02/20/2009 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| Alaska Native Tribal Health Consortium | |
| SB10 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | TELECONFERENCED | ||
| = | SB 10 | ||
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 20, 2009
1:34 p.m.
MEMBERS PRESENT
Senator Bettye Davis, Chair
Senator Joe Paskvan, Vice Chair
Senator Johnny Ellis
Senator Joe Thomas
MEMBERS ABSENT
Senator Fred Dyson
COMMITTEE CALENDAR
Presentation: Alaska Native Tribal Health Consortium
HEARD
SENATE BILL NO. 10
"An Act requiring health care insurers to provide insurance
coverage for medical care received by a patient during certain
approved clinical trials designed to test and improve
prevention, diagnosis, treatment, or palliation of cancer;
directing the Department of Health and Social Services to
provide Medicaid services to persons who participate in those
clinical trials; relating to experimental procedures under a
state plan offered by the Comprehensive Health Insurance
Association; and providing for an effective date."
MOVED CSSB 10(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 10
SHORT TITLE: MEDICAID/INS FOR CANCER CLINICAL TRIALS
SPONSOR(s): SENATOR(s) DAVIS
01/21/09 (S) PREFILE RELEASED 1/9/09
01/21/09 (S) READ THE FIRST TIME - REFERRALS
01/21/09 (S) HSS, L&C, FIN
02/18/09 (S) HSS AT 1:30 PM BUTROVICH 205
02/18/09 (S) Heard & Held
02/18/09 (S) MINUTE(HSS)
02/20/09 (S) HSS AT 1:30 PM BUTROVICH 205
WITNESS REGISTER
ANGEL DOTOMAIN, President CEO
Alaska Native Health Board
Anchorage, AK
POSITION STATEMENT: Provided an overview of the Alaska Native
Health Board.
VALERIE DAVIDSON, Senior Director
Legal and Governmental Affairs
Alaska Native Tribal Health Consortium
Anchorage, AK
POSITION STATEMENT: Presented information about the role of the
Alaska Native Tribal Health Consortium.
ACTION NARRATIVE
1:34:58 PM
CHAIR BETTYE DAVIS called the Senate Health and Social Services
Standing Committee meeting to order at 1:34 p.m. Present at the
call to order were Senators Ellis, Paskvan and Davis.
CHAIR DAVIS announced a presentation by Alaska Native Tribal
Health.
^Alaska Native Tribal Health Consortium
Presentation: Alaska Native Tribal Health Consortium
CHAIR DAVIS announced the first order of business is a
presentation by the Alaska Native Tribal Health Consortium.
1:36:10 PM
VALERIE DAVIDSON introduced herself and Angel Dotomain. They
will be doing a dual presentation providing overviews of the
Alaska Native Health Board and the Alaska Native Health System.
ANGEL DOTOMAIN, President CEO, Alaska Native Health Board
(ANHB), Anchorage, AK, said she would like to present some
topics for discussion including the mission and operations of
the board, their membership, the impact that ANHB has on the
economy, their statewide priorities and their needs within
tribal health. She encouraged the members to ask questions
during her presentation.
Slide 3 - The mission of the Alaska Native Health Board is "to
promote the spiritual, physical, mental, social and cultural
well being and pride of Alaska Native People."
AHNB was founded in 1968; it has a 24 member board of directors
whose focus is tribal health advocacy. They facilitate statewide
forums and federal tribal consultation in Alaska and disseminate
information to all of the tribes to ensure there is good two-way
communication.
Slide 4 - The Alaska Native Health Board has members from all
over the state; they range from small village tribal councils to
large regional health organizations including the Alaska Native
Tribal Health Consortium.
Slide 5 - There are eight tribal health members among Alaska's
100 largest employers, accounting for approximately 6400
employees.
Slide 6 - This slide illustrates the distribution and service
levels of the facilities that make up the Alaska Native health
care system, from small village health clinics to hospitals such
as the Alaska Native Medical Center in Anchorage.
Slide 7 - Tribal Health care has improved health for Alaska
Natives, particularly through improved access to health care.
With Community Health Aids and the construction of many sub-
regional health clinics, they touch 130,000 Alaska Native people
across the state. In addition, public health measures such as
vaccinations and water and sanitation facilities have had a huge
impact, but there are challenges including chronic under-
funding, staff shortages, increasing health care costs and a
growing Alaska Native population.
