02/21/2014 01:30 PM Senate HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SB169 | |
| SB162 | |
| SB161 | |
| SB151 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 169 | TELECONFERENCED | |
| *+ | SB 162 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | SB 161 | ||
| = | SB 151 | ||
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
February 21, 2014
1:31 p.m.
MEMBERS PRESENT
Senator Bert Stedman, Chair
Senator Peter Micciche, Vice Chair
Senator Kevin Meyer
MEMBERS ABSENT
Senator Pete Kelly
Senator Johnny Ellis
COMMITTEE CALENDAR
SENATE BILL NO. 169
"An Act establishing in the Department of Health and Social
Services a statewide immunization program and the State Vaccine
Assessment Commission; creating a vaccine assessment account;
requiring a fee assessment from health care insurers and other
program participants for statewide immunization purchases;
repealing the temporary child and adult immunization program;
and providing for an effective date."
- HEARD & HELD
SENATE BILL NO. 162
"An Act authorizing a licensed optometrist to prescribe a
pharmaceutical agent containing hydrocodone."
- HEARD & HELD
SENATE BILL NO. 161
"An Act relating to duties and procedures of the state medical
examiner and the Department of Health and Social Services; and
relating to death certificates."
- MOVED SB 161 OUT OF COMMITTEE
SENATE BILL NO. 151
"An Act relating to chemicals that are of high concern for
children and to the manufacture and sale of products containing
certain flame retardant chemicals; relating to an interstate
chemicals clearinghouse; adding an unlawful act to the Alaska
Unfair Trade Practices and Consumer Protection Act; and
providing for an effective date."
- MOVED SB 151 OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SB 169
SHORT TITLE: STATEWIDE IMMUNIZATION PROGRAM
SPONSOR(s): SENATOR(s) GIESSEL
02/10/14 (S) READ THE FIRST TIME - REFERRALS
02/10/14 (S) HSS
02/21/14 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 162
SHORT TITLE: HYDROCODONE PRESCRIPTION BY OPTOMETRISTS
SPONSOR(s): SENATOR(s) OLSON
02/07/14 (S) READ THE FIRST TIME - REFERRALS
02/07/14 (S) HSS
02/21/14 (S) HSS AT 1:30 PM BUTROVICH 205
BILL: SB 161
SHORT TITLE: AUTOPSIES AND DEATH CERTIFICATES
SPONSOR(s): SENATOR(s) OLSON
02/07/14 (S) READ THE FIRST TIME - REFERRALS
02/07/14 (S) HSS
02/19/14 (S) HSS AT 1:30 PM BUTROVICH 205
02/19/14 (S) Heard & Held
02/19/14 (S) MINUTE(HSS)
BILL: SB 151
SHORT TITLE: HIGH-RISK CHEMICALS FOR CHILD EXPOSURE
SPONSOR(s): SENATOR(s) OLSON
01/31/14 (S) READ THE FIRST TIME - REFERRALS
01/31/14 (S) HSS, JUD
02/19/14 (S) HSS AT 1:30 PM BUTROVICH 205
02/19/14 (S) Heard & Held
02/19/14 (S) MINUTE(HSS)
WITNESS REGISTER
SENATOR CATHY GIESSEL
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Sponsor of SB 169.
JANE CONWAY, Staff
Senator Cathy Giessel
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Described the changes in SB 169 on behalf of
the sponsor.
WARD HURLBERT, Chief Medical Officer
Division of Public Health
Department of Health and Social Services (DHSS)
Juneau, Alaska
POSITION STATEMENT: Provided information related to SB 169.
ROSALYN SINGLETON, Physician
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 169.
LILY LOU, M.D., Medical Director
Newborn Intensive Care Unit
Providence Children's Hospital
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 169.
PATRICIA SENNER, Director
Professional Practices
Alaska Nurses Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 169.
RANDI SWEET, representing herself
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 169.
AMY DRESSEL, Pediatrician
Juneau, Alaska
POSITION STATEMENT: Testified in support of SB 169.
