                               
medical  or intermediate  care facilities;  and providing  for an                                                               
effective date."                                                                                                                
     MOVED CSSB 27(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
SENATE BILL NO. 87                                                                                                              
"An  Act  expanding  medical  assistance  coverage  for  eligible                                                               
children  and  pregnant  women;  relating  to  cost  sharing  for                                                               
certain recipients  of medical assistance;  and providing  for an                                                               
effective date."                                                                                                                
     MOVED CSSB 87(HES) OUT OF COMMITTEE                                                                                        
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  62                                                                                                                  
SHORT TITLE: TASK FORCE ON HEALTH CARE INFECTIONS                                                                               
SPONSOR(s): SENATOR(s) STEVENS                                                                                                  
                                                                                                                                
01/19/07       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/07       (S)       HES, FIN                                                                                               
03/05/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
03/05/07       (S)       Heard & Held                                                                                           
03/05/07       (S)       MINUTE(HES)                                                                                            
03/12/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  76                                                                                                                  
SHORT TITLE: TUITION FOR CERTAIN CHILDREN                                                                                       
SPONSOR(s): SENATOR(s) ELLIS                                                                                                    
                                                                                                                                
02/07/07       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/07/07       (S)       HES, FIN                                                                                               
03/05/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
03/05/07       (S)       Heard & Held                                                                                           
03/05/07       (S)       MINUTE(HES)                                                                                            
03/12/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  27                                                                                                                  
SHORT TITLE: MEDICAL ASSISTANCE ELIGIBILITY                                                                                     
SPONSOR(s): SENATOR(s) DAVIS                                                                                                    
                                                                                                                                
01/16/07       (S)       PREFILE RELEASED 1/5/07                                                                                
01/16/07       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/16/07       (S)       HES, FIN                                                                                               
03/12/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  87                                                                                                                  
SHORT TITLE: MEDICAL ASSISTANCE ELIGIBILITY                                                                                     
SPONSOR(s): SENATOR(s) WIELECHOWSKI                                                                                             
                                                                                                                                
02/19/07       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/19/07       (S)       HES, FIN                                                                                               
03/12/07       (S)       HES AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                              
Doug Letch, Aide                                                                                                                
  to Senator Gary Stevens                                                                                                       
Alaska State Capitol                                                                                                            
Juneau AK                                                                                                                       
                                                                                                                                
POSITION STATEMENT: Presented SB 62 for the sponsor                                                                           
                                                                                                                                
Jay Butler, Director                                                                                                            
Division of Public Health                                                                                                       
Department of Health and Social Services (DHSS)                                                                                 
Juneau AK                                                                                                                       
POSITION STATEMENT: Available for questions on SB 62                                                                          
                                                                                                                                
Senator Johnny Ellis                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, AK                                                                                                                      
POSITION STATEMENT: Sponsor of SB 67                                                                                          
                                                                                                                                
Tom Obermeyer, Staff                                                                                                            
  to Senator Davis                                                                                                              
Alaska State Capitol                                                                                                            
Juneau, AK                                                                                                                      
POSITION STATEMENT: Commented on SB 27 for the sponsor                                                                        
                                                                                                                                
Senator Bill Wielechowski                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, AK                                                                                                                      
POSITION STATEMENT: Sponsor of SB 87                                                                                          
                                                                                                                                
Karleen Jackson, Commissioner                                                                                                   
Department of Health & Social Services                                                                                          
Juneau AK                                                                                                                       
POSITION STATEMENT: Testified on SB 27 and SB 87                                                                              
                                                                                                                                
Jerry Fuller, Medicaid Director                                                                                                 
Department of Health & Social Services                                                                                          
Anchorage AK                                                                                                                    
POSITION STATEMENT: Testified on SB 27 and SB 87                                                                              
                                                                                                                                
Jon Sherwood                                                                                                                    
Office of Program Review                                                                                                        
Department of Health & Social Services (DHSS)                                                                                   
Juneau AK                                                                                                                       
POSITION STATEMENT: Testified on SB 27 and SB 87                                                                              
                                                                                                                                