1:40:04 PM
MS. DOTOMAIN said these multiple challenges combine to create a
perfect storm (Slide 8). Socio-economic status has a major
impact on health care; high unemployment rates and low income
levels mean very little economic base in many rural communities.
Their patients have to travel farther than others to receive
health care services, many times with money they can't afford;
they are usually sicker and have more medical issues when they
are seen because they don't have access to a physician or health
care provider very often and the facilities they can reach
generally have fewer medical resources available. The costs at
those facilities are generally much higher than other facilities
in the United States.
MS. DOTOMAIN proceeded to Slide 9, which identifies The Alaska
Native Health Board's six major state priorities. These are:
energy solutions for health care, Medicaid support, behavioral
health, water and sanitation, electronic health records and
ensuring safe communities.
Slide 10 - Energy solutions for health care is the top priority
this year; they are hearing from every tribal health
organization that their power and energy costs have, in some
places, more than doubled. Health organizations often have to
make very tough decisions about whether they are going to pay
their energy bills or provide direct services; in some cases the
decision is between energy bills and employees. What they would
like to encourage is an expansion of power cost equalization to
include health clinics and regional health non-profits.
Slide 11 - Medicaid is also a major issue. About a year ago, the
Alaska Native Tribal Health Consortium and Yukon Kuskokwim
Health Corporation (YKHC) were awarded a tribal Medicaid reform
grant which resulted in enhanced funding. As a result of that,
Alaska Native beneficiaries who are served at an Alaska Native
facility and are eligible for Medicaid are covered 100 percent
under the Federal Medical Assistance Percentages (FMAP). There
has been a lot of talk about long-term care and behavioral
health capital investment because over the past year, data has
revealed that these are the two major areas of Medicaid spending
for tribal beneficiaries who are sent to non-tribal facilities.
She encouraged the legislature to continue to support the
Medicaid reform process and to think about capital investment in
tribal long-term care and tribal behavioral health.
1:43:23 PM
Slide 12 - Behavioral Health has been very much in focus lately.
Over the past three days, the health board has held their "mega-
meeting" here in Juneau and the issue that has come up most
often is suicide. Suicide prevention programs must be encouraged
and funded across the state. Substance Abuse and Mental Health
Services Administration (SAMSA) provided a $1.5 million grant
yesterday to the State of Alaska; she hopes part of that grant
will be directed to tribal health programs, especially since the
Alaska Native Tribal Health Consortium has recently developed a
suicide prevention plan.
Slide 13 - water and sanitation are critical issues and she
encouraged continued support of the Village Safe Water Program.
Public health is directly impacted by whether or not a village
has safe water and sanitation facilities; Alaska Native Health
would like to ensure that those villages that do not currently
have water and sanitation facilities are given the opportunity
for greater public health. In addition, they have requested a
$15 million subsidy to support water and sewer facility
operations and maintenance and offset the difficulty presented
by high energy costs.
Slide 14 - Electronic health records represent the opportunity
for greater continuity of care, reduced medical and
pharmaceutical errors and increased efficiency throughout the
tribal heath system. It is not just the tribal health system
however; Alaska eHealth Network would actually connect the
tribal health system to all public and private health systems.
There is an opportunity to obtain grant funding for this but it
does require a ten percent match from the State of Alaska.
1:46:18 PM
MS. DOTOMAIN commented that many people wonder how "safe
communities" fit into this discussion (Slide 15). She explained
that village public safety officers (VPSOs) and community health
aids work hand-in-hand to provide first responder services in
villages; when there aren't enough VPSOs the community health
aids end up taking on a lot of the work in response to sexual
assault, domestic violence and child neglect and abuse. Alaska
Native Health wants to be sure that their community health aids
aren't so burdened that they burn out and can no longer do their
jobs.
Slide 16 - An issue that did not make their top six but is very
important is workforce development. Tribal health care has some
of the highest vacancy rates of anyplace in the State. In most
of the state, there is about an 11.5 percent vacancy rate, but
in tribal health care the rate is 27 percent. The vacancy rate
for dentists and pharmacists is running 17.7 percent in most of
the state but 42.9 percent in rural areas. They need support for
loan repayment and incentive programs to induce providers to
come out to those areas to provide care and to increase outreach
and workforce development opportunities to the young people who
are the future of health care so they will continue to believe
they can be doctors, nurses, pharmacists or community health
aids.
She closed by saying she is encouraged by the meetings this week
and hopes that the legislature will join in their efforts to
improve health care for Alaskan Native people.