DAVE SCOTT, Staff
Senator Donny Olson
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented information on SB 162, SB 161, and
SB 151 on behalf of the sponsor.
MICHAEL BENNETT, Optometrist
Juneau, Alaska
POSITION STATEMENT: Testified in support of SB 162.
RACHEL REINHARDT, Ophthalmologist
American Academy of Ophthalmology
Seattle, Washington
POSITION STATEMENT: Testified in opposition to SB 162.
STEVEN DOBSON, Optometrist
Alaska Optometric Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 162.
JEFF GONNASON, Optometrist
Alaska Optometry Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of SB 162.
ACTION NARRATIVE
1:31:55 PM
CHAIR BERT STEDMAN called the Senate Health and Social Services
Standing Committee meeting to order at 1:31 p.m. Present at the
call to order were Senators Micciche, Meyer, and Chair Stedman.
SB 169-STATEWIDE IMMUNIZATION PROGRAM
1:32:41 PM
CHAIR STEDMAN announced that the first order of business would
be SB 169. He said it is the first hearing on the bill. The
intent is to adopt a new Committee Substitute, have the sponsor
introduce the bill, take public testimony, and then set the bill
aside for further review.
1:32:47 PM
SENATOR MEYER moved to adopt the CS for SB 169, labeled 28-
LS1219\P, as the working document.
CHAIR STEDMAN objected for discussion purposes.
SENATOR CATHY GIESSEL, Alaska State Legislature, Juneau, Alaska,
sponsor of SB 169, introduced the bill. She stated that SB 169
would permanently put the state vaccine program in place with
monies other than the state's money. She related that after
Senator Stevens left the U.S. Senate, the Center for Disease
Control changed how they viewed Alaska. Alaska had been getting
$4.3 million per year to provide vaccines for all residents.
That funding decreased to $700,000. The state's vaccination
program was greatly curtailed. She recalled the vaccine-
preventable diseases that the program targeted.
SENATOR GIESSEL related that two years ago, after hearing this
same bill, the state funded the program for $4 million per year
for 3 years. At the end of 3 years, the Department of Health and
Social Services (DHSS) was charged with finding a way to fund
the program, in collaboration with the state's insurance
companies. She said that is what this bill does.
1:35:45 PM
JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State
Legislature, Juneau, Alaska, described the changes in SB 169 on
behalf of the sponsor. She said changes were made from version O
to version P, the current CS. She noted the original bill used
the name "State Vaccine Assessment Commission" for the group
being set up to administer the vaccine program. That name was
changed to the "State Vaccine Assessment Council" so it would
not be confused with the current "State Health Care Commission."
All throughout the bill the term was changed. Another term was
changed in version P; "health care insurer" was changed to "an
assessable entity" for a broader usage. It is a term used by
other states for their vaccine assessment programs.
MS. CONWAY referred to page 5, line 18; the manner in which the
definition "assessable entity" is written is different than
version O, but is using the same reference by definition and it
encompasses the detail list from version O. This language
recommended by legislative legal services.
CHAIR STEDMAN removed his objection to adopting version P. There
being no objection, version P was before the committee.
1:38:10 PM
At ease
1:39:42 PM
SENATOR MEYER inquired about the change in wording from
"commission" to "council." He asked if the council would be
treated like a commission in the sense that people from all over
the state make up the members, they meet on a regular basis, and
are subject to an audit.
MS. CONWAY explained that the council is a group that is
appointed by the commissioner of Public Health; it is not a
board. The council will meet throughout the year to set up the
program and assess the entities. They will work under the
auspices of DHSS and they will serve without compensation or
reimbursement.
SENATOR MEYER asked if they would serve at the pleasure of the
commissioner.
MS. CONWAY said the commissioner of DHSS would appoint an 8-
member board.
