Legislature(2011 - 2012)BUTROVICH 205

03/21/2012 01:30 PM HEALTH & SOCIAL SERVICES


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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 118 MEDICAID REIMBURSEMENT FOR FAMILY THERAPY TELECONFERENCED
Moved SB 118 Out of Committee
+= SB 55 MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES TELECONFERENCED
Moved CSSB 55(HSS) Out of Committee
*+ SB 221 ALCOHOLIC BEV. TAX/PREVENTION FUND TELECONFERENCED
Moved SB 221 Out of Committee
Bills Previously Heard/Scheduled
= SB 5 MEDICAL ASSISTANCE ELIGIBILITY
Moved CSSB 5(HSS) Out of Committee
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         March 21, 2012                                                                                         
                           1:33 p.m.                                                                                            
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Bettye Davis, Chair                                                                                                     
Senator Dennis Egan                                                                                                             
Senator Kevin Meyer                                                                                                             
Senator Fred Dyson                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
Senator Johnny Ellis                                                                                                            
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 221                                                                                                             
"An Act relating to the disposition of proceeds from the                                                                        
alcoholic beverage tax and to the alcohol and other drug abuse                                                                  
treatment and prevention fund."                                                                                                 
                                                                                                                                
     - MOVED SB 221 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 118                                                                                                             
"An Act providing medical assistance reimbursement for the                                                                      
services of licensed marital and family therapists."                                                                            
                                                                                                                                
     - MOVED SB 118 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 5                                                                                                               
"An Act relating to eligibility requirements for medical                                                                        
assistance for certain children and pregnant women; and                                                                         
providing for an effective date."                                                                                               
                                                                                                                                
     - MOVED CSSB 5(HSS) OUT OF COMMITTEE                                                                                       
                                                                                                                                
SENATE BILL NO. 55                                                                                                              
"An Act relating to mental health patient rights, notifications,                                                                
and grievance procedures."                                                                                                      
                                                                                                                                
     - MOVED CSSB 55(HSS) OUT OF COMMITTEE                                                                                      
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB 221                                                                                                                  
SHORT TITLE: ALCOHOLIC BEV. TAX/PREVENTION FUND                                                                                 
SPONSOR(s): FINANCE                                                                                                             
                                                                                                                                
02/29/12       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/29/12       (S)       HSS, FIN                                                                                               
03/21/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB 118                                                                                                                  
SHORT TITLE: MEDICAID REIMBURSEMENT FOR FAMILY THERAPY                                                                          
SPONSOR(s): SENATOR(s) DAVIS                                                                                                    
                                                                                                                                
04/01/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/01/11       (S)       HSS, FIN                                                                                               
03/21/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  5                                                                                                                   
SHORT TITLE: MEDICAL ASSISTANCE ELIGIBILITY                                                                                     
SPONSOR(s): SENATOR(s) DAVIS, EGAN, ELLIS, FRENCH, WIELECHOWSKI                                                                 
                                                                                                                                
01/19/11       (S)       PREFILE RELEASED 1/7/11                                                                                
01/19/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/11       (S)       HSS, FIN                                                                                               
03/07/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/07/11       (S)       Heard & Held                                                                                           
03/07/11       (S)       MINUTE(HSS)                                                                                            
03/23/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/23/11       (S)       Heard & Held                                                                                           
03/23/11       (S)       MINUTE(HSS)                                                                                            
03/28/11       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/28/11       (S)       Moved SB   5 Out of Committee                                                                          
03/28/11       (S)       MINUTE(HSS)                                                                                            
03/30/11       (S)       HSS RPT 3DP 1DNP 1AM                                                                                   
03/30/11       (S)       DP: DAVIS, ELLIS, EGAN                                                                                 
03/30/11       (S)       DNP: DYSON                                                                                             
03/30/11       (S)       AM: MEYER                                                                                              
04/08/11       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
04/08/11       (S)       Heard & Held                                                                                           
04/08/11       (S)       MINUTE(FIN)                                                                                            
04/11/11       (S)       FIN RPT  4DP 2NR                                                                                       
04/11/11       (S)       DP: HOFFMAN, THOMAS, EGAN, ELLIS                                                                       
04/11/11       (S)       NR: STEDMAN, OLSON                                                                                     
04/11/11       (S)       FIN AT 9:00 AM SENATE FINANCE 532                                                                      
04/11/11       (S)       Moved SB   5 Out of Committee                                                                          
04/11/11       (S)       MINUTE(FIN)                                                                                            
04/14/11       (S)       RETURNED TO RLS COMMITTEE                                                                              
03/16/12       (S)       RETURNED TO HSS COMMITTEE                                                                              
03/19/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/19/12       (S)       Heard & Held                                                                                           
03/19/12       (S)       MINUTE(HSS)                                                                                            
03/21/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
BILL: SB  55                                                                                                                  
SHORT TITLE: MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES                                                                          
SPONSOR(s): SENATOR(s) DAVIS                                                                                                    
                                                                                                                                
01/19/11       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/19/11       (S)       HSS, FIN                                                                                               
02/15/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
02/15/12       (S)       Heard & Held                                                                                           
02/15/12       (S)       MINUTE(HSS)                                                                                            
03/21/12       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
JAY LIVEY, Staff                                                                                                                
Senator Lyman Hoffman                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Introduced SB 221 on behalf of the Senate                                                                 
Finance Committee, sponsor of SB 221.                                                                                           
                                                                                                                                
KATE BURKHART, Executive Director                                                                                               
Advisory Board on Alcoholism and Drug Abuse                                                                                     
Division of Behavior Health                                                                                                     
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified in support of SB 221.                                                                           
                                                                                                                                
