Legislature(2017 - 2018)BELTZ 105 (TSBldg)

04/14/2017 05:15 PM HEALTH & SOCIAL SERVICES

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Location Change --
-- Time Change --
<Bill Hearing Canceled>
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved HJR 14 Out of Committee
-- Public Testimony --
Heard & Held
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         April 14, 2017                                                                                         
                           5:17 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Senator David Wilson, Chair                                                                                                     
Senator Peter Micciche                                                                                                          
Senator Tom Begich                                                                                                              
MEMBERS ABSENT                                                                                                                
Senator Natasha von Imhof, Vice Chair                                                                                           
Senator Cathy Giessel                                                                                                           
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 72                                                                                                              
"An Act adding  to the powers and duties of  the State Commission                                                               
for Human Rights; and relating  to and prohibiting discrimination                                                               
based on sexual orientation or gender identity or expression."                                                                  
     - HEARD & HELD                                                                                                             
HOUSE JOINT RESOLUTION NO. 14                                                                                                   
Urging  the Federal  Communications  Commission  to increase  the                                                               
Rural  Health  Care Program  budget  sufficiently  to adjust  for                                                               
inflation,  advances in  technology  and  the services  available                                                               
with  increased  broadband,  and   the  increase  in  demand  for                                                               
broadband-based services and  provide for any unused  funds to be                                                               
carried  forward to  future funding  years,  ensuring that  rural                                                               
communities in  the state continue  to have access  to affordable                                                               
broadband telehealth services.                                                                                                  
     - MOVED HJR 14 OUT OF COMMITTEE                                                                                            
HOUSE BILL NO. 186                                                                                                              
"An Act  relating to the donation  of food; and relating  to food                                                               
     - BILL HEARING CANCELED                                                                                                    
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: SB 72                                                                                                                   
SHORT TITLE: DISCRIMINATION: GENDER ID.; SEXUAL ORIENT.                                                                         
SPONSOR(s): SENATOR(s) GARDNER                                                                                                  
03/01/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/01/17       (S)       HSS, JUD, FIN                                                                                          
03/31/17       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/31/17       (S)       Heard & Held                                                                                           
03/31/17       (S)       MINUTE(HSS)                                                                                            
04/10/17       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/10/17       (S)       -- MEETING CANCELED -                                                                                  
04/14/17       (S)       HSS AT 5:15 PM BELTZ 105 (TSBldg)                                                                      
BILL: HJR 14                                                                                                                  
SHORT TITLE: FCC: INCREASE RURAL HEALTH CARE BUDGET                                                                             
SPONSOR(s): REPRESENTATIVE(s) EDGMON                                                                                            
03/06/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
03/06/17       (H)       L&C                                                                                                    
03/15/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
03/15/17       (H)       -- MEETING CANCELED --                                                                                 
03/17/17       (H)       L&C AT 3:15 PM CAPITOL 106                                                                             
03/17/17       (H)       Heard & Held                                                                                           
03/17/17       (H)       MINUTE(L&C)                                                                                            
03/20/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
03/20/17       (H)       Moved HJR 14 Out of Committee                                                                          
03/20/17       (H)       MINUTE(L&C)                                                                                            
03/22/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
03/22/17       (H)       Moved HJR 14 Out of Committee                                                                          
03/22/17       (H)       MINUTE(L&C)                                                                                            
03/24/17       (H)       L&C RPT 7DP                                                                                            
03/24/17       (H)       DP: SULLIVAN-LEONARD, STUTES, WOOL,                                                                    
                         JOSEPHSON, BIRCH, KNOPP, KITO                                                                          
04/05/17       (H)       TRANSMITTED TO (S)                                                                                     
04/05/17       (H)       VERSION: HJR 14                                                                                        
04/06/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/06/17       (S)       HSS                                                                                                    
04/12/17       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
04/12/17       (S)       -- MEETING CANCELED --                                                                                 
04/14/17       (S)       HSS AT 5:15 PM BELTZ 105 (TSBldg)                                                                      
WITNESS REGISTER                                                                                                              
TIMOTHY CLARK, Staff                                                                                                            
Representative Bryce Edgmon                                                                                                     
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided an overview of HJR 14.                                                                           
JON ZASADA, Policy Integration Director                                                                                         