1:42:04 PM
WARD HURLBERT, Chief Medical Officer, Division of Public Health,
Department of Health and Social Services (DHSS), Juneau, Alaska,
provided information related to SB 169. He shared a story to
highlight the vast changes from vaccinations in Alaska. He said
in 1953 in Ketchikan there were 93 cases of polio, 83 of which
were paralytic. Today, a woman came in and was resistant to
having her child immunized because she did not know what polio
was. He told a story about a measles outbreak in Dillingham in
1961 when children died from the disease. He said it has been a
long time since an Alaskan has been lost to measles, due to
vaccinations.
DR. HURLBERT shared data about the effectiveness of
vaccinations. The flu vaccine is only about 50 percent to 60
percent effective for those over 65 years old. Worldwide,
smallpox no longer exists. It is nearly the same with polio. He
concluded that immunizations have made a big difference.
1:44:56 PM
He explained that the proposed methodology in the bill is used
by 9 other states. He called it a "win/win" because the payers
have to pay less because the state will buy vaccinations at
wholesale rates. The modest surcharge will pay for vaccines for
underinsured children. About five years ago Alaska was 49th
among states in immunization rates for ages two and under.
Currently, Alaska is 37th or 38th and about 65 percent of kids
are immunized. He predicted that this legislation would improve
these numbers much like New Hampshire was able to do.
1:46:29 PM
ROSALYN SINGLETON, M.D., representing herself, Anchorage,
Alaska, testified in support of SB 169. She called the bill a
cost-saving model which will improve access to vaccines for all
Alaskans, streamline the distribution of vaccines, and reduce
the huge administrative burden that health providers currently
have. She said vaccinations demonstrated the dramatic effect of
reducing Hepatitis A from the highest to the lowest rate in the
country. Also, Alaska has been free of measles since 2000.
She said Alaska's expanse challenges the ability to provide on-
time immunizations, so ready access to vaccines is critical. Due
to the administrative burden, some providers in small
communities no longer can provide all of the recommended
vaccines due to having to front costs and keep separate stocks
of vaccine from state and private purchases. She remarked that
she has received calls from providers and parents who cannot
access vaccines.
She said other states have experienced cost savings and
streamlined distribution when using the model the bill would
create.
1:49:28 PM
LILY LOU, M.D., Medical Director, Newborn Intensive Care Unit,
Providence Children's Hospital, Anchorage, Alaska, testified in
support of SB 169. She shared that she is the president of the
Alaska Chapter of the American Academy of Pediatrics (AAP) and
the District 8 representative, for the Western United States and
Canada, to the executive committee of the AAP section on
perinatal pediatrics. She said she is speaking as an individual
in favor of the bill for four reasons. First, is the
effectiveness of vaccines, second, is good stewardship, third,
is access to care, and fourth, is the future.
DR. LOU related that the prevention of infectious diseases by
immunization has been one of the most significant advances in
health care in human history. She shared statistics related to
16 measles outbreaks in 2011, the cost of which was estimated to
be $5.3 million. She maintained that vaccinations will protect
everyone and a universal purchase program will likely lead to
savings.
She said a vaccine assessment account will allow the state to
benefit from volume purchasing at discounted federal rates.
Other states have shown significant savings and have streamlined
the process. The new system will provide more access to care,
especially in small communities. It will also have a positive
effect on the future.
1:54:04 PM
PATRICIA SENNER, Director, Professional Practices, Alaska Nurses
Association, Anchorage, Alaska, testified in support of SB 169.
She spoke of frustrations she has experience as a nurse
practitioner providing immunizations since the state moved away
from universal coverage. She said she had to keep separate sets
of vaccines for those eligible and not eligible for vaccines
through the state. That made for increased costs and increased
administrative difficulties, as well as for waste.
1:55:54 PM
RANDI SWEET, representing herself, Anchorage, Alaska, testified
in support of SB 169.
1:56:37 PM
AMY DRESSEL, Pediatrician, Juneau, Alaska, testified in support
of SB 169. She listed many reasons for supporting the bill. She
said vaccines are very expensive and there are problems with
access. The bill helps all vaccine-eligible children in Alaska.