1:49:04 PM
VALERIE DAVIDSON, Senior Director, Legal and Governmental
Affairs, Alaska Native Tribal Health Consortium, Anchorage, AK,
provided an overview of the tribal health system; the role of
the Alaska Native Tribal Health Consortium in that system; the
sustainability issues facing tribal health and Medicaid's role
in maintaining that infrastructure.
Slide 4 - Health care in Alaska used to be provided for American
Indians and Alaska Natives by the Indian Health Service. Over
the past 25 years or so, there has been a gradual transition
away from management by the federal government.
Slide 5 - Self-management of health care here in Alaska makes
sense; there are limits to how well the Indian Health Service
can manage health care from Washington DC. She pointed out that
tribal management of health care is possible only because of
their tribal status; without tribal recognition, those resources
would go away.
Slide 6 - The Alaska Tribal Health System (ATHS) is a voluntary
affiliation of 30 tribes and tribal health organizations that
provide health care. They serve a specific geographic region
that includes about 130,000 Alaska Natives, but because they are
often the only provider in rural communities, they actually
serve everyone there whether or not they are Native.
1:51:14 PM
SENATOR THOMAS joined the meeting.
MS. DAVIDSON continued; ATHS has significant economic impact in
the state, employing about 7000 people state wide. The good news
is that because these employees are local, when resources come
into the state they stay here.
Slide 7 - About 20 percent of the state's population is Native
and most are very young.
Slides 8 - 9 illustrate the distribution of the ATHS service
population by numbers and percentage of the total population,
show the leading causes of death, some causes for primary care
visits and the leading causes of hospitalization.
Slide 12 - What does the health care system look like? ATHS is a
multi-tiered health care delivery system. Most of the care
occurs in small community village clinics or primary care
centers; there are about 180 of these throughout the state.
There are 25 sub-regional clinics that provide mid-level care,
four physician health centers, six regional hospitals and the
Alaska Native Medical Center, which provides tertiary care.
Those who require more specialized care are referred to
facilities outside the Native Medical Center as shown on the
referral pattern map on slide 13.
MS. DAVIDSON explained that they have 550 community health aids
and practitioners providing health care on a daily basis in the
small community health centers. This is a unique Alaska provider
type that receives more training than EMTs but not quite as much
as nurses and does just about everything from prenatal and well-
baby exams to immunizations. She stated that in 2006 they
achieved an immunization rate of over 90 percent for Native
children, due in large part to the Community Health Aid Program.
They also rely heavily on public health nurses located in hub
communities in rural Alaska to ensure that everyone is covered.
Many people don't know that for all intents and purposes, the
Alaska Tribal Health System really is the public health agency
in the state of Alaska for almost every community. She pointed
out that the Alaska Department of Health and Social Services
employs about 3000 people while ATHS employs 7000; so their
capacity is about double that of DHSS.
MS. DAVIDSON said that ANHS is funded at only 51 percent of need
and doesn't have the resources to hire a psychiatrist in every
community, so they created a new provider type called a
behavioral health aid that is trained to deal with emotional and
substance abuse issues. The behavioral health aids can do
screenings when kids come in for the [Early and Periodic
Screening, Diagnosis and Treatment] EPSDT exams and are embedded
in the community clinics so they can catch problems in the first
encounter with a patient. A Recent study done in lower 48 of
veterans returning from active duty who subsequently committed
suicide, found that only about 33 percent of them had actually
seen a mental health or substance abuse specialist even though
they were displaying clear behavioral health indicator issues.
However, the medical record review indicated that at least three
out of four of them had been to see a primary care provider in
that time. The symptoms they described at their primary care
visits were things that a simple two minute screening would have
picked up on and flagged for a behavioral health referral and
treatment; these were symptoms like insomnia, loss of appetite
and nightmares. Inserting those simple screening tools into
every primary care visit, makes it much more likely that those
problems will be caught and treated early.
1:58:09 PM
MS. DAVIDSON emphasized the importance of the relationship
patients develop with their primary health care provider; if a
provider the person knows and trusts suggests seeing a
behavioral health professional, he or she is much more likely to
take that advice.
The Alaska Native Health System is now extending the community
health aid model to areas like dental, home-health and personal
care attendants.
She showed pictures of some of their clinics. Some new clinics
have been built thanks to the efforts of the Denali Commission
and a variety of HUD resources.