DALE FOX, President                                                                                                             
Alaska CHARR                                                                                                                    
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 221.                                                                           
                                                                                                                                
CHRISTY LAWTON, Director                                                                                                        
Office of Children's Services                                                                                                   
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified during the discussion of SB 221.                                                                
                                                                                                                                
JEFF JESSEE, Chief Executive Officer                                                                                            
Alaska Mental Health Trust Authority                                                                                            
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 221.                                                                           
                                                                                                                                
KAREN EAKES, Chair                                                                                                              
Ketchikan Wellness Coalition                                                                                                    
Ketchikan, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 221.                                                                           
                                                                                                                                
MARILEE FLETCHER, Behavioral Health Specialist                                                                                  
Division of Behavioral Health                                                                                                   
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions related to SB 221.                                                                     
                                                                                                                                
JOANNA BALES, Deputy Director                                                                                                   
Tax Division                                                                                                                    
Department of Revenue                                                                                                           
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered questions related to SB 221.                                                                     
                                                                                                                                
CELESTE HODGE, Staff                                                                                                            
Senator Bettye Davis                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Introduced SB 118 on behalf of the sponsor.                                                               
                                                                                                                                
KEN MCCARTY, Marriage and Family Therapist                                                                                      
Kodiak, Alaska                                                                                                                  
POSITION STATEMENT: Spoke in favor of SB 118.                                                                                 
                                                                                                                                
MICHAEL WEINGARTEN, Marriage and Family Therapist                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 118.                                                                           
                                                                                                                                
JANA MINER-COLLINS, Marriage and Family Therapist                                                                               
Palmer, Alaska                                                                                                                  
POSITION STATEMENT: Testified in support of SB 118.                                                                           
                                                                                                                                
LINDA KING, President                                                                                                           
Alaska Association of Marriage and Family Therapy                                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 118.                                                                           
                                                                                                                                
JON SHERWOOD, Medicaid Special Projects                                                                                         
Office of the Commissioner                                                                                                      
Department of Health and Social Services                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided information on a fiscal note for SB                                                              
118.                                                                                                                            
                                                                                                                                
                                                                                                                                
TERI KEKLAK, Section Manager                                                                                                    
Program Integrity Section                                                                                                       
Division, Department of Behavioral Health                                                                                       
Department of Health and Social Services                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Provided information related to SB 118.                                                                   
                                                                                                                                
DIXIE HOOD, Marriage and Family Therapist                                                                                       
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Urged the committee to support SB 118.                                                                    
                                                                                                                                
JEAN MISCHEL, Attorney                                                                                                          
Legislative Legal Counsel                                                                                                       
Legislative Legal and Research Services                                                                                         
Legislative Affairs Agency                                                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions pertaining to SB 5                                                                     
                                                                                                                                
THOMAS OBERMEYER, Staff                                                                                                         
Senator Bettye Davis                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT:  Explained changes in  SB 5 on behalf  of the                                                             
sponsor.                                                                                                                        
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:33:59 PM                                                                                                                    
CHAIR BETTYE DAVIS  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 1:33 p.m.  Present at the                                                               
call  to  order were  Senators  Dyson,  Meyer, and  Chair  Davis.                                                               
Senator Egan arrived shortly thereafter.                                                                                        
                                                                                                                                
           SB 221-ALCOHOLIC BEV. TAX/PREVENTION FUND                                                                        
                                                                                                                              
1:35:01 PM                                                                                                                    
CHAIR DAVIS  announced that the  first bill before  the committee                                                               
would be SB 221.                                                                                                                
                                                                                                                                
JAY LIVEY, staff  to Senator Lyman Hoffman, introduced  SB 221 on                                                               
behalf of  the Senate  Finance Committee, sponsor  of SB  221. He                                                               
began  by saying  that SB  221 is  a relatively  simple bill.  It                                                               
states  that  the  legislature should  allocate  100  percent  of                                                               
existing alcohol  tax revenues to fund  substance abuse treatment                                                               
prevention programs.  This allocation  is intended  to supplement                                                               
and not  supplant existing money  that has been  appropriated for                                                               
treatment programs.                                                                                                             
                                                                                                                                
He  explained that  the  bill proposes  a  significant change  in                                                               
thinking about funding  alcohol and drug abuse  programs. It does                                                               
not  create  a   dedicated  fund,  as  money  still   has  to  be                                                               
appropriated before it can be spent.  But it does send the signal                                                               
that as a state we do  understand the great need for more alcohol                                                               
and drug abuse treatment.                                                                                                       
                                                                                                                                
MR.  LIVEY reported  that  during the  current  fiscal year,  the                                                               
revenue  to  the  fund  was  approximately  $19.8  million.  This                                                               
accounts for half of the  alcohol taxes collected.   Expenditures                                                               
from the fund  during this fiscal year  total approximately $19.6                                                               
million.  He related  that the  bulk of  this expenditure  is for                                                               
behavioral health grants - this  category of funding accounts for                                                               
almost 80  per cent of  the expenditures -  with the bulk  of the                                                               
rest going  to rural services  and suicide prevention,  and small                                                               
portions to  administration and Medicaid.  He referred to  a list                                                               
of grantees in members' packets.                                                                                                
                                                                                                                                