Alaska Primary Care Association                                                                                                 
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Provided information in support of HJR 14.                                                                
ACTION NARRATIVE                                                                                                              
5:17:26 PM                                                                                                                    
CHAIR DAVID WILSON called the Senate Health and Social Services                                                               
Standing Committee meeting to order at 5:17 p.m. Present at the                                                                 
call to order were Senators Begich, Micciche, and Chair Wilson.                                                                 
        SB 72-DISCRIMINATION: GENDER ID.; SEXUAL ORIENT.                                                                    
5:17:53 PM                                                                                                                    
CHAIR WILSON announced the consideration of SB 72 and stated the                                                                
     At this  time, I would  like to close  public testimony                                                                    
     on   [SB  72],   "Discrimination:  Gender   ID,  Sexual                                                                    
     Orientation"  that  was  presented by  Senator  Gardner                                                                    
     which we first heard on March 31.                                                                                          
SENATOR BEGICH objected and explained as follows:                                                                               
      Mr. Chairman, I object to closing testimony on that                                                                       
        bill without proper notification to people. I am                                                                        
     confused by that, could you explain this to me?                                                                            
CHAIR WILSON explained as follows:                                                                                              
     Yes, we can always reopen testimony another time, but                                                                      
     at this time just for, yes, SB 72.                                                                                         
SENATOR BEGICH replied as follows:                                                                                              
     You said SB 72.                                                                                                            
CHAIR WILSON replied yes.                                                                                                       
SENATOR BEGICH noted his objection and concern as follows:                                                                      
     I find that uncomfortable. We  have received so much e-                                                                    
     mail,  we received  phone calls  asking about  when the                                                                    
     next public testimony is going to  be on this and I was                                                                    
     not aware  that you were going  to do that today.  So I                                                                    
     feel  a  little  blindsided  by that.  I  have  assured                                                                    
     constituents  that I  would tell  them that  if I  knew                                                                    
     there was public  hearing open still that  I would pass                                                                    
     that  on to  them and  I  feel a  little blindsided  by                                                                    
     this. You might want to take an at-ease.                                                                                   
5:19:03 PM                                                                                                                    
At ease.                                                                                                                        
5:20:13 PM                                                                                                                    
CHAIR WILSON called the committee back to order. He explained                                                                   
the purpose of closing public testimony on SB 72 as follows:                                                                    
     So  this  being  the  closing down  into  the  interim,                                                                    
     prepping for the  interim, we found it best  to sort of                                                                    
     close public testimony so that  we don't, folks waiting                                                                    
     for to  come back to  testify and  we can take  this up                                                                    
     and  open testimony  at a  later date  in time  when we                                                                    
     have a bill to come back before us another day.                                                                            
SENATOR BEGICH withdrew his objection as follows:                                                                               
     Mr.  Chairman,  thank  you   for  that  explanation,  I                                                                    
     withdraw my objection.                                                                                                     
[CHAIR WILSON held SB 72 in committee for future consideration,                                                                 
and public testimony was closed.]                                                                                               
         HJR 14-FCC: INCREASE RURAL HEALTH CARE BUDGET                                                                      
5:20:50 PM                                                                                                                    
CHAIR  WILSON announced  the consideration  of HJR  14. He  noted                                                               
that the  legislation is time  sensitive and his intention  is to                                                               
hear  the bill,  take public  testimony, and  hopefully move  the                                                               
resolution out of committee.                                                                                                    
5:21:15 PM                                                                                                                    
TIMOTHY CLARK, Staff, Representative Bryce Edgmon, Alaska State                                                                 
Legislature, Juneau, Alaska, sponsor of the resolution, provided                                                                
the following overview of HJR 14:                                                                                               
     HJR  14  has  to   do  with  a  Federal  Communications                                                                    
     Commission (FCC)  funded broadband support  program for                                                                    
     rural centers  in Alaska and across  the country. Rural                                                                    
     Alaska has  made great strides  in recent years  in the                                                                    
     long  distance  delivery  of   health  care  via  tele-                                                                    
     medicine;  these  broadband   services  expand  locally                                                                    
     available  treatment options  for an  increasing number                                                                    