Slides 18 - 30 show a number of regional health facilities and
indicate the number of communities that each of those tribal
health organizations serve; Yukon Kuskokwim Health Corporation
serves 58 communities. She said that in the interior [Tanana
Chiefs Conference] TCC area, they have an arrangement with the
Fairbanks Memorial Hospital as well as sub-regional mid-level
health centers. Southeast has a hospital in Sitka and
relationships with hospitals in Juneau and Ketchikan. South-
Central Foundation is considered the regional provider for the
Anchorage area and manages the Alaska Native Medical Center
jointly with the Alaska Native Tribal Health Consortium.
Slide 31 - ANTHC provides the statewide services that were
previously provided by the Indian Health Service. They have
about 1800 employees and do everything from tertiary and
specialty medical care to community health and research,
sanitation construction, health information technology and
professional recruitment and training.
Slides 32 - 33 provide some information about the Alaska Native
Medical Center in Anchorage. It has 150 beds, over 6000
admissions annually and over 1400 infants are delivered each
year. Outpatient visits have quadrupled in the past ten years
from about 100,000 to 400,000 annually without facility
expansion or any increase in funding.
Slide 34 - There are a limited number of residential treatment
centers throughout the state and the Indian Health Service has
not historically funded behavioral health or long-term care
programs; so the greatest number of expenditures from the
General Fund to Alaska Native Medicaid beneficiaries is for
behavioral health issues and long-term care. There is a very
long wait for services; people can expect to spend from six to
nine months on a waiting list before they are able to get into a
treatment program. Unfortunately, the people who do get into
treatment are often those who are court-mandated to attend and
others who need help cannot get it.
MS. DAVIDSON stated that Alaska has some of the highest oral
health disparities in the country. As noted on slide 35, ANTHC
has deployed a Dental Health Aid Therapy program modeled after
programs offered in 42 other countries and graduated their first
four Dental Health Aid Therapist students in December 2008. The
United States is actually the only country that doesn't
authorize a mid-level dental practice. She added that her
children received their dental care from one of these dental
health aids and that they now ask anyone who visits their home
about their dental care and nutritional habits because their
health aid has stressed the importance of these things to them.
Slide 36 - Community health services is another division of
ANTHC. Although they are in the business of providing primary
care, they would really like to focus more on health promotion,
injury prevention and other prevention programs.
2:03:41 PM
Slide 38 - 42 Sanitation is a real problem in rural Alaska. In
many villages children are responsible for chores such as
disposal of the contents of "honey buckets" and children, she
reminded the committee, are clumsy. When those buckets spill, it
is a significant public health hazard. Babies in communities
without adequate sanitation are 11 times more likely to be
hospitalized for respiratory infections and 5 times more likely
to be hospitalized for skin infections; so any time they have
the opportunity to invest in sanitation they see a significant
and immediate impact on the public health system.
Slide 45 - MS. DAVIDSON reiterated that the Indian Health
Service funds only 51 percent of the level needed to provide
basic health care services and the funding does not keep pace
with inflation. With medical inflation running from seven to ten
percent per year, that means a decrease of 60 to 80 percent in
their buying power over a period of ten years. Why does that
happen? Unfortunately, they represent a discretionary line item
and compete with the national parks for funding because they
fall under the Department of Interior budget rather than the
Department of Health and Human Services (HHS).
Slide 46 - Sustainability issues result from inadequate funding
and the things that have been most limited have been adult
dental services, long-term care and behavioral health issues.
Slide 47 - Congress has recognized that even though they are
non-profit tribal health organizations, IHS facilities have to
operate as businesses if they are to be sustainable; so they
rely upon Medicaid, Medicare and Denali Kid Care as well as
grant programs to make up that funding shortfall.
Slides 48 - 50 After the Pacific Health Policy Group came out
with their report about the impact and long-term sustainability
of the Medicaid program, they partnered with the state to do a
Tribal Medicaid Demonstration Project to focus on the issues of
long-term care, behavioral health continuum of care and
developing their financial and other infrastructure requirements
for sustainability. They also looked at whether a managed care
system would make sense. The study found that 40 percent of
Alaska's Medicaid recipients are Alaska Native and American
Indian; $378 million in Medicaid expenditures were for services
provided to Alaska Natives and American Indians, of which $139
million were Medicaid resources to tribal providers and $238.9
million were to non-tribal providers.