Alaska is lowest on the national vaccine record. The bill would
help all Alaskans, provide favorable rates, and universal
access, decrease the administrative burden, and make for a more
efficient system.
1:59:06 PM
CHAIR STEDMAN closed public testimony.
CHAIR STEDMAN detailed five fiscal notes: one fiscal note that
reflects the fund transfer to the new vaccine assessment account
in the amount of $4,496,000 from an appropriation in the
Governor's current FY 15 budget; one net zero fiscal note from
the Department of Health and Social Services (DHSS), Public
Health Division, showing the program's expenses of $26,950,000
and the same amount in program revenue; and one indeterminate
fiscal note from the Department of Health and Social Services
(DHSS), Medicaid Service Division; one zero fiscal note from the
Department of Commerce, Community and Economic Development
(DCCED); and one indeterminate fiscal note from the Department
of Administration.
2:00:34 PM
SENATOR MICCICHE asked if it was an initial $4.4 million to fund
the program and then about $33,000 in fees to make it
sustainable.
MS. CONWAY clarified that $4 million is left over in the vaccine
program now and will be transferred to the new model. That
amount will help to purchase the initial vaccine for the next
year. The department will then use a formula to assess how many
vaccines will be needed statewide and purchase them in bulk with
money from the assessable entities. After the initial $4 million
the program becomes funded by insurance payers.
SENATOR MICCICHE stated that $4.4 million is leftover previous
funding.
MS. CONWAY said correct.
CHAIR STEDMAN held SB 169 in committee.
SB 162-HYDROCODONE PRESCRIPTION BY OPTOMETRISTS
2:02:55 PM
CHAIR STEDMAN announced that the next order of business would be
SB 162. He said it is the first hearing on SB 162. The intent
today is to have the sponsor introduce the bill, take public
testimony, and set the bill aside for further review.
2:03:34 PM
DAVID SCOTT, Staff, Senator Donny Olson, Alaska State
Legislature, Juneau, Alaska, presented SB 162 on behalf of the
sponsor. He explained that the bill would retain licensed
optometrists' authority to prescribe hydrocodone to patients.
Currently, on the federal level, there is an effort to
reschedule hydrocodone from Schedule III to Schedule II. The
sponsor does not want there to be a lapse in optometrists'
ability to treat their patients. He emphasized that SB 162 does
not increase the scope of the practice of optometry.
He noted that the sponsor is aware of the concern regarding the
nationwide epidemic of prescription painkiller abuse. He drew
attention to page 1, lines 13 and 14, of the bill which state
that the prescription cannot exceed four days.
He highlighted new language on page 1, lines 11 and 12 that
ensures there is no lapse in the current practice of optometry
to prescribe hydrocodone.
CHAIR STEDMAN said there is one zero fiscal note from the
Department of Commerce, Community and Economic Development
(DCCED).
SENATOR MEYER asked what kind of drug hydrocodone is.
MR. SCOTT explained is commonly referred to Vicodin when it is
mixed with acetaminophen and is a painkiller.
SENATOR MEYER asked if the bill only pertains to optometrists.
MR. SCOTT said yes. Other medical professionals already can
prescribe hydrocodone.
SENATOR MEYER questioned if the bill should be broadened to
other medical professions.
MR. SCOTT explained that physicians already can prescribe these
medications. Hydrocodone is the only painkiller optometrists can
prescribe.
2:07:11 PM
SENATOR MICCICHE agreed with the previous answer. He inquired if
the bill limits the prescription to one four-day quantity.
MR. SCOTT read from page 1, lines 13 and 14, "the pharmaceutical
agent . . . is prescribed in a quantity that does not exceed
four days of prescribed use if it is a controlled substance."
CHAIR STEDMAN opened public testimony.
2:07:56 PM
MICHAEL BENNETT, Optometrist, Juneau, Alaska, testified in
support of SB 162. He clarified that when the initial
pharmaceutical bill for optometry was passed in 2007,
optometrists were restricted to Schedule III narcotics, of which
Vicodin is the drug of choice. They were not authorized to
prescribe Schedule II narcotics, such as oxycontin, with even
more abuse potential. He explained that if the FDA moves
hydrocodone into a Schedule II classification, optometrists
would not have a drug to prescribe for acute, severe pain.