Dr. David Alexander, Chair                                                                                                      
Medical Care Advisory Committee                                                                                                 
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Theda Pittman, representing herself                                                                                             
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Regan Mattingly, State Affairs Coordinator                                                                                      
Alaska Primary Care Association                                                                                                 
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
TAMI ELLER                                                                                                                      
Grand Families Network Project                                                                                                  
Volunteers of American                                                                                                          
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Dr. George Brown, Pediatrician                                                                                                  
Douglas AK                                                                                                                      
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Walter Majoris, Executive Director                                                                                              
Juneau Youth Services                                                                                                           
Juneau AK                                                                                                                       
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Carol Lee, representing herself                                                                                                 
Juneau AK                                                                                                                       
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Nancy Davis, Vice President                                                                                                     
Alaska Nurses Association                                                                                                       
Juneau AK                                                                                                                       
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Debbie Standefer, Operations Director                                                                                           
Central Peninsula Health Center                                                                                                 
Kenai AK                                                                                                                        
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
George Hieronymus, Volunteer State President                                                                                    
American Association of Retired Persons (AARP)                                                                                  
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SB 27 and SB 87                                                                             
                                                                                                                                
Janice Tower                                                                                                                    
American Academy of Pediatrics                                                                                                  
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Patricia Senner                                                                                                                 
Alaska Nurses Association                                                                                                       
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Clover Simon, Chief Executive Officer                                                                                           
Planned Parenthood of Alaska                                                                                                    
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Karen Robinson                                                                                                                  
Alaska Women's Lobby                                                                                                            
Juneau AK                                                                                                                       
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Patricia O'Gorman, Program Coordinator                                                                                          
Anchorage School District                                                                                                       
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Chip Wagoner, Executive Director                                                                                                
Alaska Conference of Catholic Bishops                                                                                           
Juneau AK                                                                                                                       
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Mariko Selle                                                                                                                    
Alaska Public Health Association                                                                                                
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
Amy Devereaux                                                                                                                   
Anchorage AK                                                                                                                    
POSITION STATEMENT: In support of SBs 27 and 87                                                                               
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
CHAIR  BETTYE  DAVIS  called the  Senate  Health,  Education  and                                                             
Social Services  Standing Committee  meeting to order  at 1:35:32                                                             
PM. Present  at the  call to order  were Senators  Thomas, Elton,                                                             
Dyson, and Chair Davis.                                                                                                         
                                                                                                                                
          SB  62-TASK FORCE ON HEALTH CARE INFECTIONS                                                                       
                                                                                                                                
1:36:28 PM                                                                                                                    
CHAIR BETTYE DAVIS announced SB 62 to be up for consideration.                                                                  
                                                                                                                                
DOUG  LETCH,  aide   to  Senator  Stevens,  sponsor   of  SB  62,                                                               
introduced himself  and said he  would be presenting the  bill to                                                               
the committee for the second time.                                                                                              
                                                                                                                                
JAY  BUTLER, Director  for the  Division of  Public Health,  said                                                               
that he was available to  answer questions and summarize previous                                                               
testimony. He  explained that SB 62  will create a task  force to                                                               
consider public  disclosure of health  care-associated infections                                                               
and  reporting  of  the  data   in  a  way  that's  valuable  for                                                               
consumers. Particular  challenges to  Alaska include the  size of                                                               
the  hospitals, and  interpretable numbers  won't necessarily  be                                                               
available for  the majority of  the institutions.  Fourteen other                                                               
states require  public reporting of infection  rates in hospitals                                                               
and preventative measures taken.                                                                                                
                                                                                                                                
He explained that  the Center for Disease Control  (CDC) does not                                                               
take  a  position  on  infection   reporting,  but  does  provide                                                               
guidelines for  state governments  that wish to  do so.  The task                                                               
force  created  by  SB  62   would  outline  the  parameters  for                                                               
reporting as well as outcome measures.                                                                                          
                                                                                                                                
1:41:39 PM                                                                                                                    
                                                                                                                                
SENATOR  DYSON asked  about medical  facilities that  wouldn't be                                                               
required to report under this legislation.                                                                                      
                                                                                                                                
MR.  BUTLER  said  that  inpatient   acute  care  facilities  and                                                               
outpatient surgical centers may not be included.                                                                                
                                                                                                                                
1:42:48 PM                                                                                                                    
                                                                                                                                
PAT LUBY,  Advocacy Director for  the Alaska AARP, said  that the                                                               
organization  is in  support of  SB 62  and that  the bill  won't                                                               
necessarily stigmatize hospitals, which  must be held accountable                                                               
so that  they can  correct their  errors. SB 62  is a  good first                                                               
step towards reducing medical infections.                                                                                       
                                                                                                                                