2:08:03 PM
MS. DAVIDSON explained that if she was a Medicaid beneficiary
and went to The Alaska Native Medical Center for her care,
because that is an IHS facility the federal government would
reimburse the state at 100 percent for providing that Medicaid
care; however, if she went to a non-tribal provider, she would
be treated like every other Medicaid patient. Once she moves
outside the four corners of a tribal facility, the state has to
kick in General Fund dollars for her care, so every time an
Alaska Native Medicaid beneficiary goes outside the Alaska
Native Health System, it costs the state General Fund 49 percent
of that person's cost of care; that represents $238.9 million
state wide to non-tribal providers. If the tribal health system
is interested in providing more services but lacks capacity and
the state can save General Fund resources, it makes sense to
invest the money necessary to develop their capacity and reduce
or reverse the trend toward treatment in non-native facilities.
She added that the reason she focused on long-term care and
behavioral health is that these services offer the largest
opportunities for savings. The biggest payments to non-tribal
providers were $69 million for long-term care, over $50 million
for behavioral health and $36 million for acute hospital stays
exceeding the capacity of the Alaska Native Medical Center.
2:10:14 PM
MS. DAVIDSON touched briefly on managed care feasibility. The
Pacific Health Policy Group said they should focus on
establishing a managed care organization for tribal providers in
Alaska; she believes that is because their experience is in
California where managed care is the norm. The challenge for
states that establish managed care organizations is that until
the programs are up and running, the only people who benefit are
lawyers and accountants. So ANTHC determined that instead of
using their limited resources to build a managed care structure,
they would manage the care of people; they looked at changing
their reimbursement structure, better managing patients' care to
get the right person the right care at the right time and in the
right sequence in order to accomplish the goals of managed care
without the burden of more programmatic overhead.
2:12:06 PM
MS. DAVIDSON spoke about the energy impacts on health in Alaska
(slide 51). She stressed that they are seeing a significant
public health crisis directly attributable to the energy crisis.
There is an increased demand for health care services and a
decrease in their ability to provide them.
Slide 52 - Many families cannot keep up with their energy costs
so they are combining households, resulting in 10 to 20 people
living in one house. This tremendous overcrowding has caused an
increase in the rates of infectious disease, which is especially
problematic in communities without adequate sanitation. Families
are also under tremendous emotional pressure and there has been
a huge increase in behavioral health issues; people who do not
seek help often self-medicate with alcohol or other substances.
MS. DAVIDSON pointed out that people who rely on durable medical
equipment and cannot afford to pay the increased electricity
costs to keep their equipment running end up being medevaced out
of their communities at a cost of sometimes $16,000 per medevac.
Slide 53 - At the same time they have seen a huge increase in
the demand for care, ANTHC has seen a decrease in their capacity
to provide that care. Before the energy crisis, energy accounted
for 33 percent of the cost of clinic operation; as energy costs
have risen, clinics have had to limit their hours of operation
or reduce services. Every major health organization has had to
implement reductions in service or staffing during the past
three years.
She closed by saying that their vision at the Alaska Native
Tribal Health Consortium is "Alaska Natives are the healthiest
people in the world" and she knows they cannot realize it alone;
to get where they need to be is going to take everyone working
together. If people aren't enrolled in available services
because they aren't informed or because care is not available in
their communities and the system does not adequately reimburse
people for the cost of providing that care so those programs can
be sustained over time, then the system has failed.
2:19:29 PM
SENATOR ELLIS thanked Ms. Dotomain and Ms. Davidson for their
presentations and said that Senator Begich is excited about the
opportunities that the federal stimulus package will offer
Alaskans. There are $2 billion in the bill for community health
clinics but he did not ask Senator Begich whether that was
purely capital or included operating funds as well. When the
Denali Commission was established, the language provided that
only rural community health clinics could participate in Denali
Commission funding; the health clinic in his Anchorage community
was not eligible for Denali Commission funding, but Senator
Begich said that all community health clinics in Alaska, urban
and rural, qualified for the $2 billion. He asked if Ms.
Dotomain or Ms. Davidson were clear on whether the funds could
be used for operating expenses such as increased energy costs.
MS. DAVIDSON said she thinks the funds are for both capital and
operating costs; but not all community health centers or Section
330 clinics are tribal health clinics. There are some community
health centers that are tribally operated in Alaska but not very
many. What works in other states doesn't necessarily work in
Alaska, so they end up with competing or dually operated health
systems. She gave an example related to veterans' care, saying
they have been struggling for the past several years to take
care of their veterans in rural communities, but they have no
access to veterans' services. She asserted that it makes more
sense to utilize the tribal health system in those areas and
provide a method for reimbursement than to create another level
of care. She feels that there must be a way to ensure that
energy programs and stimulus funding cover the health needs of
clinics regardless of the category of the clinic; Alaskans have
been incredibly creative about tailoring new funding streams and
finding ways to make them work for people in the communities
they serve.