MR.  LIVEY  pointed out  that  if  this  bill  were to  pass,  an                                                               
additional $20.4  million would  be available  for appropriation.                                                               
He opined  that everyone  could suggest areas  in which  to spend                                                               
the  money -  domestic violence  programs, child  abuse treatment                                                               
and prevention, corrections, fetal  alcohol syndrome, and others.                                                               
He said  many would agree  that there is a  need in all  of these                                                               
areas for expanded or new  programs. He believed that between the                                                               
advocates, the experts in the  department, and the legislature, a                                                               
rational  plan for  determining  the most  cost-effective use  of                                                               
this money can be crafted.                                                                                                      
                                                                                                                                
1:38:41 PM                                                                                                                    
SENATOR  MEYER  said  he  looked  at  the  list  of  items  under                                                               
behavioral health and saw the inclusion of the FASD Program.                                                                    
                                                                                                                                
MR. LIVEY agreed  it was there. He said he  thought a little over                                                               
$2 million went to that program.                                                                                                
                                                                                                                                
SENATOR  MEYER wanted  to  be sure  that  education was  included                                                               
along  with prevention  and intervention  of FASD.  He summarized                                                               
that  a separate  prevention  fund  would be  set  up from  which                                                               
amounts could be appropriated.                                                                                                  
                                                                                                                                
MR.  LIVEY said  that was  correct.  He explained  that the  fund                                                               
already exists.  Currently, half of  all alcohol tax  revenues go                                                               
into that  fund and  50 percent  of the fund  is available  to be                                                               
appropriated by the legislature.                                                                                                
                                                                                                                                
CHAIR DAVIS opened public testimony.                                                                                            
                                                                                                                                
1:41:28 PM                                                                                                                    
KATE BURKHART,  Executive Director, Advisory Board  on Alcoholism                                                               
and  Drug  Abuse,  Division of  Behavior  Health,  Department  of                                                               
Health and Social  Services, testified in support of  SB 221. She                                                               
referred  to a  letter  of  support from  the  Board in  members'                                                               
packets that included  strong support that all of  the money from                                                               
the  alcohol   excise  tax  be   allocated  to   substance  abuse                                                               
prevention  and  treatment  services. She  said  the  legislative                                                               
intent behind the  increase in the alcohol tax  is to supplement,                                                               
not supplant general funds.                                                                                                     
                                                                                                                                
She  addressed  ways  the  funding  could  be  used.  She  shared                                                               
statistics  about youth  drinking.  This  legislation would  make                                                               
additional  resources available  for prevention,  as well  as for                                                               
treatment  services.  The  Alaska  Judicial  Council  released  a                                                               
report on  the impact of  the Therapeutic Justice  program, which                                                               
showed  a lower  rate of  recidivism after  participation in  the                                                               
process. She concluded that an  investment in treatment will reap                                                               
savings.                                                                                                                        
                                                                                                                                
1:45:04 PM                                                                                                                    
DALE FOX,  President, Alaska  CHARR, testified  in support  of SB                                                               
221. He urged  the committee to provide more funds  for detox and                                                               
rehab services.  One challenge is having  programs available when                                                               
people are ready  to receive help. Frequently,  citizens look for                                                               
help and are  unable to find the services they  need. He said the                                                               
alcohol industry supports SB 221.  He made three recommendations:                                                               
the  state should  study available  programs  to determine  which                                                               
ones are producing  results, fund more beds,  doctors, and nurses                                                               
at detox facilities,  and assist more people get  help from rehab                                                               
services.                                                                                                                       
                                                                                                                                
1:48:21 PM                                                                                                                    
CHRISTY LAWTON,  Director, Office  of Children's  Services (OCS),                                                               
Department of  Health and Social  Services, spoke of her  role in                                                               
working with alcohol abuse issues.  She reported that most of the                                                               
cases reported to  OCS are related to substance abuse  and due to                                                               
neglect,  sexual  abuse,  physical   abuse,  and  mental  injury.                                                               
Neglect is the  prevailing issue. Western Alaska  has the highest                                                               
number of substance  abuse cases. OCS connects  families to state                                                               
resources statewide.  She noted  that sometimes alcohol  abuse is                                                               
the  prevailing issue  that brings  families to  OCS's attention,                                                               
and other times  another issue unveils a  substance abuse problem                                                               
in the family. She did not  have data that provided the number of                                                               
cases that  are as a  direct result of substance  abuse; however,                                                               
she said her personal experience  shows that substance abuse is a                                                               
daily challenge.                                                                                                                
                                                                                                                                
JEFF JESSEE, Chief Executive Officer,  Alaska Mental Health Trust                                                               
Authority,  testified in  support  of  SB 221.  He  termed it  an                                                               
important first  step in trying  to get a  handle on some  of the                                                               
alcohol problems  in the  state. He  reported that  several years                                                               
ago the Trust funded  a study on what the cost  of alcohol was to                                                               
the state  and to  the state budget.  Overall, alcohol  abuse and                                                               
problems  related  to alcohol  abuse  cost  the state  over  $700                                                               
million.  Alcohol  abuse  costs  the  state  budget  hundreds  of                                                               
millions  of dollars  in  terms  of abuses  and  crimes and  lost                                                               
productivity.                                                                                                                   
                                                                                                                                
MR. JESSEE stressed  that AMHTA is in total  agreement with CHARR                                                               
on this  issue. He  suggested that  the next steps  are to  get a                                                               
good  evaluation of  current programs  and share  which ones  are                                                               
successful  with the  public.  The second  goal  is to  determine                                                               
where  the  unmet  needs  are.  Next,  the  legislature  and  the                                                               
executive branch  should set some  goals. For example,  one might                                                               
be to provide treatment for  domestic violence and sexual assault                                                               
victims. Other  examples might be  treatment for parents  who are                                                               
involved with  OCS or  treatment for  those who  are incarcerated                                                               
and support services upon release  from prison. He emphasized how                                                               
important it  is to provide  treatment immediately for  those who                                                               
need it.  He suggested setting  goals in these areas  and working                                                               
with multiple  agencies to develop  policies in order  to improve                                                               
the quality  of life  and to  reduce the  costs of  alcoholism in                                                               
Alaska.                                                                                                                         
                                                                                                                                