1:43:43 PM                                                                                                                    
                                                                                                                                
MR. LETCH  said that  the bill isn't  about pointing  fingers but                                                               
rather  protecting   consumers  and  taking  steps   to  decrease                                                               
preventable fatalities.  He then  related a personal  story about                                                               
hospital infections.                                                                                                            
                                                                                                                                
1:45:14 PM                                                                                                                    
                                                                                                                                
SENATOR DYSON  made a motion  to move  SB 62 from  committee with                                                               
individual  recommendations and  attached  fiscal note(s).  There                                                               
being no objection, the motion carried.                                                                                         
                                                                                                                                
              SB  76-TUITION FOR CERTAIN CHILDREN                                                                           
                                                                                                                              
CHAIR DAVIS announced SB 76 to be up for consideration.                                                                         
                                                                                                                                
1:46:23 PM                                                                                                                    
                                                                                                                                
SENATOR ELLIS,  sponsor of SB 76,  said that the bill  will allow                                                               
the  private  sector  to  open  education  funding  accounts  for                                                               
children in  foster care.  This structure is  needed to  show the                                                               
community how  to aid  foster youth.  He added  that there  is no                                                               
known  opposition to  the bill,  and mentioned  that a  committee                                                               
substitute was before the committee that needed to be adopted.                                                                  
                                                                                                                                
1:48:43 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON  moved to adopt  the proposed  committee substitute                                                               
to  SB  76,  labeled  25-LS0443/C,  Version  C,  as  the  working                                                               
document of the committee.   There being no objection, the motion                                                               
carried.                                                                                                                        
                                                                                                                                
SENATOR  DYSON moved  to pass  CSSB 76(HES)  from committee  with                                                               
individual recommendations  and accompanying fiscal  notes. There                                                               
being no objection, it was so ordered.                                                                                          
                                                                                                                                
                                                                                                                                
             SB  27-MEDICAL ASSISTANCE ELIGIBILITY                                                                          
             SB  87-MEDICAL ASSISTANCE ELIGIBILITY                                                                          
                                                                                                                              
CHAIR DAVIS announced SB 27 and SB 87 to be under consideration.                                                                
                                                                                                                                
1:50:23 PM                                                                                                                    
                                                                                                                                
TOM OBERMEYER,  staff to  Senator Davis, sponsor  of SB  27, said                                                               
that  the  bill  updates  eligibility  requirements  for  medical                                                               
assistance for  certain children, pregnant women,  and persons in                                                               
medical  care  facilities. One  third  of  American children  get                                                               
their health  services through Medicaid  or the  State Children's                                                               
Health Insurance Program (SCHIP),  represented by Denali Kid Care                                                               
(DKC) in Alaska.  The cost of DKC in 2006  was $25.9 million, $18                                                               
million of which was paid  by the federal government. Eligibility                                                               
rates have  been frozen  at the  2003 federal  poverty guideline,                                                               
and SB  27 will increase the  rate to 200 percent  of the poverty                                                               
guideline.  It  also requires that those who  are able contribute                                                               
to  their health  care costs.  If SB  27 is  not implemented,  by                                                               
April 2007  the eligibility rate  will decline to 154  percent of                                                               
the poverty level and 1,000 children will be dropped from DKC.                                                                  
                                                                                                                                
He  added that  there are  18,000 uninsured  children in  Alaska;                                                               
these  children are  far  more likely  to  have health  problems.                                                               
7,600 children  were covered  under DKC  last year  at a  cost of                                                               
$1,700  per  child  annually, whereas  private  health  insurance                                                               
costs $8,000  to $17,000 for a  family annually. SB 27  also will                                                               
reverse  legislation from  2003  that froze  the Medicaid  income                                                               
eligibility and  waiver standards;  the bill will  be implemented                                                               
immediately if passed.                                                                                                          
                                                                                                                                