     of  maladies including  treatment for  substance abuse,                                                                    
     they  accelerate  diagnosis  and  treatment,  and  help                                                                    
     Alaskans avoid  expensive travel for care,  but despite                                                                    
     these advances, we are about to hit a roadblock.                                                                           
     The  existence  of such  services  depends  on the  FCC                                                                    
     Rural  Health Care  Universal Service  Support Program.                                                                    
     The budget for the program  has been capped at the same                                                                    
     level since  it was established in  1997, 20-years ago.                                                                    
     The  program   is  funded  through   Universal  Service                                                                    
     charges,  there  is  no state-funding  obligation.  For                                                                    
     most  of  the  program's existence,  the  $400  million                                                                    
     budget has been  enough to meet demand, but  as you can                                                                    
     imagine  after  decades   of  advances  in  technology,                                                                    
     increases in  demand, and the effect  of inflation, the                                                                    
     FCC expects  the demand exceed  the budget cap  for the                                                                    
     first time in 2017.                                                                                                        
     HJR 14 urges the FCC  to increase the Rural Health Care                                                                    
     Universal  Support budget  sufficiently  to adjust  for                                                                    
     inflation, to  keep up with advances  in technology and                                                                    
     services available  to increase broadband, and  to meet                                                                    
     the   increased   demand  for   these   broadband-based                                                                    
     services; additionally,  the resolution  encourages the                                                                    
     FCC to  index the program  budget for inflation  and to                                                                    
     allow any unused funds to  be carried forward to future                                                                    
     funding  years, this  will allow  health-care providers                                                                    
     to continue  improving access to  health care  in rural                                                                    
5:24:24 PM                                                                                                                    
SENATOR MICCICHE said he respects the noted names and                                                                           
organizations that support HJR 14. He asked Mr. Clark if he was                                                                 
aware of any opposition to HJR 14.                                                                                              
MR. CLARK answered none that he  was aware of. He noted that when                                                               
the  resolution  crossed  the  floor of  the  House  concern  was                                                               
expressed regarding  the way programs from  the Universal Service                                                               
charges are  funded. He opined  that the objection may  have been                                                               
related to  the potential  for increased  costs to  consumers. He                                                               
pointed  out that  a $200  million increase  to the  budget would                                                               
equate  to pennies  on consumers'  bills  because the  fund is  a                                                               
nationwide program.                                                                                                             
CHAIR WILSON asked Mr. Zasada if he had any comments to add.                                                                    
5:26:50 PM                                                                                                                    
JON  ZASADA, Policy  Integration  Director,  Alaska Primary  Care                                                               
Association, Anchorage,  Alaska, addressed  the need  to increase                                                               
the rural health-care budget as follows:                                                                                        
     This  issue  is  moving  quickly,  federally.  For  the                                                                    
     current  fiscal year  that we  are  in, some  community                                                                    
     health  centers  are  already  seeing  a  drop  in  the                                                                    
     subsidy  that they  are  receiving  through this  fund,                                                                    
     meaning  that some  providers'  monthly internet  bills                                                                    
     are  going up  from $500  a  month to  almost $4,000  a                                                                    
     month. The  cap-increase effort is very  timely, we are                                                                    
     working so  that it doesn't  occur for the  fiscal year                                                                    
     that starts July 1.                                                                                                        
     Additional ramifications  that I  wanted to  just share                                                                    
     with the  committee, certain SB 74  redesign components                                                                    
     could also be  endangered if the cap is  not raised and                                                                    
     these include: the ability of  rural providers to fully                                                                    
     use  tele-health, to  undertake  care coordination,  to                                                                    
     continue  to  support  mental-health  parity  in  rural                                                                    
     communities and in their efforts  to address the opioid                                                                    
     Basically,  rural  health  providers have  built  their                                                                    
     care   systems  around   dedicated  internet   that  is                                                                    
     subsidized  through   this  program  and  it   is  very                                                                    
     important. We  believe the state  of Alaska  showed its                                                                    
     full  support  to  the  federal  government  as  we  go                                                                    
     through the process of having the cap increased.                                                                           
5:28:44 PM                                                                                                                    
SENATOR MICCICHE asked if Mr.  Zasada believes that Alaska enjoys                                                               