1:55:43 PM                                                                                                                    
KAREN EAKES,  Chair, Ketchikan  Wellness Coalition,  testified in                                                               
support of SB  221. She shared the results of  a community survey                                                               
which  showed  that substance  abuse  had  the highest  needs  in                                                               
Ketchikan. She  said that  37 percent  of the  respondents viewed                                                               
substance  abuse as  one of  the three  biggest health  issues in                                                               
Ketchikan.  She   stated  the  benefits  of   funding  prevention                                                               
programs.                                                                                                                       
                                                                                                                                
MARILEE  FLETCHER,  Behavioral  Health  Specialist,  Division  of                                                               
Behavioral  Health,  Department  of Health  and  Social  Services                                                               
(DHSS), answered questions related to SB 221.                                                                                   
                                                                                                                                
1:58:31 PM                                                                                                                    
SENATOR DYSON  asked what was  behind the policy decision  to not                                                               
put  all  the   proceeds  from  the  alcohol   tax  into  alcohol                                                               
treatment.                                                                                                                      
                                                                                                                                
MS. FLETCHER said she understood  that they were used for alcohol                                                               
treatment.                                                                                                                      
                                                                                                                                
SENATOR DYSON  pointed out that  only 50 percent of  the receipts                                                               
go towards treatment.                                                                                                           
                                                                                                                                
JOANNA  BALES,  Deputy  Director,  Tax  Division,  Department  of                                                               
Revenue (DOR),  addressed Senator Dyson's question.  She recalled                                                               
that 50  percent of the  alcohol tax  revenue went into  the fund                                                               
when it was  first created in 2002. At that  time the alcohol tax                                                               
was bringing  in between $12  million and $13 million  each year.                                                               
She said she understood that  when alcohol tax revenues increased                                                               
to about $30 million a year,  50 percent of the tax exceeded what                                                               
was currently going  into the fund - about $19  million. It was a                                                               
policy  call  to  continue  to   contribute  50  percent  to  the                                                               
prevention fund.                                                                                                                
                                                                                                                                
SENATOR  DYSON  understood  that   it  was  an  executive  branch                                                               
decision, not a legislative decision.                                                                                           
                                                                                                                                
MS. BALES clarified  that the legislation was  sponsored by then-                                                               
Representative Lisa Murkowski.                                                                                                  
                                                                                                                                
SENATOR DYSON  stated that  he supports  expanding the  amount of                                                               
money  that  goes into  treatment.  He  asked  if there  was  any                                                               
discussion  of deducting  administrative costs  from alcohol  tax                                                               
receipts.                                                                                                                       
                                                                                                                                
MS. BALES replied that she was  not aware of that discussion. She                                                               
explained that most DOR programs  are not receipt driven, but are                                                               
funded by general funds.                                                                                                        
                                                                                                                                
2:01:21 PM                                                                                                                    
SENATOR DYSON asked if DHSS uses  a percentage of the receipts to                                                               
cover the administration of the fund.                                                                                           
                                                                                                                                
MS. FLETCHER said she believed  a small percentage does go toward                                                               
administering the fund.                                                                                                         
                                                                                                                                
CHAIR DAVIS noted that Senate Finance  will hear SB 221 next. She                                                               
reported numerous  letters of support  for the bill and  said she                                                               
has received no opposition to the bill.                                                                                         
                                                                                                                                
2:02:23 PM                                                                                                                    
SENATOR  EGAN  moved to  report  SB  221  out of  committee  with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being no  objection, SB 221 was reported out  of the Senate                                                               
Health and Social Services Standing committee.                                                                                  
                                                                                                                                
At-ease from 2:02 p.m. to 2:05 p.m.                                                                                             
                                                                                                                                
        SB 118-MEDICAID REIMBURSEMENT FOR FAMILY THERAPY                                                                    
                                                                                                                                
2:05:21 PM                                                                                                                    
CHAIR DAVIS stated that SB 118 was before the committee.                                                                        
                                                                                                                                
CELESTE HODGE, staff, Senator Bettye Davis, sponsor of SB 118,                                                                  
introduced the bill. She read from the following sponsor                                                                        
statement:                                                                                                                      
                                                                                                                                
     SB 118 is  a simple bill that  adds counseling services                                                                    
     provided by a licensed  marital and family therapist to                                                                    
     the list  of optional  services covered by  the Medical                                                                    
     Assistance  Program  in  the  state  of  Alaska.  Under                                                                    
     current  Alaska   law,  licensed  marital   and  family                                                                    
     therapists   are  not   eligible   to  receive   direct                                                                    
     reimbursement  for   services  provided   to  Medicaid-                                                                    
     eligible clients.  Community behavioral  health service                                                                    
     providers  and mental  health physicians'  clinics that                                                                    
     are enrolled  with the Medicaid  program and  employ or                                                                    
     contract  with licensed  family and  medical therapists                                                                    
     may receive Medicaid reimbursement for those services.                                                                     
                                                                                                                                