1:56:31 PM                                                                                                                    
                                                                                                                                
SENATOR WIELECHOWSKI, sponsor  of SB 87, said that  the bill will                                                               
make insurance available to all  children in Alaska, while asking                                                               
families  who  can  afford  it  to  contribute  to  their  costs.                                                               
Ensuring that  all children have  access to health  services will                                                               
reduce costs to  the state in the long run;  the bill is cheaper,                                                               
smarter, and more  moral than the status quo. The  number of kids                                                               
covered by  private insurance has  declined by 31 percent  in the                                                               
last  decade;  these children  are  at  a  higher risk  for  many                                                               
illnesses and  use emergency rooms  more frequently.   Providence                                                               
and   Alaska  Regional   hospitals   provided   $89  million   in                                                               
uncompensated care on 2006; these  costs result in higher charges                                                               
for medical  services and higher insurance  premiums. These costs                                                               
can  be reduced  by ensuring  that  all children  have access  to                                                               
health insurance.                                                                                                               
                                                                                                                                
He explained that  SB 87 raises the DKC eligibility  limit to 200                                                               
percent  of the  federal  poverty level;  this  change would  put                                                               
Alaska in line  with other states, and 70 percent  of the cost of                                                               
the program would be covered  by the federal government. The bill                                                               
would  provide for  a sliding  scale and  co-pay; those  with the                                                               
greatest means  would reimburse the  state roughly 90  percent of                                                               
the cost.  With this act, Alaska  will join other states  such as                                                               
Idaho and Illinois  that are working to ensure  that all children                                                               
are insured.                                                                                                                    
                                                                                                                                
He said that  in 2006 the department paid under  $1,400 per child                                                               
for DKC coverage;  it could cost up to $5.7  million to cover all                                                               
kids  who are  eligible  at  up to  350  percent  of the  federal                                                               
poverty level.                                                                                                                  
                                                                                                                                
2:01:07 PM                                                                                                                    
                                                                                                                                
SENATOR THOMAS  said that  he was trying  to see  the differences                                                               
between SBs  27 and 87,  and asked if there  will be a  change in                                                               
the supplemental security income benefit.                                                                                       
                                                                                                                                
SENATOR WIELECHOWSKI replied that there will not be.                                                                            
                                                                                                                                
2:02:09 PM                                                                                                                    
                                                                                                                                
SENATOR  DYSON said  that the  legislature  will likely  be in  a                                                               
deficit position  for the  next decade,  and asked  what services                                                               
will have to be cut to provide future funding for this program.                                                                 
                                                                                                                                
SENATOR WIELECHOWSKI  replied that other  states seem to  make do                                                               
with  their  funding for  similar  programs,  and no  matter  the                                                               
fiscal situation Alaska needs to make this issue a priority.                                                                    
                                                                                                                                
2:04:12 PM                                                                                                                    
                                                                                                                                
KARLEEN JACKSON,  Commissioner for  the Department of  Health and                                                               
Social Services  (DHSS), said that the  DKC eligibility threshold                                                               
should not be frozen in statute.                                                                                                
                                                                                                                                
SENATOR  ELTON remarked  that the  savings of  the bills  will be                                                               
unclear, and it appeared that  not approving the program would be                                                               
tantamount  to a  tax  increase. He  then  asked about  potential                                                               
savings resulting from preventative care.                                                                                       
                                                                                                                                
2:06:34 PM                                                                                                                    
                                                                                                                                
MS. JACKSON  replied that a  dollar amount would be  difficult to                                                               
name  but she  agreed prevention  will make  a big  difference in                                                               
later costs.                                                                                                                    
                                                                                                                                
2:07:11 PM                                                                                                                    
                                                                                                                                
JERRY FULLER, Medicaid Director for  the DHSS, said that an ounce                                                               
of prevention  is worth a pound  of cure, and that  while studies                                                               
from  other states  on savings  could perhaps  be referenced,  it                                                               
would be better not to speculate.                                                                                               
                                                                                                                                
SENATOR  ELTON asked  if  future savings  will  exceed the  costs                                                               
incurred by the bills.                                                                                                          
                                                                                                                                
JOHN SHERWOOD,  with the Office  of Program Review for  the DHSS,                                                               
said  that health  care savings  don't accrue  to the  state; the                                                               
cost  of  treatment  is  borne  across  the  population,  through                                                               
private  insurance, state  employee  insurance,  etc. It's  well-                                                               
known  that preventative  measures  save money,  and in  prenatal                                                               
care, for example,  every one dollar spent saves  four dollars in                                                               
later costs. As opposed to saving  money now, the program will be                                                               
reducing future cost increases.                                                                                                 
                                                                                                                                