2:23:15 PM
SENATOR THOMAS asked who trains their health care workers and
community health aids.
MS. DAVIDSON answered that there are two- to three-year training
programs for community health aids and community health aid
practitioners in Bethel, Anchorage and in several other places
throughout the state. Behavioral health aids are trained by the
University of Alaska, but some tribal providers are interested
in taking over that training themselves much as they have the
community health aid training programs. The Dental Health Aid
Therapy program is operated by ANTHC; the first year is done
through a partnership with the University of Washington Dentex
program, which is modeled after the University of New Zealand's
and University of Canada's programs. Students do their second
year of training in Bethel, after which they provide care under
the supervision of a dentist and then go through the
certification process. When that is complete, they can provide
care independently under the general supervision of a dentist.
SENATOR THOMAS wondered where their funding comes from.
MS DAVIDSON responded that the Community Health Aid Program gets
most of its funding from the Indian Health Service through their
funding agreement; the Dental Health Aid Therapy Program was
funded by a grant from the Kellogg foundation for $8 million;
that grant runs out in 2010 and they are looking at other
avenues for funding.
2:26:29 PM
SENATOR THOMAS said it seems to him that coordination and
collaboration with the University of Alaska Nursing Program
would be helpful.
2:27:37 PM
MS. DAVIDSON said they do a lot of collaboration with the
University of Alaska and do a lot to recruit Alaska Natives into
nursing; they provide clinical training opportunities in their
facilities and there are a number of programs throughout the
state that make sure resources are available so that those
opportunities exist for Alaska Natives. She said they also
collaborate with Allied Health Professions for everything from
phlebotomy to pharmacy technician jobs. Because they have such a
young population, the best opportunities are distance-delivery
programs. Students start with one class at a time while working
in the community, often supporting 15 to 20 family members. When
students have success in one class, they are often eager to take
more classes.
2:29:44 PM
SENATOR THOMAS asked why the Indian Health Service does not fund
behavioral health.
2:30:02 PM
MS. DAVIDSON couldn't answer that question. She thinks The IHS
is limited by federal appropriations and for last 10 to 12 years
they have been told that resources are not available to fund
those programs; then they see that money go into a fund that
provides millions or billions of dollars in health resources to
other countries. It is frustrating, but the IHS is a federal
agency and is only allowed to support a budget that is approved
by the administration. President Obama seems to have a
commitment to Alaska Natives and American Indians however, and
she is hopeful that this new administration will place greater
emphasis on minority health and narrowing disparities in the
health care system.
2:31:56 PM
SENATOR PASKVAN said that he is working on an electronic health
records bill now and they are working through some of the
privacy issues that are so important. He thinks it will save a
lot of money for all Alaskans in the long run. On the issue of
distance delivery, his wife works with the Center for Distance
Education and he thinks it is a very important part of the
health of Alaska in general. Regarding energy costs, he is very
aware of the issues raised last year by the huge increases in
energy costs which forced some people to choose between heat and
putting food on the table.
2:33:26 PM
MS. DAVIDSON said they are aware of Senator Paskvan's efforts
with electronic health records and the health information
exchange and think it's brilliant. The more they can improve
administrative efficiencies, the more it will help them ensure
that, as patients move from one place to another in Alaska or
outside, their records will follow them, improving treatment and
saving money.
2:34:29 PM
MS. DOTOMAIN encouraged Senator Paskvan to speak with the Alaska
Federal Healthcare Access Network, which will be here on Tuesday
of next week to testify about how they've worked through the
security issues with HIPPA.
SENATOR PASKVAN commented that he believes more male mentors are
needed in the schools. The female Natives have already seen the
need and become active but men trail behind them in most
communities.
SB 10-MEDICAID/INS FOR CANCER CLINICAL TRIALS
2:35:52 PM
CHAIR DAVIS announced the consideration of SB 10. [Version E CS
for SB 10 was before the committee.]
SENATOR PASKVAN moved to report CS for SB 10 from committee with
individual recommendations and attached fiscal note(s). There
being no objection, CSSB 10(HSS) moved from committee.
2:37:55 PM
There being no further business to come before the committee,
Chair Davis adjourned the meeting at 2:37 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| Alaska Native Health Board Overview & Priorities Senate 2-20-09.ppt |
SHSS 2/20/2009 1:30:00 PM |
Ak Native Health Care |