03/21/2012 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB221 | |
| SB118 | |
| SB5 | |
| SB55 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 118 | TELECONFERENCED | |
| += | SB 55 | TELECONFERENCED | |
| *+ | SB 221 | TELECONFERENCED | |
| = | SB 5 | ||
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 |