SENATOR ELTON commented  that he feels more  comfortable with the                                                               
program now.                                                                                                                    
                                                                                                                                
CHAIR  DAVIS asked  if the  DHSS had  any comments  regarding the                                                               
fiscal note,  and said that she  thought the issue would  be best                                                               
addressed in the finance committee.                                                                                             
                                                                                                                                
She  added that  she would  be  interested in  seeing studies  of                                                               
other states' health care plans and savings.                                                                                    
                                                                                                                                
2:11:26 PM                                                                                                                    
                                                                                                                                
DR.  DAVID ALEXANDER,  Chair,  Medical  Care Advisory  Committee,                                                               
said  that  there's no  question  that  the number  of  uninsured                                                               
children  has vastly  increased; at  routine visits  children are                                                               
screened for the  most common issues and  those without insurance                                                               
are being  missed. The state  as a  whole has created  a fourfold                                                               
increase  in health  care costs  by  cutting money  from the  DKC                                                               
program, which also results in federal funding losses.                                                                          
                                                                                                                                
He opined  that sliding scale  insurance would be  more effective                                                               
than requiring families to purchase  private insurance, like some                                                               
states have  done. Government programs can  provide approximately                                                               
50 percent  more health  coverage than  private companies  due to                                                               
low overhead costs. Supporting these  bills will greatly decrease                                                               
expenses for the whole state.                                                                                                   
                                                                                                                                
2:14:46 PM                                                                                                                    
                                                                                                                                
THEDA PITTMAN,  representing herself, said  that she is  in favor                                                               
of increasing the eligibility threshold  for DKC, a modest co-pay                                                               
for  those in  the  upper  levels of  eligibility,  and a  buy-in                                                               
option for  those not eligible. Medicare  eligibility should also                                                               
be expanded.                                                                                                                    
                                                                                                                                
She urged  the committee to  adopt the more generous  features of                                                               
each bill.                                                                                                                      
                                                                                                                                
2:15:50 PM                                                                                                                    
                                                                                                                                
REGAN  MATTINGLY,  State  Affairs   Coordinator  for  the  Alaska                                                               
Primary Care  Association (APCA),  said that  in 2005  the APCA's                                                               
sites provided primary  health care to 23,258  children, 6,566 of                                                               
whom were  enrolled in DKC. The  uninsured are more likely  to be                                                               
hospitalized for  a treatable  condition because  of the  lack of                                                               
early intervention;  the uninsured  segment of the  population is                                                               
greatly underserved  due to high  non-insured health  care costs.                                                               
The expansion  of the  program will  increase health  care access                                                               
for  nearly  18,000  uninsured  Alaskan  children  who  need  and                                                               
deserve such care.                                                                                                              
                                                                                                                                
2:18:46 PM                                                                                                                    
                                                                                                                                
TAMI  ELLER,  Grand  Families   Network  Project,  Volunteers  of                                                               
American, related a  personal story about a six-year  old boy who                                                               
when his  grandparents got him  at three  years old, he  had four                                                               
rotted teeth in his mouth,  had received no immunizations and had                                                               
significant behavioral difficulties.   His grandparents were able                                                               
to access  Denali Kid Care  and were able  to get his  four front                                                               
teeth pulled  out, to get his  immunizations and to get  him into                                                               
mental  health care.  Without Denali  Kid Care  they would  never                                                               
have been able to  do that and the boy would not  be as happy and                                                               
health as he is today.                                                                                                          
                                                                                                                                
Grandparents raising  young children  kids are often  using their                                                               
own  Medicare  insurance  for  their  grandchildren  rather  than                                                               
themselves.  The bills  before committee  would allow  everyone's                                                               
health to be taken care of equally.                                                                                             
                                                                                                                                
2:21:25 PM                                                                                                                    
                                                                                                                                
DR. GEORGE  BROWN, Private Pediatrician,  said that  Medicaid and                                                               
SCHIP,  what   people  know  as   Denali  Kid  Care,   have  been                                                               
instrumental  in   providing  health   care  for   Alaskans,  and                                                               
referenced  a  report that  showed  a  direct connection  between                                                               
infant mortality  and poverty. He likened  infant mortality rates                                                               
to a canary in a coal  mine, and cited statistics showing how the                                                               
US  health  care  system  is  inferior  to  other  industrialized                                                               
countries'.  While  these  rates have  gradually  declined,  they                                                               
remain  high among  minorities  and poor  families  who are  less                                                               
likely to have steady health care.                                                                                              
                                                                                                                                