     The Department  of Health and Social  Services will pay                                                                    
     for  behavioral health  services provided  by a  mental                                                                    
     health  physician's clinic,  only if  the services  are                                                                    
     for treatment and a  diagnosable mental health disorder                                                                    
     and the services  are provided by a  psychiatrist or by                                                                    
     one of  the following  licensed professionals  who work                                                                    
     under  the  direct  supervision  of  the  psychiatrist.                                                                    
     Those  professional individuals  include psychologists,                                                                    
     psychological  associates,   clinical  social  workers,                                                                    
     physician  assistants,  advanced  nurse  practitioners,                                                                    
     psychiatric nursing  clinical specialists,  marital and                                                                    
     family  therapist,  or   professional  counselors.  For                                                                    
     community  behavior  health service  providers,  clinic                                                                    
     services must be provided by  a member of the community                                                                    
     behavior  health  service  provider's staff  who  is  a                                                                    
     physician,  a  physician's  assistant,  advanced  nurse                                                                    
     practitioner, or  mental health  professional clinician                                                                    
     under the general direction  of a physician. Otherwise,                                                                    
     the  only independent  providers  who  are eligible  to                                                                    
     bill directly  for Medicaid behavioral  health services                                                                    
     are licensed psychologists and physicians.                                                                                 
                                                                                                                                
     According  to the  Kaiser Family  Foundation, about  47                                                                    
     percent of  Alaska's population, or 334,975  are living                                                                    
     in mental  health professional shortage areas.  Of that                                                                    
     group, Kaiser estimates that over  38 percent are under                                                                    
     served. In  September of 2011, the  Alaska Primary Care                                                                    
     Association  issued  a resolution  supporting  Medicaid                                                                    
     licensed marriage and  family therapists, among others,                                                                    
     in  order  to address  the  shortage  of mental  health                                                                    
     providers and  to improve  access to  behavioral health                                                                    
     services in the state.                                                                                                     
                                                                                                                                
SENATOR DAVIS opened public testimony.                                                                                          
                                                                                                                                
2:08:35 PM                                                                                                                    
KEN MCCARTY, Marriage and Family  Therapist, spoke in favor of SB                                                               
118. He discussed the lack of  family therapists in the state. He                                                               
described some  of the  frustrations from  this issue  and shared                                                               
examples in Kodiak, Barrow, and  Nome. He explained that American                                                               
Family Therapists  can provide mental  health work  and substance                                                               
abuse treatment.  Adding them  to the list  under Title  47 would                                                               
give the state more resources to provide for community needs.                                                                   
                                                                                                                                
2:11:20 PM                                                                                                                    
MICHAEL WEINGARTEN,  Marriage and Family Therapist,  testified in                                                               
support of  SB 118. He  shared his  experience with all  types of                                                               
clients. He  related that very  few Medicaid clients show  up for                                                               
counseling  without  a  referral  from some  agency,  person,  or                                                               
court.  Many children  in residential  treatment are  required to                                                               
have  family  treatment.  Most  Medicaid  patients  show  up  for                                                               
treatment because  they must.  He spoke  in favor  of independent                                                               
therapists being included  on the list of  providers, as included                                                               
in this bill.                                                                                                                   
                                                                                                                                
2:17:16 PM                                                                                                                    
JANA MINER-COLLINS,  Marriage and Family Therapist,  testified in                                                               
support of  SB 118.  She spoke  of the  possibility of  having to                                                               
turn Medicaid  clients away  because of the  loss of  a physician                                                               
who provided  those services. Those  clients will not be  able to                                                               
receive services  because therapists are not  currently listed as                                                               
Medicaid providers.                                                                                                             
                                                                                                                                
LINDA KING, President, Alaska Association  of Marriage and Family                                                               
Therapy,  testified  in  support  of  SB  118.  She  related  her                                                               
experience in a  clinic that turns away  Medicaid clients because                                                               
therapists are  not currently considered providers.  She reported                                                               
that Alaska has  a high number of child neglect  and abuse cases,                                                               
and there  is a problem with  lack of therapy services  for these                                                               
children, leading  to a  cycle of abuse.  She reported  that most                                                               
states  allow  licensed  marital  and  family  therapists  to  be                                                               
included as Medicaid providers.                                                                                                 
                                                                                                                                
2:22:52 PM                                                                                                                    
CHAIR DAVIS requested  someone from the Department  of Health and                                                               
Social Services to testify on the bill.                                                                                         
                                                                                                                                
JON   SHERWOOD,  Medicaid   Special  Projects,   Office  of   the                                                               
Commissioner, Department of Health  and Social Services, provided                                                               
information  about a  fiscal note  for SB  118 regarding  medical                                                               
assistance  administration.  He  related  information  about  the                                                               
changes to  the claims  payment system.  He estimated  a one-time                                                               
cost of $275,000 of which $68,800 would be general funds.                                                                       
                                                                                                                                
CHAIR DAVIS asked  if family therapists would be an  asset to the                                                               
state under Medicaid.                                                                                                           
                                                                                                                                
2:25:17 PM                                                                                                                    
TERI   KEKLAK,  Section   Manager,   Program  Integrity   Section                                                               
Division, Department  of Behavioral Health, Department  of Health                                                               
and Social Services, provided information  related to SB 118. She                                                               
reported that the division is  neutral on the bill. She explained                                                               
that when a  new provider is added to the  Medicaid system, there                                                               
are  issues to  work on  before implementation  of a  new service                                                               
category can be  added. She stated that adding a  new provider to                                                               
Medicaid improves access to clients.                                                                                            
                                                                                                                                
CHAIR DAVIS said the bill would  be going to Senate Finance next.                                                               
She opined that the bill  was needed. She asked committee members                                                               
for their opinions.                                                                                                             
                                                                                                                                
2:27:36 PM                                                                                                                    
SENATOR DYSON shared that he did  not have a conflict of interest                                                               
now that  his wife has retired  as a licensed marital  and family                                                               
therapist.                                                                                                                      
                                                                                                                                