more support  from the  program than what  the state  likely pays                                                               
into the program.                                                                                                               
MR. ZASADA replied that Senator  Micciche's query is probably the                                                               
case. He detailed that Alaska uses  about $100 million out of the                                                               
$400 million fund: $38 million  for community health, $27 million                                                               
for rural hospitals, and other care entities take up the rest.                                                                  
SENATOR  MICCICHE  explained that  his  question  related to  the                                                               
concern  about  increased costs  and  pointed  out that  Alaskans                                                               
enjoy much more benefit on a dollar value than what is paid in.                                                                 
MR. CLARK  stated that  his assumption is  that Alaskans  enjoy a                                                               
considerable  benefit from  the  program, far  short  of what  is                                                               
being contributed to the program.                                                                                               
5:30:44 PM                                                                                                                    
SENATOR BEGICH  commended Senator Micciche for  his question that                                                               
underscored the state receiving 25  percent of the fund. He asked                                                               
Mr. Zasada  to verify that the  state receives 25 percent  of the                                                               
MR. ZASADA answered correct.                                                                                                    
SENATOR BEGICH agreed  that the state really  is benefitting from                                                               
the fund to a great degree.                                                                                                     
CHAIR WILSON disclosed  that during his time  at Eastern Aleutian                                                               
Tribes he  was able to  see some of the  tele-health technologies                                                               
and its capabilities. He said he  could only imagine what some of                                                               
the  health-care centers  are  doing  now in  some  of the  rural                                                               
entities to try to hopefully lower health-care costs.                                                                           
5:32:09 PM                                                                                                                    
CHAIR WILSON opened public testimony on HJR 14.                                                                                 
5:32:24 PM                                                                                                                    
CHAIR WILSON closed public testimony on HJR 14.                                                                                 
5:32:39 PM                                                                                                                    
SENATOR  MICCICHE  moved  to  report  HJR  14,  version  J,  [30-                                                               
LS0422\J],  from committee  with  individual recommendations  and                                                               
attached zero-fiscal note.                                                                                                      
5:32:49 PM                                                                                                                    
CHAIR  WILSON announced  that being  no objection,  HJR 14  moved                                                               
from the Senate Health and Social Services Standing Committee.                                                                  
5:32:56 PM                                                                                                                    
At ease.                                                                                                                        
        SB  72-DISCRIMINATION: GENDER ID.;SEXUAL ORIENT.                                                                    
5:34:05 PM                                                                                                                    
CHAIR  WILSON  called  committee  back to  order  and  recognized                                                               
Senator Micciche.                                                                                                               
SENATOR MICCICHE commented on closing  public testimony on SB 72,                                                               
stating the following:                                                                                                          
     Mr. Chairman,  I do think sometimes  the public doesn't                                                                    
     understand  when  we   temporarily  close  down  public                                                                    
     testimony. I  think I appreciate your  explanation, the                                                                    
     fact is we  are in the last couple of  days and we will                                                                    
     be prioritizing to just a  few bills and the bills that                                                                    
     are in this  stage of the process will not  be taken up                                                                    
     until next year.  So I just wanted to make  sure on the                                                                    
     SB 72 issue that people  understood that we don't leave                                                                    
     public  testimony open  over the  interim and  when the                                                                    
     bill  is going  to be  heard  it gets  picked back  up.                                                                    
     Sometimes people just call in,  they may be kind of new                                                                    
     to this  process and  they just call  in for  that bill                                                                    
     and don't realize that that's  not an unusual thing. So                                                                    
     I  just wanted  to clarify  a  little bit  more, but  I                                                                    
     appreciate you  doing your part earlier  to clarify for                                                                    
     the public. I think our process can be confusing.                                                                          
CHAIR  WILSON agreed  with Senator  Micciche. He  added that  his                                                               
office  is  always still  open  to  take comments,  questions  or                                                               
concerns on SB 72.                                                                                                              
SENATOR  BEGICH  thanked  Chair  Wilson  for  his  commitment  to                                                               
appreciating  that  the process  can  continue  in the  following                                                               
session on SB 72.                                                                                                               
[SB 72 was held in committee with public testimony closed.]                                                                     
5:35:43 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair  Wilson adjourned  the Senate  Health  and Social  Services                                                               
Committee at 5:35 p.m.