He said that  despite these issues, Medicaid and  SCHIP have been                                                               
beneficial to  a great  number of  children whose  families would                                                               
otherwise  be  afraid to  seek  high-cost  uninsured care.  SCHIP                                                               
coverage needs  to be increased to  cover those at more  than 200                                                               
percent of the federal poverty level.                                                                                           
                                                                                                                                
He  then  referenced newspaper  articles  about  the health  care                                                               
crisis, and said  that increasing youth health care  is the least                                                               
expensive  and longest  lasting investment  that can  be made  on                                                               
behalf  of children.  Including early  education and  health care                                                               
costs,  every  one  dollar  spent saves  six  dollars  later  on;                                                               
there's no question that it's cost effective.                                                                                   
                                                                                                                                
2:30:19 PM                                                                                                                    
                                                                                                                                
WALTER  MAJORIS,  Executive  Director of  Juneau  Youth  Services                                                               
(JYS), said  that the relationship  between DKC and  youth mental                                                               
health services is important; DKC is  the main way that kids with                                                               
mental, emotional,  behavioral, and chemical  dependency problems                                                               
access behavioral  health services in Alaska.  As the eligibility                                                               
threshold  goes down,  fewer kids  receive these  services, which                                                               
need  to be  improved  so that  kids can  remain  closer to  home                                                               
during treatment.                                                                                                               
                                                                                                                                
He said that  historically 75 percent of JYS's  clients have used                                                               
DKC, but in  the last year the number has  declined to 69 percent                                                               
and  will likely  decline further.  Additionally,  the number  of                                                               
children  on  the  wait-list  has   increased  greatly  and  some                                                               
children who do  not qualify for basic services  are being forced                                                               
into  extreme levels  of service  provision. The  Alaskan program                                                               
has  the third-lowest  threshold of  eligibility in  the country;                                                               
it's critical  that Alaska support  these bills for  insurance so                                                               
that the  state can invest  early and prevent more  serious later                                                               
issues.                                                                                                                         
                                                                                                                                
CAROL  LEE, representing  herself, explained  how her  family has                                                               
benefited greatly from the DKC program.                                                                                         
                                                                                                                                
NANCY DAVIS,  Vice President of  the Alaska  Nurse's Association,                                                               
said that  the effort to  bring health  care coverage to  a wider                                                               
population is a return to the  progress that the state was making                                                               
in past  years; the bills  are steps  in the right  direction for                                                               
Alaska. In 2003,  when the enrollment reduced,  there were 10,500                                                               
youth  in kid  care; now  there are  7,500. Reducing  coverage is                                                               
counterintuitive  because  the state  is  falling  behind in  its                                                               
commitment to  its population. The  state could potentially  be a                                                               
model for  health care  coverage, with its  large budget  and low                                                               
population.                                                                                                                     
                                                                                                                                
2:39:21 PM                                                                                                                    
                                                                                                                                
DEBBIE STANDEFER,  Operations Director for the  Central Peninsula                                                               
Health Center,  listed the numbers  of youth being served  by the                                                               
center  and  explained that  even  discounted  health care  is  a                                                               
barrier to many people.                                                                                                         
                                                                                                                                
2:40:38 PM                                                                                                                    
                                                                                                                                
GEORGE  HIERONYMUS, Volunteer  State President  for the  American                                                               
Association  of   Retired  Persons,  related  a   personal  story                                                               
regarding DKC,  and said that  the 89,000 AARP members  in Alaska                                                               
are in strong support of the bills.                                                                                             
                                                                                                                                
2:42:29 PM                                                                                                                    
                                                                                                                                
JANICE  TOWER, with  the American  Academy  of Pediatrics  (AAP),                                                               
said that  the 88 AAP-affiliated pediatricians  across Alaska are                                                               
in  strong  support  of  the  increase  of  the  DKC  eligibility                                                               
threshold.  The emergency  room is  a terrible  place to  deliver                                                               
primary care and  children shouldn't be seen as  costs but rather                                                               
as people deserving of health care.                                                                                             
                                                                                                                                
PATRICIA SENNER,  with the Alaska  Nurses Association,  said that                                                               
paying   for  health   care  must   be   a  partnership   between                                                               
individuals, employers, and the government.                                                                                     
                                                                                                                                