DIXIE HOOD,  Marriage and Family  Therapist, urged  the committee                                                               
to support  SB 118. She  said she the  bill would allow  for more                                                               
options for  patients seeking counseling services,  especially in                                                               
areas  with  limited mental  health  providers.  She opined  that                                                               
including  therapists under  Medicaid  would save  money from  no                                                               
longer having  psychiatrists and psychologists travel  to provide                                                               
those  services.  Passage  of  SB 118  would  also  provide  fair                                                               
reimbursement to therapists.                                                                                                    
                                                                                                                                
She shared  her experience of  providing a sliding fee  scale for                                                               
Medicaid  patients in  order  to  serve them.  She  spoke of  the                                                               
qualifications  to be  a licensed  therapist, her  wide range  of                                                               
experience,  and  the   unfairness  of  not  being   able  to  be                                                               
reimbursed for Medicaid.                                                                                                        
                                                                                                                                
2:35:12 PM                                                                                                                    
CHAIR  DAVIS thanked  Ms. Hood  for her  work. She  closed public                                                               
testimony.                                                                                                                      
                                                                                                                                
CHAIR DAVIS stated that she felt the bill was needed.                                                                           
                                                                                                                                
SENATOR  EGAN  moved  to  report   SB  118  from  committee  with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being  no objection,  SB 118 was  reported from  the Senate                                                               
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
At-ease from 2:36 p.m. to 2:38 p.m.                                                                                             
                                                                                                                                
             SB   5-MEDICAL ASSISTANCE ELIGIBILITY                                                                          
                                                                                                                                
2:38:17 PM                                                                                                                    
CHAIR DAVIS  announced that  the next  bill before  the committee                                                               
was SB 5.  She noted that at  the previous meeting the  CS for SB                                                               
5, version I, was adopted.                                                                                                      
                                                                                                                                
SENATOR  MEYER asked  if anyone  from the  Department of  Law was                                                               
present.                                                                                                                        
                                                                                                                                
JEAN  MISCHEL, Attorney,  Legislative Legal  Counsel, Legislative                                                               
Legal   and  Research   Services,  Legislative   Affairs  Agency,                                                               
answered questions pertaining to SB 5.                                                                                          
                                                                                                                                
SENATOR MEYER  pointed out that the  new version [I] of  the bill                                                               
addresses   previous   concerns   about  abortion   funding.   By                                                               
[maintaining]  Medicaid  coverage for  children  over  12 at  175                                                               
percent of the  federal poverty level (FPL), the  risk of funding                                                               
more  abortions is  reduced. He  asked if  two classes  of people                                                               
were being created  by the bill; those over 12  who are funded at                                                               
175 percent of the  FPL and those 12 and under  who are funded at                                                               
200  percent  of  the  FPL.  He  questioned  if  SB  5  could  be                                                               
challenged  in  court  for  that reason.  He  requested  a  legal                                                               
explanation of  what the  court would  likely do  if the  bill is                                                               
challenged.                                                                                                                     
                                                                                                                                
MS. MISCHEL  replied that she  did consider the  equal protection                                                               
issue  that  might  be  raised  when  drawing  a  line  regarding                                                               
eligibility based on  age. She said she could not  predict if the                                                               
bill will be  challenged for that reason; however,  she opined if                                                               
the  bill is  challenged on  equal protection  grounds, it  would                                                               
likely survive constitutional scrutiny  because Medicaid has many                                                               
age categories  for both mandatory  and optional  services. Under                                                               
an equal  protection analysis, the  courts would  examine whether                                                               
or not  children over 13  are similarly situated to  the expanded                                                               
income  eligibility category  that version  I of  SB 5  provides.                                                               
That would  be a hurtle  for a challenger because  teenagers have                                                               
different types  of health problems  and the legislature  has the                                                               
ability  to make  cost decisions  and provide  services that  the                                                               
legislature  considers, from  a policy  standpoint, valuable  and                                                               
cost effective.                                                                                                                 
                                                                                                                                
MS. MISCHEL  explained that Congress provides  that for mandatory                                                               
coverage, all  states that participate  in Medicaid  must provide                                                               
mandatory medical  services for kids  age six and younger  at 133                                                               
percent of  FPL. That demonstrates  that there already is  an age                                                               
cutoff. Some  states only provide  for that age group;  Nevada is                                                               
an example. She continued  to say if a family is  at or below 100                                                               
percent of  the FPL,  that age  limit goes away.  SB 5  goes well                                                               
above the mandatory minimums.                                                                                                   
                                                                                                                                
MS. MISCHEL  stated that if  the court found that  teenagers were                                                               
similarly situated  to kids under  13, then the court  would look                                                               
at whether or  not there is a fundamental interest  at stake. She                                                               
said  she  could  not  answer   that  complicated  question.  She                                                               
stressed that it is up to  the legislature to articulate either a                                                               
compelling interest  or a legitimate interest,  depending on what                                                               
the court  determines is at  stake. Because there is  a potential                                                               
for dealing  with reproductive services for  teenagers, the court                                                               
could apply the  compelling interest standard if  they found that                                                               
teenagers  were similarly  situated. She  noted that  would be  a                                                               
higher  burden for  the  state  to meet,  but  not an  impossible                                                               
burden.  There are  many potential  state interests,  such as  to                                                               
provide medical services  to a more vulnerable  population, or to                                                               
cover  immunizations  for  school-age children.  The  legislature                                                               
would have  to justify  treating similarly  situated individuals.                                                               
If  a court  found that  it was  just an  economic interest,  the                                                               
state would need to articulate  a legitimate interest for drawing                                                               
the age distinction  and provide some rational  basis for cutting                                                               
off the age limits.                                                                                                             
                                                                                                                                