He pointed out that hydrocodone is used relatively infrequently
in eye care practice. It is used for eye trauma. Eyes heal
quickly and only a short-term prescription is required. If pain
management is required for longer periods, the patient is
referred to a higher level of care. It is also used for chemical
injuries and an acute form of glaucoma frequently found in
American Eskimos.
He emphasized that SB 162 is not an expansion of prescriptive
authority that has been in place for seven years. There have
been no reports of issues or incidents to the state board or to
the DEA.
2:10:55 PM
RACHEL REINHARDT, Ophthalmologist, American Academy of
Ophthalmology, Seattle, Washington, testified in opposition to
SB 162. She said there is a national crisis for drug overdose
deaths related to prescription narcotics. The FDA is making the
recommendation to change hydrocodone-containing narcotics to a
more restrictive class - Schedule II. There has been a 300
percent increase in the sale of these prescriptions since 1999
and a five-fold increase in the death rate. Alaska ranks fifth
of all states for prescription narcotic overdose deaths, more
than twice the national average for the death rate for
prescription overdoses. Hydrocodone is the number one drug
abused. The point is to restrict the number of providers who can
prescribe hydrocodone.
She contested the uses of hydrocodone for optometrists. She
noted a similar bill was defeated in Washington and maintained
that SB 162 is premature. She concluded that $72 billion is
spent every year on medical costs associated with prescription
overdoses. The bill sets a precedent for mid-level providers to
request an exception, undercutting the research related to drug
deaths.
2:17:14 PM
STEVEN DOBSON, Optometrist, Alaska Optometric Association,
Anchorage, Alaska, testified in support of SB 162. He said
optometrists have been able to prescribe a limited quantity of
hydrocodone for the past seven years for the management of
acute, severe ocular pain due to injuries or infections. He
maintained that the potential for abuse is with chronic, long-
term recurrent pain management conditions. The bill would allow
optometrists to continue to prescribe hydrocodone compounds for
a limited period and for limited use without expanding their
current scope of practice. He stressed that this medication is a
god-send for extreme ocular pain. He shared a story of a
patient's pain and the benefit of relief.
2:20:13 PM
SENATOR MICCICHE shared the concern for hydrocodone abuse. He
asked if there is another compound that could be used.
DR. DOBSON said in the case he just gave there is no substitute.
He pointed out that due to the geographic broadness of Alaska,
optometrists are often the front line for urgent eye care
emergencies. He agreed that there is a problem with prescription
drug abuse, but maintained that it is not from optometric urgent
eye care because it is so specific and for such a limited amount
of time.
2:21:47 PM
JEFF GONNASON, Optometrist, Alaska Optometry Association,
Anchorage, Alaska, testified in support of SB 162. He defined a
controlled substance as a drug or chemical that is regulated by
the government. He said they are classified according to
Schedules, with Schedule I being the highest for potential for
abuse. For example, Schedule II drugs require more restrictive
regulations than Schedule III drugs to help prevent abuse.
Fourteen years ago the Alaska Legislature authorized qualified
optometrists to prescribe medication including Schedule II
drugs, but the governor at the time vetoed the bill. In 2007, a
new bill was signed into law with the current restrictions of
only Schedule III, IV, and V, not including Schedule II, and a
restriction of only supplying a maximum 4-day supply of a
controlled substance.
He explained that Alaska therapeutic optometrists have a
registered DEA number on file with the state. There have been no
instances of abuse or complaints or actions by the state board
or any other drug enforcement agency. The bill is necessary
because the FDA is recommending reclassifying hydrocodone and a
vital tool for managing pain will be taken away. He noted that
he met with two ophthalmologists who had no objection to the
bill; neither wanted to rekindle old turf battles. He concluded
that SB 162 does not change anything; it keeps status quo.