CLOVER SIMON,  Chief Executive Officer for  Planned Parenthood of                                                               
Alaska,  said  that she  supports  the  bills because  living  in                                                               
poverty can  have lasting affects on  peoples' health; increasing                                                               
the  eligibility   threshold  will  have   long-lasting  positive                                                               
effects. She also applauded the  inclusion of a sliding scale for                                                               
care fees.                                                                                                                      
                                                                                                                                
2:46:18 PM                                                                                                                    
                                                                                                                                
KAREN ROBINSON, with the Alaska  Women's Lobby, said that the two                                                               
bills are  the most important  before the legislature  this year;                                                               
the 2003 reduction  of the threshold was  a major disappointment.                                                               
She then related  a personal story about the  negative effects of                                                               
a lack of insurance.                                                                                                            
                                                                                                                                
2:49:43 PM                                                                                                                    
                                                                                                                                
PATRICIA O'GORMAN,  program coordinator for the  Anchorage School                                                               
District, said that there's a  significant need to expand the DKC                                                               
program.  Many families  live paycheck  to  paycheck and  agonize                                                               
over decisions  to seek health  care because it's  too expensive;                                                               
this results in more long-term costs to the health care system.                                                                 
                                                                                                                                
2:51:44 PM                                                                                                                    
                                                                                                                                
CHIP  WAGONER, Executive  Director for  the Alaska  Conference of                                                               
Catholic Bishops,  said that the  organization supports  both the                                                               
bills; it opposed the changes  in 2003 relating to eligibility in                                                               
the DKC  program; the  purchasing power of  the minimum  wage has                                                               
decreased for the people that can least afford it.                                                                              
                                                                                                                                
He added that  the bill onerously cites Office  of Management and                                                               
Budget  (OMB)  poverty  guidelines;  the  OMB  doesn't  establish                                                               
poverty guidelines,  but rather  only approves the  definition of                                                               
poverty. The Federal  Department of Health and  Human Services is                                                               
the entity that develops the poverty guidelines.                                                                                
                                                                                                                                
2:56:38 PM                                                                                                                    
                                                                                                                                
MARIKO  SELLE, with  the Alaska  Public Health  Association, said                                                               
that  the organization  supports expanding  the DKC  program, and                                                               
that its target is to see all Alaskan children insured by 2010.                                                                 
                                                                                                                                
AMY DEVEREAUX said that her  monthly salary doesn't fit under the                                                               
current DKC threshold,  and her work insurance  is too expensive.                                                               
She supports  both bills, as  well as  a buy-in option  for those                                                               
who don't fit the requirements.                                                                                                 
                                                                                                                                
CHAIR DAVIS  thanked the presenters  and announced  her intention                                                               
to pass the  bills to finance. She remarked that  either bill may                                                               
face issues in the next committee.                                                                                              
                                                                                                                                
2:59:55 PM                                                                                                                    
                                                                                                                                
SENATOR  ELTON moved  to adopt  a conceptual  amendment to  SB 27                                                               
that  changed   the  definition  of  "poverty   level"  as  being                                                               
established by  OMB (Office of  Management and Budget)  and asked                                                               
for  unanimous consent.   There  being no  objection, the  motion                                                               
carried.                                                                                                                        
                                                                                                                                
SENATOR ELTON moved to adopt  the same conceptual amendment to SB                                                               
87. There were no objections and it was so ordered.                                                                             
                                                                                                                                
3:01:24 PM                                                                                                                    
                                                                                                                                
SENATOR ELTON moved  to report CSSB 27 (HES)  from committee with                                                               
unanimous consent and attached fiscal  note(s). Chair Davis asked                                                               
for a roll call vote. Senators Elton, Thomas and Davis voted                                                                    
yea; and CSSB 27(HES) moved from committee.                                                                                     
                                                                                                                                
SENATOR ELTON  moved to report  CSSB 87(HES) from  committee with                                                               
attached fiscal  notes. Chair Davis  asked for a roll  call vote.                                                               
Senators  Thomas, Elton  and Davis  voted yea;  and CSSB  87(HES)                                                               
moved from committee.                                                                                                           
                                                                                                                                
There being no further business to come before the committee,                                                                   
Chair Davis adjourned the meeting at 3:02:26 PM.                                                                              
                                                                                                                                

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