MS.  MISCHEL related  that  she  could not  find  any cases  that                                                               
looked  at age  limits that  would have  precedential value.  She                                                               
gave  an  example  of  a  Washington state  case  for  home  care                                                               
services in which  an "age of 13", along with  "a child living at                                                               
home", was found  to be arbitrary. The court would  be looking to                                                               
see if the  age cutoff was arbitrary. SB 5  is neutral about what                                                               
type of  care is  provided. She  concluded that it  is up  to the                                                               
legislature to  draw the distinctions. Age  categories are common                                                               
distinctions  made for  Medicaid purposes.  She gave  examples of                                                               
age categories.  She said SB  5 just  deals with an  added income                                                               
limit.                                                                                                                          
                                                                                                                                
MS.  MISCHEL stated  that the  risk to  the state  is fairly  low                                                               
because  if  an equal  protection  challenge  did prevail,  after                                                               
first a finding  that the younger kids are  similarly situated to                                                               
the  older  ones,  and  that  the  state  either  didn't  have  a                                                               
compelling  interest or  legitimate interest  that is  reasonably                                                               
related to  the change  in the  law, the result  would not  be to                                                               
eliminate Medicaid care  for children in general, it  would be to                                                               
go back to the 175 percent category.                                                                                            
                                                                                                                                
MS. MISCHEL  pointed out that the  other thing version I  of SB 5                                                               
does is include the added  income category for children under the                                                               
age of  13 in  the cost-sharing  provision, just  as it  does for                                                               
children under 19 years old who  are from homes with incomes over                                                               
175 percent of the FPL.                                                                                                         
                                                                                                                                
2:50:36 PM                                                                                                                    
SENATOR MEYER  summarized that if the  courts would find SB  5 to                                                               
be  unconstitutional,  the  statute  would  revert  back  to  175                                                               
percent of the FPL for everyone.                                                                                                
                                                                                                                                
MS. MISCHEL said yes. The court would invalidate the change.                                                                    
                                                                                                                                
SENATOR  MEYER noted  that  the reason  the  age distinction  was                                                               
being made in  the bill was due to the  possibility of abortions.                                                               
He  asked if  the  court  would find  that  reason arbitrary  and                                                               
capricious.                                                                                                                     
                                                                                                                                
MS.  MISCHEL said  she did  not  know, but  thought it  extremely                                                               
unlikely. The  Alaska Supreme  Court has  already found  that the                                                               
state  has  a  legitimate  interest in  protecting  children  and                                                               
providing medically  necessary services. In the  parental consent                                                               
case, it was  found that parents and the state  have a legitimate                                                               
interest in preventing abortions for  children to the extent that                                                               
is allowed under the privacy interests  in the state. She did not                                                               
think "arbitrary"  would be considered.  The question  is whether                                                               
or not  the court would say  the only reason the  legislature has                                                               
limited  the   increased  eligibility  category  is   to  exclude                                                               
abortion  coverage. She  opined  that someone  might  be able  to                                                               
argue  the case  on  privacy  grounds. The  court  would apply  a                                                               
compelling interest standard  and that interest would  have to be                                                               
narrowly tailored to  the change. Even under the  higher level of                                                               
scrutiny,  the court  could find  compelling  state interest,  as                                                               
they did in the parental notice litigation.                                                                                     
                                                                                                                                
SENATOR  MEYER gave  an example  of a  qualifying child,  age 12,                                                               
losing eligibility at age 13.                                                                                                   
                                                                                                                                
MS. MISCHEL agreed with Senator Meyer's example.                                                                                
                                                                                                                                
SENATOR DYSON thanked  Ms. Mischel for her work.  He guessed that                                                               
the bill would be challenged, and  that it would be difficult for                                                               
the amendment to survive the court challenge.                                                                                   
                                                                                                                                
2:54:23 PM                                                                                                                    
MS. MISCHEL suggested articulating  additional policy reasons for                                                               
the  age cutoff,  in  addition to  preventing  teen abortions  or                                                               
pregnancies.  She gave  examples such  as how  many children  are                                                               
affected, the  cost benefit analysis,  and types of  medical care                                                               
younger children need versus older children.                                                                                    
                                                                                                                                
SENATOR DYSON understood it was up  to the state to demonstrate a                                                               
compelling state  interest for the  position it is taking  on the                                                               
amended version of SB 5 in order to meet any challenges.                                                                        
                                                                                                                                
CHAIR DAVIS  said the bill  would not  go to Senate  Finance, but                                                               
rather  to Senate  Rules. She  requested that  the bill  be moved                                                               
from committee.                                                                                                                 
                                                                                                                                
SENATOR MEYER asked about the new fiscal notes.                                                                                 
                                                                                                                                
CHAIR  DAVIS said  fiscal notes  will be  attached when  the bill                                                               
goes to the Rules Committee.                                                                                                    
                                                                                                                                
At-ease from 2:57 p.m. to 2:58 p.m.                                                                                             
                                                                                                                                
2:58:23 PM                                                                                                                    
SENATOR EGAN  moved to report  the CS for  SB 5, version  I, from                                                               
committee  with individual  recommendations  and the  forthcoming                                                               
fiscal notes.                                                                                                                   
                                                                                                                                
SENATOR DYSON objected.                                                                                                         
                                                                                                                                
A  roll call  vote was  taken.  Senators Meyer,  Egan, and  Davis                                                               
voted in favor of the motion  and Senator Dyson voted against it.                                                               
Therefore, CSSB  5(HSS) moved from  the Senate Health  and Social                                                               
Services Committee by a 3:1 vote.                                                                                               
                                                                                                                                