2:25:54 PM
CHAIR STEDMAN closed public testimony.
CHAIR STEDMAN held SB 162 in committee.
SB 161-AUTOPSIES AND DEATH CERTIFICATES
2:26:43 PM
CHAIR STEDMAN announced that the next order of business would be
SB 161. He reminded the committee that SB 161 was previously
heard on February 19 when the sponsor introduced the bill and
public testimony was taken.
DAVID SCOTT, Staff, Senator Donny Olson, Alaska State
Legislature, Juneau, Alaska, reviewed SB 161 on behalf of the
sponsor. He said the purpose of the bill is to add compassion to
the process of how the Alaska State Medical Examiner's Office
deals with the transportation of remains, specifically in rural
Alaska. The old forms directed families toward expensive funeral
homes which were not necessary. He mentioned that the bill has a
new zero fiscal note.
CHAIR STEDMAN noted the bill would go to the Senate Finance
Committee next.
2:28:54 PM
SENATOR MEYER moved to report SB 161 from committee with
individual recommendations and attached zero fiscal note.
CHAIR STEDMAN announced that without objection, SB 161 moves
from the Senate Health and Social Services Standing Committee.
SB 151-HIGH-RISK CHEMICALS FOR CHILD EXPOSURE
2:29:40 PM
CHAIR STEDMAN announced that the final order of business would
be SB 151. He noted it was the second hearing on the bill. The
sponsor introduced the bill and public testimony was taken at
the February 19 meeting.
DAVID SCOTT, Staff, Senator Donny Olson, Alaska State
Legislature, Juneau, Alaska, reviewed SB 151 on behalf of the
sponsor. He explained that the purpose of the bill is to
prohibit products containing chlorinated tris, a flame
retardant. It would also require the Department of Environmental
Conservation to publish a list of chemicals of high concern for
children, to periodically update the list, and to participate in
the Interstate Chemicals Clearinghouse.
2:30:52 PM
SENATOR MEYER asked if other states participate in this program.
MR. SCOTT said they do and he offered to provide a list of the
states.
SENATOR MICCICHE commented that research shows the chemicals are
problematic to the health of young people. He voiced
appreciation for the bill.
SENATOR MICCICHE moved to report SB 151 from committee with
individual recommendations and attached fiscal notes.
CHAIR STEDMAN announced that without objection, SB 151 is
reported from Senate Health and Social Services Standing
Committee.
2:32:42 PM
There being no further business to come before the committee,
Chair Stedman adjourned the Senate Health and Social Services
Standing Committee at 2:32 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| CSSB169 vsn P.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 3 Support Letters.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DCCED fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DHSS fiscal note #2.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DHSS fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 DOA fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Fund Transfers fiscal note.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Dr. Brown support letter.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Support Atwood.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Support Brand.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Support Letters.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 Support Singleton.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 vsn O.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 AKVax ScheduleKids.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Sectional Analysis.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Sponsor Statement Immunization Program.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Support Anch Pediatric.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Support Jacob.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Support Woodard.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 Vaccines In AK short vsn.pptx |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 VaxBenefit CostRatio.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 VaxFundsNonFedMap Adults_AIM.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 VaxFundsNonFedMapKids_AIM.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 VaxSupply MapKids_AIM.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169 WhoPaysFor VaccineInAK.pdf |
HHSS 4/8/2014 3:00:00 PM SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169FAQ1pg_16Feb2014.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB169FlowChart10_Feb2014.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 162 - Blower support.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 - Dobson support letter.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 - Epidemiology bulletin.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 - FDA announcement.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 - Lentfer support.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 - Sponsor Statement.docx |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 AAO letter.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 AK Optometric Assoc support letter.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 ASAM letter.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| SB 162 DCCED fiscal note.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 162 |
| AK SB 169_BIO Letter_2 21 14 Final.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| SB 169 AaNA and Dr. Lou testimony.pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |
| CSSB 169(HSS).pdf |
SHSS 2/21/2014 1:30:00 PM |
SB 169 |