At-ease from 2:59 p.m. to 3:00 p.m.                                                                                             
                                                                                                                                
        SB  55-MENTAL HEALTH PATIENT RIGHTS & GRIEVANCES                                                                    
                                                                                                                                
3:00:14 PM                                                                                                                    
CHAIR DAVIS  announced that SB  55 was before the  committee. She                                                               
related that  the committee  has already heard  the bill  and she                                                               
wished to move it on to the next committee of referral.                                                                         
                                                                                                                                
SENATOR  EGAN moved  to  adopt  the CS  for  SB  55, labeled  27-                                                               
LS0082\R, as the working draft before the committee.                                                                            
                                                                                                                                
CHAIR DAVIS objected for discussion purposes.                                                                                   
                                                                                                                                
3:01:44 PM                                                                                                                    
THOMAS OBERMEYER, Staff, Senator Bettye  Davis, sponsor of SB 55,                                                               
explained the  changes in the bill.   Section 1 of  the bill adds                                                               
eight rights  to the list  of rights  of the person  undergoing a                                                               
mental health evaluation. This  change accommodates requests made                                                               
by  the  Department of  Health  and  Social Services  (DHSS)  and                                                               
others.                                                                                                                         
                                                                                                                                
Section  2  establishes the  grievance  procedure  that had  been                                                               
described before,  but now more carefully  defines "grievance" to                                                               
mean  "a complaint  concerning the  patient's  treatment care  or                                                               
rights at  a mental  health evaluation  or treatment  facility in                                                               
the state."  It includes that  the imposition of  attorney's fees                                                               
on the grievant would inflict undue hardship.                                                                                   
                                                                                                                                
Section 3  requires that  DHSS provide  a standardized  notice to                                                               
patients  that  separately  describes patient  rights,  available                                                               
assistance, and  the grievance procedure,  and provide  a written                                                               
copy.                                                                                                                           
                                                                                                                                
Section  4 provides  that the  presumption in  Section 2  has the                                                               
effect of changing Rule 82, Alaska Rules of Civil Procedure.                                                                    
                                                                                                                                
Section 5 provides a conditional  effect of the presumption added                                                               
in  Section  2 that  it  would  take  effect  only if  Section  4                                                               
receives  a two-thirds  majority  vote of  each  house. Only  one                                                               
section would require a two-thirds vote  and that is if the court                                                               
rules regarding attorney's fees were changed.                                                                                   
                                                                                                                                
CHAIR DAVIS  noted the changes  made were  at the request  of the                                                               
committee at a previous meeting.                                                                                                
                                                                                                                                
CHAIR DAVIS asked  for a motion to move the  bill from committee.                                                               
[The assumption  was that the  objection for  discussion purposes                                                               
was removed.]                                                                                                                   
                                                                                                                                
SENATOR EGAN  moved to report the  CS for SB 55,  version R, from                                                               
committee  with individual  recommendations and  the accompanying                                                               
fiscal  notes.  There  being  no   objection,  CSSB  55(HSS)  was                                                               
reported  from the  Senate Health  and  Social Services  Standing                                                               
Committee.                                                                                                                      
                                                                                                                                
3:04:44 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Davis  adjourned the  Senate  Health  and Social  Services                                                               
Standing Committee at 3:04 p.m.                                                                                                 

Document Name Date/Time Subjects
SB 221.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
SB 221 Sponsor Statement.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
11 7 11 Alcohol Drug Abuse GF Funding LegLog 870-1.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Economic Costs of Alcohol and Other Drug Abuse in Alaska - McDowell 2005 Report.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Substace Abuse and Mental Health Services Administration Cost Offset of Tx.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
SB 221 Fiscal Note.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Copy of FY11 Alcohol Drug Abuse Treatment GF SA Rev Expend as of 10 31 11.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
FY12 Substance Abuse Authorized Components (2).pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Alaska Federation of Natives Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Anchorage Assembly Resolution 2011-347.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Fairbanks Native Association Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
ISER 2009 Report - The Cost of Crime.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Mental Health Trust Authority Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Nine Star Enterprises Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Partners for Progress Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
SB 221-Letter of Support-ABADA.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
2011 Annual Drug Report.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
News Article.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
CHARR Support Letter.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
Anchorage CHARR Support Letter.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
SB 118 Sponsor Statement.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 Bill.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 Fiscal Note.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 Medicare Coverage of MFT.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 MFT in Other States- Medicaid.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 Medical Assistance Reimbursement- Medical Assistance Reimbursement
SB 118 Letters of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 SOA Briefing.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB 118 Response to SOA Briefing.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB 118 Medical Assistance Reimbursement- Marital and Family Therapists
SB221Fiscal Note 2-DOA-DOF-3-16-12.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
SB 221 Alcoholic Beverage Tax Fund
SB118 Fiscal Note DHSS-BHA.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB118 Fiscal Note DHSS-BHMS.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB118 Fiscal NoteDHSS-MAA.pdf SHSS 3/21/2012 1:30:00 PM
SB 118
SB221Fiscal Note 2-DOA-DOF-3-16-12.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
Log 1102 Alcohol and Other Drug Treatment and Prevention Fund Grantees Final Response (2).pdf SHSS 3/21/2012 1:30:00 PM
SB 221
Alaska Wine Spirit Wholesalers Association.pdf SHSS 3/21/2012 1:30:00 PM
SB 221
Catholic Social Services Letter of Support.pdf SHSS 3/21/2012 1:30:00 PM
SB 221